Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00418
-l. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/03
PARCEL: 2S 11X8 -13300
SITE ADDRESS: 14896 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 3 ZONING: R -7
BLOCK: LOT: 142 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:
Remarks: Install exterior A/C unit. Do not install within the required setbacks
Owner: FEES
EKBERG, TIMOTHY L + LILLY M Description Date Amount
14896 SW KENTON DR
TIGARD, OR 97224 [MECH] Permit Fee 7/23/03 $72.50
[TAX] 8% StateTax 7/23/03 $5.80
Phone: 503 - 684 - 5092 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 640 - 3607 Final Inspection
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Issued By: Permittee Signature: ,A4 /
Call ( 03) 639 -4175 by 7:00 P.M. for inspections needed the next business day
f.. C•
n Mechanical Permit Application
,. , , k, City of Tigard ECE Date received: Permit no
City ofTrg 2rd
Address: 13125 SW Hatt. Blvd, Tigard, OR 9722 �� °) �� a pp l —n Expire date:
,Phone: (503) 639 -417I J U L 2 Date issued: By: Receipt no.:
Fax: (503) 59$ -1960 2 20 3 Case file no.:
Payment type:
Land use approval: _ CITY OF TI 4 : s Building permit no.:
•
o I TYP OF PE .
1 1ll11 g'l &'< family dwelling or accessory Cl Commercial/industrial
Cl New :onstruction 0 Multi- family 0 Tenant improvement
all L7 Addition/alteration/replacPment 0 Ocher.
JOB SITE INFOR IATION COMMERCIAL VALUATION SCHEDULE
. .lob addrr ss: , 9 c.t,tt p t.■ bosh_
Bids no D v- , Indicate equipment quantities in boxes below. Indicate the dollar
Suite no.: value of all mechanical materials, equipment labor, overhead,
Tax map/ !ax lot/account no.: profit. Value $ -
Lot Block: 1 Subdivision: _ *See checklist for Important application information and
Project rz ' roc: jurisdiction's fee schedule for residential permit fee.
City /county: ' (J - i{ --` F . i: . ' -ad ., I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Des.iiptit.n and Loco locidion of work on premises: AND COMMERICAIJINDUSTRIAi. FQUIPINIE,NTSCHEDITI.
Est_ date t f comple n: Fee(ea.) To
Tenant improvement or change of use: - f VA ;phon Qty. R�•O�y Res. only
Is :zisting space heated or conditioned? Q Yes Cl No Air handling unit CFM
Cl Na Air conditioning e (site plan required)
Is :: xisting space insulated? Q Yes
Alteration of existing 13 VAC system
MECHANICAL CON RACTOR Boiler cnmpressorx
Bttsi Hess r e r n e : p G , :1 ' Q (, f 4 Fit State boiler permit no.:
AdcLess: p S_ HP To
BTU/H
(�,� r2 Gt ' Fire /smoke dam set:c/duct smoke detectors
Ci ty : J -, . " . State :b,Z ZIP: / 24. eat pum . site pian
Phone (p b - (00 • Fax: , ,; - `} E-mail: natal replace mac r �urner 1ITU /[�
CCB no.: 6 Including ductworktvent liner 0 Yes O No
City/ 00. lie. no.: . - install/replacehelocate beaten - suspe
Nam +, (P �' f (P _ wall, or floor mounted
IMO le; ism print): Q n GC sr2 ... 0/ S ea.--, Vent for appliance other than furnace
CONTACT PER ON Refrigeration:
Nana:: Absorption units alU /H
Addr:ss: — - ,�� Chillers H
Comyressors _ HP
City: Statct: I ZIP: Environmental exhaust and veatllation
Rum:: Fax: ppliance vent
E-mail: RI E - mom Dryercxhaust
OWNER. nods, e / res. kitchen/ azmat
Nari1C • rt./‘ ! hood fire suppression system
i /i b.4 y�5 Exhaust fan with single duct (bath fans)
Mani ig address:
Exhausts stem a. art from heating or AC
City: State: ; pip eg an , n a On up to 4 out ets
Phone 1- SD e/ Fax: H- m ad o: I F NO Oil
Fuelpiping cacti additional over 4 outlets
P'o'i piping (schematic required)
Name : Number of outlets
Address: i er appliance or equipment:
City: ` — Deoorativefireplace
State: ZIP: Insert -type ,
Phone:
Aetna. .r,nfi -�, L,,c � ,E-mail: : t oedamveipclletstuvr. _... --
Applicant's signature: C, L._�_.c). c -L---) Date: -)- ^2.....1r ,,,? other ..
Name (print ■: n ► - e cti O rce.. r -
Na 211 jui isdletioz s accept credit cards, lease call 'ur'isdictioa for more i
° reti , Permit fee $
Notice: This permit application
expires if a minimum fee
p permit is not obtained $ ) ' S�
ex
within 180
days after it has been Plan review (at 4t,) $
accepted as complete. State surcharge (13%) .., $
TOTAL $ ' ;_ a
• 44O'$47 tomotcoM)
ZutleaH RzietoadS eZ�t8D ED ZZ i�C
f ti
SITE PLAN
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PL
STREET
Specialty Heating & Cooling, Inc
9528 SW Tigard Street .s
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hil1sbor_o Phot..e-5 -03- 640.3 607 Fax-50-3-;68-1.0-7-93
2'01 8TLO 86S EOS 244z�eaH R IetoadS e217:8O EC] zz Inc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received q / Date Reque ted /q AM PM v BUP
Location / � g / 0 Suite MEC G
Contact Person Ph ( ) PLM •
Contractor Ph ( //ll ) 7 � 7 SWR
BUILDING Tenant/Owner (7-- 1,�i i- 15h' °� ► gfi a ! 1 LC
Footing ELC 3 -00V37,3
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. � , �1 t 1 -� n -
•
Firewall � ``1 >V d I J �`� �V` L ( N p To + ..
Fire Sprinkler )
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL F.'"‘
PLUMBING ` ti
Post & Beam
Under Slab g
Rough -In ,�
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole .
Storm Drain
Shower Pan •
Other:
Final
T FAIL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
•
:T FAIL
LECTRICAL
-
Rough -In
UG /Slab
Low Voltage
Fire arm
rtri 111
AIM PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE LI Please call f reinsnection RE: I I Unable to inspect — no access
Fire Supply Line ' - - -
ADA �5 "
Approach/Sidewalk Dat v inspect �� — AL Ext
Other:
Final DO NOT REMOVE this inspection record fr ' m the ob site.
PASS PART FAIL