Permit t � .
"' CITY OF TIGARD MECHANICAL PERMIT
ah I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00041
�� SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/4/03
PARCEL: 2S103DB -10300
SITE ADDRESS: 13220 SW GENESIS LP
1 SUBDIVISION: GENESIS NO. 3 ZONING: R -4.5
BLOCK: LOT: 072 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
• > 10000 cfm:
Remarks: Gu-o , . „,„_, -._, 46 --Q-Q_
Owner: � � j . co�'� (”" ,1 - - d . FEES
CUTONILLI, STEPHEN + DIANA Description Date Amount
13220 SW GENESIS LOOP
TIGARD, OR 97223 [MECH] Permit Fee 2/4/03 $72.50
[TAX] 8% StateTax 2/4/03 $5.80
Phone: Total $78.30 _
Contractor:
OREGON HEATING +A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 538
Heating Unt Insp
Reg #: LIC 125815 Cooling Unt Insp
Il l
Final Inspection
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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
---.'--"-----> Iss ed By: � ∎ed. � , /ai, _ L P ermittee Signature: , AM------ .'---.'--"----->
-Call (503) 6 9 -4175 by 7:00 P.M. for inspections needed the next business day
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Feb 04 03 07:57a Oregon Heating and Air 503 - 537 -2172 p.2
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MechanicalPermxtAppl cation OFFICE sE, ONLY
City ri �gar� Date received:, 4/ 0 Permit tto.:}f i ,, 00,
"'- ��. Project /appl. no.: I date:
Coy of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By Receipt no.:
Fax: (503) 598 - 1960 Case file no.: - Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
O t & 2 family dwelling or accessory O Commercial /industrial U Multi- family • ❑ Tenant improvement
U New construct ion .:■ Addition/alteration/replacement U Other:
.1OB SUE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: l ''2i20 l� (c 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: 6,, C - - jurisdiction's fee schedule for residential permit fee.
City /county: a--irk) I ZIP: CC -77_1, I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and ( cat{io 1 C n of work on premises: C 0 ,A f 0/ i AND CO V1MERIC;U. /1ND1.ISTRIAL EQUIPMENT SCHEDULE
I V \S' 36.( _ 1 t t O C' Ai ( l tu. Fee (ea_) Total
Est. date of completion /inspection: Description Qty. Res. only Rex only
Tenant improvement or change of use: 1
Air handling unit CFM
Is existing space heated or conditioned? U Yes O No Air conditioning (site plan required) 4
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4
s existing space insulated? O Yes O No Alteration of existing 1-IVAC system
MECHANICAL CONTRACTOR _ Boiler /compressors
1 Business name: State boiler permit 110.:
OREGON HEATING HP Tons BTUffl •
Address: & AIR CONDITIO.fltipl INC,. Fire /smoke dampers/duct smoke detectors
City: P.O- Box 397, Dundee (*WIT 1 g J ZIP: t ump (site plan required)
Phone: (503Y 8 -2953 E -mail: sta replace furnace/burner BTU / ,. j
7 S Including ductwork/vent liner O Yes U No / J /, DO /4• (0
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CCB no.: - ' (itsfa replacz re ocate hiaters - suspended,
City/metro he. no.: "k. '>, 2n wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONIACI PERSON Refrigeration:
Absorption units BTU /H
Name: 4 Chillers HP '
Address: Compressors HP
Environmental exhaust and ventilation: '
City: State: I ZIP: Appliance vent l( (
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type I/ II /res. kitchen/hazmat
hood Ere suppression system _
Na m e : ��/ G16 ' '' Exhaust Fan with single duct (bath fans)
Mailing add Tess: ( '2. ,-2:4 5.,) ��re i LS. • - Exhaust system apart from heating or AC __
Fuel l p t; io and distribut5ion p t 4 outlets
City: ' , � Stat J 'LIP: / Type: LPG / NG Oil / 54 S 10
Phone: , E -mail: Fuel .i.ing each additional over 4 outlets ,
ENGINEER . Process piping (schematic required)
Name: Number of outlets
�Ittr appliance or equipment:
Address: Decorative fireplace
City: State: I ZIP: Insert - type ___
Phone: _max: - I ' • Woodstove/pellet stove
r- Other:
AppIicant's signa itr
ir /� „...0 MI Other!
Name (print): v, ^ /se e t- 4 ,7 . r
r • Perm F ee .... ... .. ............ `I _
Not all jurisdictions accept credit earth, please call jurisdiction for more uttixmation. _ _ -__.
Notice: This permit application
0 visa 0 MasterCard lV[immum fe u . . ,_ s_ -__ •
ex if a pennit is not obtained
Ccdit card number: / / Plan review (at %) $ Cxpires within 180 days after it has been State surcharge (8 %)
- -- $ �__.
Na(Tlt al l'JfltIiICr ;41' :thuWn on credit carat � - �- accepte as complete. p - - -
t_ar111u>IIT�r ,, +1 ;n :unm Amount iM>- al (6!U) /CO4t)
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007 -(1AZ1
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CITY OF TIGARD 24 -Hour
BUILDING Inspection tine: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/D/ �� BUP
Received Date Requested % AM PM BUP
Location ) 3 t)5C 6 eYl Suite MEC eV 3— O e7q
Contact Person 4- Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
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Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling C
Roof
Other:
Final
P ASS PART FAIL
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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
Smo e Dampers
PART FAIL
C - . •
Service
Rough -In
UG/Slab
Low Voltage
're Alarm
I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA- PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
- d
Approach/Sidewalk Date / /i1 / � Inspect o�� � Ext
Other:
Final DO NOT REMOVE this inspection record from the Jo , site.
PASS PART FAIL
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