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Permit - CITY OF TIGARD MECHANICAL PERMIT .4 ,I' DEVELOPMENT SERVICES PERMIT #: MEC2003 -00095 '� ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/11/03 PARCEL: 2S 103CB -00700 SITE ADDRESS: 12235 SW JAMES ST SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: 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: OIL 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: Install oil furnace with 1 outlet. Owner: FEES TIBBETS, KATHLEEN M + Description Date Amount GEORGE L [MECH] Permit Fee 3/11/03 $72.50 12235 TIGARD, OR 97223 SW JAMES ST [TAX] 8% StateTax 3/11/03 $5.80 GA Total $78.30 Phone: Contractor: SUNSET FUEL CO PO BOX 42287 2944 SE POWELL BLVD REQUIRED INSPECTIONS PORTLAND, OR 97242 Phone: 503 Gas Line Insp Heating Unt Insp Reg #: LIC 2374 Duct Inspection 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: / C �a r/ �1G1 \/ / 1 , i Permittee Signature: ! 40. A,„' 1 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Ili ' - • — • , Mechanical'Pearmit Application Date r nt eived -// - O per mit no.: . • • m'c ��003�� 9 �I� City of Tigard ��!��� . • 3. 03 � � � Projeet/appl. no.: Expire date: • A ddress: 13125 SW Hall Blvd, Tigard, OR 97223 p City of7igard Irate issued: Phone: (503) 639 -4171 MAR 0 5 2003 R eeeiptn o.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: CITY OF TIGARD Building permit no.: TYPE OF 1'1 R.3111 X l & 2 family dwelling or accessory ID Commercial/industrial 0 Multi - family ❑ Tenant improvement 0 New construction • Addition/alteration/replacement © Other: JOB SITE 1NFORMA71ON COMMERCIAL 1'ALIJA1'ION SC'IIEDIII,E Job address: , > a • ■ 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: E IA r , • ' J jurisdiction's' fee schedule for residential permit fee. City /county: • a ZIP: I .\ 2 FA'111t. ' MI FILLING PER AlII' FIH1. st'IIEDLII: Des ription and 1. . tion of work on premises:.,,j�(1~,Q1 i �1 T Ai I 1� ('UMNIFRU'AL /,NDE'S'l1n AL. I Qt t 1' �VrtGtC.t_ Fee(ea.) Total ` Est. date of completion/inspection: - Descrij,Hon Qty. Res.only�Res only Tenant improvement or change of use: C: Is existing space heated or conditioned? U Yes ❑ No Air handling unit CFM Is existing space insulated? CI Yes CI No itconditiontng site plan required) Alteration of existing HVAC system Boiler compressors —' _Address: Business name: StkhS� I State boiler permit no.: HP Tons BTU /1•t ti LI S O we I I iv . FireJsmoke dampers/duct smoke detectors W City: Po r State:p , ZIP: 9 z, Z eat pump site p ante uired) , r Phase; 2-3 bee (1 Fax 4 • - Ig E-ma natal rep ace urnac •umer iD� 1/H — ' _ CCB no.: a3 LJ - Including ductwork/vent liner I es d No - 0 nstall/re a c re ocatebeaters - suspended, City /metro lic. no.: 21462 wall, or floor mounted • Name (please print): - Vent fora fiance other than furnace - - e era on: Absorption units BTU/11 Name: Chillers HP _ Address: Comp ressors City: State: -171P: Appliance last and von a IIII Appliance vent Phone: Pax: E-mail: Dryer exhaust " Dods, Type es" to c haztmet hood tire suppression system Name: Acm Exhaust fan with single duct (bath fans) Mailing address: Exhaust s stem�apart from heating or AC City: State: ZIP: ' Fuel piping and Wstrdbut on (up t Phone: - (11 _� SD '� 3 ax: E-mail: — l. Tyl LPG . NG Oil i �a Fuel i ing each additional over 4 o - recess pap g (schematic requiree7) "— Name: • N umber of outlets Address: t ap tier 1: • . p ante or equipment: Decorative fireplace City: State: ZIP: Insert - type Phone: Pax: E -mail; Woodsto`ve/pellletstove — te Applicant's signature: �6 W. i Dat b Other: Name (print): t ' Not all jurisdictions ac «pt credit Canis, please call jurisdiction Por more information Permit fee $ r I - ❑ Visa CI MasterCard Notice: This permit applicatio Minimum fee $ , Chit card number: _ expires if a permit is not obtained -- £ within 180 days after it has been Plan review (at %) $ `= s :piR' y State surcharge (8%) .... $ Name of cardhol�as shown on medic card accepted as complete. Cardholder signature S TOTAL $ �: `a r /lmount__, .. • .. 17 (60/COM) Z 0 /T0 30tld 17tf ti17t/tlt7ti :EVEN 0090000 LT:VT E00 /5a /E0 CITY OF TIGARD 24 -Hour BUILDING - Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 3 — ° 6 AM PM BUP Location l a a 3 S "- -P- -it Suite MEC 3 - odd g� Contact Person Ph ( ) of 1 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing 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 AaLltor PART FAIL ELECTRICAL 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 0 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA 3 - - — �3 Inspector Ext Approach /Sidewalk Date p Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL •