Permit < OF TIGARD MECHANICAL PERMIT
4 ' 4 I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00073
e- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/21/03
PARCEL: 2S102CA -00228
SITE ADDRESS: 13118 SW ASH DR
SUBDIVISION: VIEWCREST TERRACE ZONING: R -4.5
BLOCK: 02 LOT: 017 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: I
Owner: FEES
WALTER, BURT L + ANDREA D Description Date Amount
13118 SW ASH DR
TIGARD, OR 97223 [MECH] Permit Fee 2/21/03 $72.50
[TAX] 8% StateTax 2/21/03 $5.80
Phone: Total $78.30
Contractor:
T + K MECHANICAL
11525 SW CANYON ROAD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone: 503 626 - 4652 Gas Line Insp
Mechanical Insp
Reg #: LIC 121165 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: / 1G , �� _ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
FROM •:. FIREPLACE PHONE N0. : 15035269138 Feb. 18 2003 12 :37PM P1
Mechanical Permit Application � Permit no.: I ) tJJI�
� + ' , � E Date received :�, ..4 -tom
A
,,A4-..1 City of e ( 1'toJ� pP o
f �1l � Ua l.no,: Expire date:
City Address: 13125 SW Hall Blvd, igard, OR 97 23 ,2 Dam issued: By: Yj 1 Receipt
City of 8 Phone: (503) 639 -4171 V 1
Case file no.. Payment 'type:
Fax: (503) 598 -1960 0-0 OF T1 v 1A S, Building permit no.:
Land use approval: L�\t�
TYPE OE PERMIT "
❑ C ommercial/industrial 0 Multi - family 0 Tenant improvement
I & 2 family dwelling or accessory
0 New constriction Addition /alteration/replacement 0 Other: —
3 O S1TI INFORMATION ('o11i•IEHCIAI. VALUATION SCHEDULE.l
Job address: /4.54
>, Indicate equipment quantities in boxes below. Indicate the dollar
Suite no.: value of all mechanical materials, equipment, labor, overhead,
Bldg. no.: profit. Value $ —
Tax map/tax lot/account no.: _
'Block: I Subdivision: `See checklist for important application information and
project name: jurisdiction's fee schedule for residential permit fee.
Pro
i � 1 & 2I�A1ll D% ELLING PE LE S(-
City/county: / ZIP: I i/
Description and location of work on prem es: AND ('OM1�IERlCALl1NDESTR1Al. EQUIPMEN'1'S('111.1)1.11
if eS // A , , 411r if.S I ' . Fee(ea.) Total
V t. date of completio Inspection: Description t Res.' Res.only
'' Ct
Tenant improvement or change of use: Air handling unit CI�M
Is existing space heated or conditioned? 0 Yes 0 No Air conditioning (siteplanrequired)
Is existing space insulated? 0 Yes 0 No - Alteration of existing HVAC system
MEC!1 CONTRAC'i'()R Boller /compressors
��.���YO� State boiler permit no.:
Business name: d �j�( ' +P • u_, HP Tons BTU/II
Address' _ t_�, a Fir smoke damper: r uct smoke detectors
EN; 14 . -g _, ) HMI VP: - eat putt ■ (site p an rain red)
Phone: , �' - ..1.' s Fax: E-mail: Instal rep ace urnace/burncr _ -f /H MEI
Including ductwork/vent liner 0 Yes Cl No
CCB no.: 49 /i j Install/ replace /relocate beaters suspended,
City/metro lie. no.: L{g,(.,. wall, or floor mounted
Name (please print): a.. Vent for a • p lance other than furnace IIII
CONTACT PERSON Re ;eratson:
Absorption units BTUIH
Chillers HP
C 'P/212M1/411.%1F '
Address: // ,5 a Co • ors HP
f [�i I 1 . YROlim411tII1 OSt ' ieII on:
e j {i ' + P ! 41 h Applianeevent -
Phone: ,e,, , , ,_ ,, E-mail: iryerexhaust
OWNER Hoods, Type 1 ryas. tc c azmat
' hood fire suppression system
Name. , . � n 4 d ! 04/ Exhaust fan with single duct (bath fans) -
Mailing address: //, „'[,,) - P' i , Exhausts stem a • art from heatin : or AC •
e pip •1 • $t• •o up to . ou eta
City: s L ZIP: �'fja LPG / , NG Oil / WA
Phone: �� .w, Fax: arit Fuel • l • mg eac • a Atonal over • outlets NMI
ENGINEER ER ' ' p _ se cmaticrequired)
Name: • Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: , state: ZIP: Arrr. r � !s.�1M WiireA Friffa
Phone: F>tI'Z� "+ • • tov pe etstove MEM
Other:
Applicant's si IY1►4 % :___ � PW423 •
Name (print): ' e rnn ' , ei'vl.
Not all Judndtctipns incept credit earth, please tall juriadittion for more information. Permit fee $ n �
Cl Visa CI MasterCard Notice; This permit application Minimum fee $ , % . OD
e xpires if a permit is not obtained
Credit cars number: / / Plan review (at %) $
Expires within 180 days after it has been State surcharge 8% CJ
Name or catdeoldcr as shown on credit card accepted as complete- ) $
$ TOTAL $
Cardholder signature Amount 440 - 4617 (MSIS OM
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Re uested ° .26 /"" AM PM BUP
Location / 3 / i r � -Qi� !� Suite 402) 3-ODD 7_3
Contact Person Ph ( ) PLM
Contractor Ph ( ) . 33 7 s (/(0/4- SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: \Ei r -�- SIT
Post & Beam�X . k Cl
Shear
Ext O Ext Sheaeath/h /Shear Int Sheath/Shear ; Ir4 Q
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final n
PASS PART FAIL
PLUMBING /I /l
Post & Beam /
Under Slab
Rough -In /� f
Water Service /
Sanitary Sewer r
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
�t'H tICA
Post & Beam
Row h -In
as
Smoke Dampers
PAS PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA `
Approach /Sidewalk Date ° ° : I nspec t or �' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL