Permit �' IJ
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 - 00012
`'` `� • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/13/04
PARCEL: 2S110AD -01600
SITE ADDRESS: 10550 SW CANTERBURY LN
SUBDIVISION: LANG HILL ZONING: R -
BLOCK: LOT: 013 JURISDICTION: TIG
CLASS OF WORK: OTR 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Gas furnace conversion and gas piping.
Owner: FEES
MCMONAGLE, PAMELA D Description Date Amount
10550 SW CANTERBURY LN
TIGARD, OR 97224 [MECH] Permit Fee 1/13/04 $72.50
[TAX] 8% State SurcharE 1/13/04 $5.80
Phone: Total $78.30
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503-579-2250 Gas Line Insp
Heating Unt Insp
Reg #: LIC 108535 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 -I I' You may obtain copies of these rules or direct questions to OUNC by calling
(503 •6 -6699. -
Issu • By: + : v Permittee Signature: _AA)
Call (50 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Perna 'li- i 11
Date received: Sal . __„ -atom
.r�J:, `.fi, City of Tigard JAN 13 2004 Pmjcct/appl. no_: Ex date:
C.iry ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 9722, r1
Phone: (503) 639-4171 CM OF I I Receipt no.:
Fax: (503) 598.1960 TA R snroG Care file no.: Payment type,
Land use approval: Building permit no.:
TI1'li OF PER MI II .
p l.& 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family U Tenant improvement
U New construction 0 Addition/alteration/replacement ❑ Other:
JOB SI IT: INFORMATION ('OMMI�; (('IAI. VAI,1 A'ElON SCHEDULE
Job address: �l, / , ro ;. :m1 I ndicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no_: ' value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot /account no_: profit. Value $ .
Lot: IBlock: ( Subdivision: *Sec checklist for important application information and
Project name: • jurisdiction's fee schedule for residential permit fcc.
City /county: Brig
i sir TIV 1 & 21A1111N If \1'1:I,I.I \(: PERM" ' 111: S( 1
Description and • , .e do of w on premises: AND O\1\II:R I('AI.Ili\l)t'S'I'RIAI I:QI'lPit I S I `(111•.Pt II
61 /9t hi .:7 9 � Fee (en.) Total
F „st_ date of completion /inspection: De®cripton _ Qty. Res. only Res. only
Tenant improvement or change of use: ItVAC:
Air handling unit C:FM
Is existing space heated or conditioned'? O Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? 0 Yes ❑ No • Alteration of ex istin: I-1VAC system
i11'('lIANII - Al (Y) \7 R.• (U)R oiler /compressors
r � i State boiler permit no.:
Business name: i ‘'tf�� / 75�/. /ice � HP Tons BTU /II m .
Address: WAME4111WKI � , . I, f/ i /`X /, Fir smo n am. ers/duct smoke detectors
City: 110,A§ rEt in ( ZIP. Heat pump (site p an required)
Phone �72'� Fax: E-mail:
nsta rep ace furnacelb / /
�� Including ductwork/vent liner U Yes ❑ No
CCB no.: nstall/replace/relocatcheaters- suspended,
City/met lie_ no.: wall, or floor mounted
Name (please print): went for appliance othcr than furnace
' 0\ IAC' P' RSON etirigeaatfon:
Absorption units BTU/II `
Name: Chillers Hl'
Address: Compressors HP
Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: ' E - mail: a ryvrexhaust
() \� N I7t Hoods, Typel/ Mies. kitchen/hazmat
hood fire suppression system
_ Name: li ►4 - 4L. ' 1"t,� • r 4.....— Exhaust fan with single duct (bath fans)
Mailing address: G ry fit/ _ Exhausts stem a art from heatin or AC
City: !State: ZIP: Fuel piping Fuel ut on up to out ets)
Ty LPG NG Oil
Phone: i,. -AND Fax: E -mail: ue •1•1n each ad. in•na over 4outlets
l:NCINl'tIt ' . p • (sc ematicrequired)
Number of outlets
Name: Other listed appliance or equipment;
Address: Decorative fireplace •
City: /1 I State: 1 ZIP: ert - type
Phone: .4 ns
E - mail: Woodstovdpeltet
_ Applicant's si:. , • `7 r /1I Date: /� �r�, t ,
Name (print): r� , 0 ' li��%1 .rsa.� S. ��
i' 5
Not all jurisdithons : •.'.. crcdii cask, please call jurisdiction for Mart i ot'orma t io Permit fee
❑ Visa Q M [Card Notice: This permit application Minimum fee $
expires if a permit is not obtained plan review (at %) $
C"a" can! number: I / withi 180 days after it has been
Expires State surcharge (8%) .... $ —7 5 '.
Nmrc or audhol3er as shown on credit cad accepted as complete. TOTAL $ - A-
$
cardholder signature Amouni 440 -4617 (&0(YCOM)
t7O'd OSZZ - 6LS 9NI - 1000 '? EINI1\YJH AlEIV d5Z =5O t7O - ZI - - '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503)J39 5
INSPECTION DIVISION Business Line: (503) 6 9- 1 MST
BUP
Received �� p Date Requ -sted kW/ 1 /04 AM PM BUP
Location ( OS - Z6 LA-) /fie - _ .�`�_.lt __ _ Suite MEC L - 0 - O Z 12_
Contact Person ,%,,(J Pact- -- Ph ( 1 -
i9) �� PLM
,
Contractor ei- Ph ( ) SWR
BUILDING Tenant/Owner ELC N (AIL
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 1 e, , 6 1
Insulation V w.c�" `/
Drywall Nailing
Fi rewal I
Fire Alam Sprinkler ` -± L/1/\ eve-
Fire Alarm
Susp'd Ceiling .1�
Roof L.' - 3 D \
Ara
Other:
Final
PASS PART FAIL
PLUMBING Can/\ S �� — - -✓'��V
Post & Beam .¢
Under Slab ' L� '�r' \— '
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole 7 / /
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL a }-
Post & Beam 0 0`i (� C /�;� ��
Rough -In . .1� y ,, l�- �-�C7 _
Gas Line r '
Smoke Dam•ers �► `4
mal 1 V
Cis t.
ELECTRI '
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 11 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Date � l `' / Inspector y �/t Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL