Permit :r ITY OF TIGARD
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00555
-II °'111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/10/03
PARCEL: 2S 111 CB -01732
SITE ADDRESS: 10255 SW KABLE ST
SUBDIVISION: HOOD VIEW NO.2 ZONING: R -3.5
BLOCK: LOT: 031 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install gas line to pool heater.
Owner: FEES
LUCAS, MAURICE D AND PAMELA R Description Date Amount
10255 SW KABLE ST
TIGARD, OR 97224 [MECH] Permit Fee 9/10/03 $72.50
[TAX] 8% StateTax 9/10/03 $5.80
Phone: 503 684 - 9366 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
8900 SW BURNHAM #E1110 REQUIRED INSPECTIONS
TIGARD, OR 97223
Phone: 503 Gas Line Insp
Final Inspection
Reg #: LIC 76359
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
Issued By: , _40 jr Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business da
K. ,,
�i�Vlechanical P ;cation
la " Datereceived9 Permit no. F A 3 6 OP
1� "
.F!�+L•__.. City a Ti g and �� Project/appl.no.: Expire date:
City of Tigard Addre's's: 13125 SW Hall . Bl Tigad(i'0 23 Date issued: By: 3 Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
BUILDING DIVISION Building permit no.:
Land use approval:
TYPE OF PERMIT '
❑ l & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement .
0 New construction Addition /alteration/replacement 0 Other:
• . JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: / SS 5 /e- [ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: 'Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FIE SCHEDULE."
Description and location of work on premises: AND COMMERICALIINDUSTRIAL EQUIPINENTSCIIEDULE
9 S ///t/ 7 /J OD / , en/ r —� Fee (ea.) Total
Est. ate of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No
Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: A e�B f ,� ;N4 �, 6 /Alt, G State boiler permit no.:
H A HP Tons BTU /H
Address: p 0 g off( .2 3031,7 Fire/smoke dampers /duct smoke detectors
City: 7-7 6. A ado I State: pq I ZIP: 97/4 f Heat pump (site plan required)
Phone: G 24' ? 7 0 e., I Fax 599 Oz14 E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes O No
CCB no.: 94 3 S 9 Install /replace /relocate heaters- suspended,
City /metro lic. no.: / 7 e wall, or floor mounted
Name (please print): /72, e. A o / p 1s cz-. Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
n Absorption units BTU /H
Name: PAM OA ,/b / /•hIV DOG /�GQly Chillers HP
—
Address: g Comyressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: - 0 Fa x:5 i, , L ,� E -mail: Dryer exhaust
. OWNER _ Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: /)/ A-/ L. ue&e, l Exhaust fan with single duct (bath fans)
Mailing address: /o95$ cA/ /L CJ Exhaust system apart from heating or AC
City: �p I State: 04) ZIP: Fuel piping and distri (up to 4 outlets)
Type: T LPG NG Oil /
Phone: 4 f /- - ..4 Fax: E -mail: Fuel piping each additional over 4 outlets
rocessp ping (schematic required)
Name: • Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: ZIP: Insert - type
Phone: I Fax: I E -mail: Woodstove/pelletstove
A Applicant's signature: Date: 7---/D--0 Other:
PP g ���.r�r � Other:
Name (print): / y7,4 b)i
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
. $ TOTAL $
Cardholder signature Amount
440-4617 (6/00/COM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 9 AM PM BUP
Location /Oa -.SS _ /( -€ � 2 Suite ;20 3 — 0 o S,'S
Contact Person Ph ( ) Coaii — ° 4-1 PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner ELC �VV�
Footing ELC
Foundation Acc:
Ftg Drain een/tit/Nez.. ELR
Crawl Drain
Slab Insp- _ ► otes: SIT
Post & Beam
Shear Anchors 1= 1 `�
Ext Sheath /Shear
Int Sheath /Shear
-
Framing
Insulation i g P► PE � � c ri Ptl. Drywall Nailing �^
Firewall
Fire Sprinkler
Fire Alarm r • ! AEGS4RK — MST 0 .
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Stab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL -
Post & Beam
Ro - n
Gas Sppke Dampers
in
SS PART FAIL
ELECTRICAL
Service
Rough -In •
UG /Slab
Low Voltage
Fire Alarm
Final 1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line r
ADA C./' �l //
Approach /Sidewalk Date 0 �"�/ inspector ` >-�v'' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL