Permit {
CITY TIGARD MECHANICAL PERMIT
F i DEVELOPMENT SERVICES PERMIT #: MEC2003-00670
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/24/03
PARCEL: 2S112CB -14500
SITE ADDRESS: 14967 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 3 ZONING: R -7
BLOCK: LOT: 154 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Gas fireplace insert
Owner: FEES
ROGER WATSON Description Date Amount
14967 SW KENTON DR
TIGARD, OR 97224 [MECH] Permit Fee 11/24/03 $72.50
[TAX] 8% State 11/24/03 $5.80
Phone: 503- 624 -4895 Total $78.30
Contractor: -
THERMAL FLO
14865 SW 74TH AVE. #190
TIGARD, OR 97224 REQUIRED INSPECTIONS
Phone: 503-670-8383 Gas Line Insp
Mechanical Insp
Reg #: LIC 151847
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 01 -00. You-may - obtain_ copies -of- these - rules or- direct _questions_to_OUN -C_b_y_calling
(503)246 - 669 9.
Issued By: ! Permittee Signature: Abj r� r �_. � -
-
Call (50 ) 639 -4175 by 7:00 P.M. for inspections needed the next • u mess day
FRifM .: TkiERMAI FLO I NC FAX NO. : 5036709064 Nov. 24 2003 10 : 40AM P2
•
A Mechanical - .: i - 0 1 Qion
-r Date received :4 Permit no. i / . a ..,,,,v*, O
AN - " City of Tigard c� n `�p 0 3 Projcct/appl. no Expire date:
Address: 13125 SW Hall Blvd, T'n ..1..( (1 4 )7 223
Ciry ofTigard Pta0 Date issued: By: Receipt no.:
Phone: (503) 639 -4I71 O FD \G \�
Fax; (503) 598-1960 G \ �� G 0\ j \S Case file no_: Pa
Land use approval: $V\\ - 0 \N , Building permit no.: ,
TYPE OF PERMIT •
® I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other: _ __-
JOB SITE INFORMATION. COMMERCIAL VALUATION SCHEDULE
_ Job address: 4 ei to 7 S « J — Indicate equipment quantifies in boxes below. Indicate the dollar
Bldg. no.: - _ [Suite no_: value of all mechanical materials, equipment, Iabor, overhead,
Tax map /tax lot/account nu.: profit ValuC $ •
Lot: }Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee - -
City /county: Tt, � ZIP: CC 7 a1c`> 1' I & 2 FAMILY DWELLING PERMIT FIFE SCHEDULE
Description and I Lion of work on premises: GAS f1'L AND COMMLRICAL /1NDUSTRIALEQUIPMENTSCHEDULE
Fe
a(e .) Total
Est. date of completion/inspection.: Description Qty. Res.only Res. only
$VAC:
. Tenant improvement or change of use: Air handling unit _...�_ CFM
Is existing space heated or conditioned? 0 Yes 0 No Air conditioning (siteplaf required)
Is existing space insulated? 0 Yes C1 No Alteration of existing IIVAC system
Boiler /compressors
// State boiler permit no -
B usiness name: \o,r - ., r It�.L HP Tons r
Address: Sin) 7r./ AtJe L9 Fire/smoke dampers/ducts edetectors
City: i d State: * ZIP: el749 - neat pump (site plan required)
Fax E-mail: Install/replacefun
lacelbu WH
ner BT
Phone: s g - ., e - S Fax: 503 ; r ob4 Including ductworkfveat liner 0 Yes 0 No •
CCB no.: / ca / 8e4 7 _ Install (replace /relocateheaters- suspended, -
City /metro lie. no.: 7 3 a 7 wall, or floor mounted •
Name (please print): A. ORibiAD exn1 T' Vent for appliance other than furnace
CONTACT PERSON
�
Absorption units BTU/H
V Name: Chillers ,
1!t c`l - : �r Compressors HP
Address: — 5,,p., - ,ten , — 'Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: , 51Z - - U ` Co Fax: E-mail: Dryer ex auk
OWNER Roods, Type If likes. kitchen/ha - net T
hood fire suppression system
•
Name: hoc ' .z1' ju e.. i . - - - Exhaust fan with single duct (bath fans) _
Mailin ad: ss' (a " 7 SW Exhaust system a. art from heatin : or AC
g ' elpp ': an• • • li 1 • on upto ' outlets
City: , - EM MEM ZIP: 9 7 a� _ Type: LPG .,}<- NG Oil ( 5.4P
Phone: o a.) - ti g 9s- Fax: • E -mail: Fuel . i • in, each additional over 4 outlets .
ENGINEER rocessp ping (schernanc required •
• Number of outlets .
Name: _ - Other listed appliance or equipment:
Address: Decorativefircplace __L_ •
City: f State: I ZIP: Insert -type -
Y _ odstove/pelletstove - -
Phone. I F - - I E-m• Usher.
Applicant's signature: V � 4 Date: - 0 Other: , ^!
I
Name (print): i6Z9.9, t .0 1e_l_tcSL -
c Not all Jurisdictions accept credit cards, please call jurisdiction for more leforma No tice This permit application ivli Permit fee $ 7 .90
0 Visa Q MasterCard expires if a permit is not obtained Plan review (at %) $
Credit- card number; _ - - -- _ _. Eapiri3 - - within -I80 days after -it has -been State (S%d) $ Sr U -
. accepted as complete. TOTAL $ 7Q .
Name of cardholder as shown on credit card $
Cardholder signature Amount , ' 4404617 (5/
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 63= -x1
INSPECTION DIVISION Business Line: (503) 6 9 0 1 MST.
i2r O BuP
Received - i / /Z Date Requested 1 1 / 2 i /so 3 AM PM / BUP
Location / L iq & 7 A- Suite dal 3 -0 0 02 7?)
Contact Person ) -d-W Gt , Ph (—S75 7 (3 e-73 PLM •
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: 4-.± Ftg Drain �� �� 1 ELR
Crawl Drain
Slab Inspection Notes: J , / _ _ __ ____ S T
Post & Beam V°, A : , [ ', 19. __ •' 4t. , c- .a� _
Shear Anchors /
Ext Sheath /Shear
Int Sheath/Shear
(.40-' 2324
Framing •
Insulation
Drywall Nailing
Firewall Lig 44;7 .7
Fire Sprinkler 51,6e-442
Fire Alarm
Susp'd Ceiling
Roof i if
Other: L — — _ -`
-
Final
PASS PART FAIL
PLUMBING ``;r
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
./ •
Catch Basin / Manhole
Storm Drain
Shower Pan 1Other: li j.9.-J .-
Final
P' - FAIL
IS= ' '''-
Post : =earn
Rou, a
C Gas Line•J
eke Dampers
413
I ! PART FAIL .
CTRICAL
ervice
, 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: El Unable to inspect – no access
Fire Supply Line
ADA 1 '-')
Approach /Sidewalk Date `' l �� D Inspector • Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL