Permit C IT y O F TIGARD MECHANICAL PERMIT
A Ai s DE VELOPMENT SERVICES PERMIT #: MEC2003 -00137
" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 3/25/03
PARCEL: 2S 115BA -01100
SITE ADDRESS: 11965 SW KING JAMES PL
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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:
Remarks: Run new gas line in garage.
Owner: FEES
EKLUND, CECIL S /DOLORES T Description Date Amount
11965 SW KING JAMES PL
KING CITY, OR 97224 [MECH] Permit Fee 3/25/03 $72.50
[TAX] 8% StateTax 3/25/03 $5.80
Phone: Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 624 - 2704 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 -0010 through OAR
9 = 0 = 010.0 You _may _obtain_copies_of_ these_ r_ ules_ or _direct_questions_to_O_UNC_by calling
(503)246 - 6699. �o�
Issued By: 6 Permittee Signature: L a_/
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
03/25/ i :23 5036393771 CITY OF KING CITY PAGE 02!02
C
10/220001 10:46 50GE+393771 CITY CF KING CITY PAGE 01/02
I Kl- OUN7� rr
suvta ONTER Mechanical Permit Application o ' . ICI: USE ONLY
' h '` City of king City Datereceivedj s7 Permit no.101:ei ,a " /
}
1312 SW Hall Blvd. Projecvappl. no.; Expire date;
Clackamas Tigard OR 97223 Date issued,; 81; Receipt no.:
Multnomah Phone; ('503 6394171, FAX: (503) 6$4 -7297
Case file no,: Paymean,t type:
µ
o ,, N r " a . Land use approval: • Building permit no -:
TYPE OF PERMIT 111
Ll 1 & 2 family dwelling or accessory 0 CommerciaVitldt 0 Multi - family Cl Tenant improvement
Q New construction - lAddition/alteratior =/.replacement 0 Other: ,, _
j011 SITE INFORMATION • COMNIERCIALI VALUATION SCHEIUI
Job address: ! j cr ‘ , 1 4 - . 4 .. , .4 60 - 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 S -- — _
Lot_ Blt>cic; Subdivision' {See checklist for important application information find j
Project name: �`— jurisdiction's fee schedule for residential permit fee.
City /count h 1 & 2 FAMILY I,1W1• :I H INT; PE :RNIIT FEE SCHEI)i.I1LI
Description and location Qf work an premises: AND COMMERICAL/IND 1 STRUII, EQUIPMENT SCIIL I
L _ -APi ♦ , .I,A. .r. ., . Fee (ea.) Total
E sL date of completion/inspection: 0 DeU1•ti1)L Qty, Res. ocly Ras, only
Tenant Improvement or change of use:
is existing space heated or conditioned? 0 Yes Q No Air handling u n i t CFM
Is existing apace insulated? ated? 0 Yes 0 No
Au conditioning (site plan requ -• M
Altemtion of existing HVAC: system
MECIIANICAI CONTRACTOR. • Boilericompressors
3usinea name: ,� State boiler permit no.:
_ L A/ , / r/1
kddtess: r ( + ■ 0 .3 HP Tons 4 FITU/H
'i ,.•� Fire smoke damper /duct sm0 •eta fors I= ty c '< taij ZIP: Heat .ump (site plan tetlu�d} "
it
"hone: Fax' - ' , t D Email, install /replace furnace/burner ,_,._ - _, BTU/H
;CB no.: 7i 2S w, Gtoludin ductwork/vent liner CI Yes O No
'ity /metro tic. no.: ./. �� - - -- -- natal placelrelooate heaters - suspended, —.7
� wall, or floor mounted
fame (+lease print): [ ..4, 4 e44 Vent for app ,Srtoe o ✓ th ix+aoe .
CONTACT PERSON Refrigeration;
Absorption units _ BT1,1/H
am �A —/ Chlllera tip
ddress: — Com rassors HP ---. —» - tuv ontaett '�
try: __ State: ZIP: ettl exhaust and ventilation;
Zone: A lino Aug Fax:
J > 2 J 2-mai II er ex ast
OWNER Hoods, Typm res, tic +da�nat
/ hood fire suppression system _
"...me; "...me;
e: '. Cc' / �"l� / 410 Exhaust fan with single duct (bath fans'
%
—
ailing address: / 4 "
_ !exhaust system apart from }tr:atip or A
4.
ty: G Stat Z IP: Fuel piping and dish b on (w to 4 outlets)
• one: / ` x%�.. Fax: E - mail: T yp e- �-- LPG NCi Oil f •
Fuel .ring each addi onal oval4 oytlets
ENGINEER Process piping (schematic requ 1
me Number of outlets 1 • dress: T th lie $pp in n tit e' qu pl!rientt .........._:_i
„ . Decorative fireplace
y' State: ZIP: Gtsert type
)ne: Fax: R- rnaii: Woodstove /. - ilet stpve I
7licant's sfg,usturk� __:� Date: •t et- -
rte (prin � / i � � - ,J , Other: ��
ii jurisdictions a cc apt cre+lit earl* plena call lurisdfetion for MGM 1gm a ionro. Permit fee $ / /'1
.a C] MasterCard Notice: This permit application Minimum for. $
ctd s,amb6r' / / expires if a permit is not obtained plan rev, ew (at %) $ ' '
f*xplrae within 180 drys after it has been , y i a CI i •
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION w Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 3 AM PM BUP
Location 11 R S ff-e47 p t-_ Suite MEC 3 6 0/ 3
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ,;# k oa . > /r= 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 op-
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
Rouqh -In
Smoke Dampers
Fi -j
S PART FAIL
''ECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fife ADASupply Line — -- , Approach /Sidewalk Dates Inspector Ext
Other:
Final DO "' OT REMOVE this inspection record from the job site.
PASS PART FAIL