Permit CITY TIGARD MECHANICAL PERMIT
4 7 84 1 11 SERVICES PERMIT #: MEC2003 -00222
E 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/30/03
PARCEL: 2S110BA -07900
SITE ADDRESS: 11541 SW COLE LN
SUBDIVISION: EVERGREEN SPRINGS ZONING: R -4.5
BLOCK: LOT: 004 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: 1 DOMES. INCIN:
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:
Remarks: Installation of a /c, furnace and air cleaner.
Owner: FEES
JAKE FLOWERS Description Date Amount
11541 SW COLE LN
TIGARD, OR 97224 [MECH] Permit Fee 4/30/03 $72.50
[TAX] 8% StateTax 4/30/03 $5.80
Phone: 503 968 - 1323 Total $78.30
Contractor:
OREGON HEATING +A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Phone: Heating Unt Insp
hone: 538 2953
Cooling Unt Insp
Reg #: LIC 125815 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 -00
Issu C ► l NA G ��._� Permittee Signature:
Call (5' 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day'
. _ tw
Mechanical Permit Application OFFICE USE ONLY •
Date received: Permit no.:, yM4455 -Od
t o i City of Tigard Pro ect /a no.: Expire date:
..:..._ j PP • P
C;ryof'Ti;urtl Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: Receipt no.:
Fax: (503) 598 -1960 Case tale no.: Payment type:
Land use approval: Building permit no.:
.1'S'PE OF.`PER%IIT. .
►., 1 & 2 family dwelling or accessory U Commercial/industrial U Multi - family U Tenant improvement
U New construction U Addition /alteration/replacement U Other:
JOB SITE INFORMATION COMMERCIAL VALUA"I SCHEDULE
Job address: //s -f/ s/ co 6 Li.-7 Indicate 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: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential petuiit fee.
City/county:a,,dj ZIP: 9 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE,
— ` AND COMMERICAL /INDUSTRIAL E UIPMENTSCI1EDULE•
Description and local on ofwor t on premis s: r Q
/4 3 `c "" JQG //IQGe , CGN� 9 Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HYAC - •
Is existing space heated or conditioned? U Yes U No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? U Yes U No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: State boiler permit no.:
OREGON HEATING HP Tons BTU/I -I
Address: 84 AIR CONDITIONING INC Fire /smoke dampers/duct smoke detectors '
City: P.O. Box 397, Dundee, O 1, I ZIP: Heat pump (site plan required)
•
Phone: (503gs38 -2953 E- mail: tnstall/replace furnace /burner 51).BTU /H I
Including ductwork/vent liner U Yes U No
CCB no -: _ Install/replace /relocate heaters - suspended,
City/metro lie. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT . PE Refrigeration:
Absorption units BTU /H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Floods, Type U Hires. kitchen/hazmat
• hood fire suppression system
Name: Qk_e_ /alve/S Exhaust fan with single duct (bath fans)
Mailing address: / /54 / �- S� aa& iv L. Exhaust system apart from heating or AC
Fuel piping and distribution(up to 4 outlets)
City: ��� Stater ZIP: 9 7 2 Type: LPG NG Oil
Phone: 1— 23 Fax: E -mail: Fuel iping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment: '
Address: Decorative fireplace
City: State: ZIP: Insert - type
Phone: Fa : / E -mail: `Voodstoveipeltet stove
Applicant's sig�.h re �'�� Other:
��� ' / � Other:
Name (print): A / /J� 0.-C '
AI
-"e' Permit fee `� 7 5b
" Not all jurisdictions accept credit card.;, please call jurisdiction liar more informatio —
D vis CI MasterCard
Notice: This permit application Vtinirnum fee
ex if a permit is not obtained
Credit card number: — — / / Plan review (at %)
E -- within 180 days after it has been —
State surcharge (8%) .... $ 5. 0
Name o f cardholder as shown on crcdwccurl accepted as complete. TOTAL $ - 77 - ...__30
\ � --- - -- Cardholder si5 ^---- - -- - -- ` ' \ crunch 14n - 1617 (6iu7lCC)N11
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CITY OF TIGARD , 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business-Line: (503) 639 -4171 MST
BUP
Received / Date Requested 6 - 4 AM PM BUP
Location
1 ! 'f/ a gn Suite MEC 3 - 4 0 0 a a - � —
Contact Person 07r1 1i12/ Ph ( ) .53 ( "0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIFT
Post & Beam � �
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing EC cG?fL4 ? 4 L jrt4 z un le 1741 g 14- 4-25+7
Insulation
Drywall Nailing (°c 'W '/'` j12
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under. Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
AS PART FAIL
CTRICAL
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: Unable to inspect — no access
Fire Supply Line
ADA /
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL