Permit ' CITY OF TIGARD MECHANICAL PERMIT
°I 1" DEVELOPMENT SERVICES PERMIT #: MEC2003 - 00016
.,�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/16/03
PARCEL: 2S115BC -13100
SITE ADDRESS: 12240 SW KING RICHARD DR
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Replace gas furnace.
Owner: FEES
FERGUSON, JAMES D Description Date Amount
12240 SW KING RICHARD DR
KING CITY, OR 97224 [MECH] Permit Fee 1/16/03 $72.50
[TAX] 8% StateTax 1/16/03 $5.80
Phone: 503- 231 -1405 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 624 - 2704
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
952= 001= 01 - 00: You- may - obtain- copies -of- these -r- ules -or- direct questions -to -O UN C-by- calling-
(503)246- 6699.7
Issued By: 2 ?� `/ �.. ` Permittee Signature: J '")
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busine s day
01 ;, '09:27 5036393771 CITY OF KING CITY PAGE 02/02
0, '"'' PAGE 01/02
10/22/2001 16146 5036393771
CITY OF KING CITY
I Kr- COUNTY
u 'SCE >[ ONLY CENTER M echanical Permit Application
��� � King City ECE I v E Date received: /-14a• 6 Penn il no,' � • ,Q�v�
;- City of
13125 SW Hail Blvd. Projecvappl. no,: Expire date
Clackamas Tigard, OR 97223 JAN 15 003 Date issurd: ... By; 0 Receipt na.:
Multnomah (503) 639 -4171, FAX: (503) 684-729T Casa file no,: Payment t
Washington CITY OF TIGARD - •. y�
T Land use approval: SUILDINSiDIVISION Building permit no.:
TYPE OF PERMIT
1 & 2 family dwelling or accessory Cl Commercialli idusn;.al . 0 Multi- family O Tenant improvement
a •New Construction • ddition/sIteratiort/replacemant 0 Other; _
JOB SITE INFORMATION COMINut RCIAL VALUATION SCHEDULE
Job address: .,-. A : m/c.10 ,, , Indicate equipment quantities in boxea below, Indicate the dollar
Bldg. n o,: _ Suite no.. valve of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value S ,,.__ •
--_____,
Lot: 13 lock: Subdivision: *See checklist for imparrant application information and
Project name: Jurfsdicrlon's fee schedule,i'ior residential permit fee.
City /county; / <Ly cl � ZIP: Ira 1 & 2 FAMILY DWE i IING PERMIT FIE SCHEDULE
Description and location of work o premises; AND COMMERICAL/IN I � ' STRIAL EQUIPMENT SCHEDULE
. _.,_, Fee (94,) Total l
Esc_ data of core letien/inspectfott: Neat .don Q. Res.oalyRes. orzlyi
I'ennnc improvement or change of use: ETNA r
Is existing space heated or conditioned? O Yes 0 No Air handling unit CFM
Is existing space insulated? 0 Yes 0 No Air conditionitiR (site plan+trtc9 i ed)" i -
Alteration of existin 1-IVAC. tlystcni
MECHANICAL. CONTRACTOR • Railer compressors
3 usuiess name: 4 i'g ' lift / State boiler patrol[ no.:
HP Tons 8TI!/H
�ddrass: - ,.
4 • A 30 7 F r smoke dam raiduct srnoice detectors
: / ..0 .. State: r ZIP: - Z Z IC- eat •ump (site . an require si.' -----1
'hone: , e . Fax: !D6 &[gall: bum /replace futnutee/burrterA;; t
NCH no.: -76_2
[ncluding ductwork/vent liner ❑ Yes 0 No
:ic /metro tic. no,: . Install/replace/relocate h ewers - suspended, —
—
wall, or floor mounted
fame (.lease punt): ,,,y • 4 - .rtpoot exit for app liance o uter chsn i1aaxtoce '-1
CONTACT PERSON Refrigeration: •
Absorption units eT1J/H I
time: /. .49 .... Chiller) • _ UP • -- I
ddress: - Corap ressors _ HP
Environmental exhaust upTi
ity: .-- � i State; 7 ZIP: Appliance vent .._1
to , ,, ,2_70 5 0 71 Email: Dryer exhaust 1 I
OWNER • Hoods, . ype 1/ res, kitc • ''timtat J I
tole: hood fire suppression system ).
t� . C ."--yr Exhaust fan with single duct (bath fans) ( .
Ailing address: ,,.... a t fie Exhaust system apart from tieatine or A
ty: State: ,/ • — Nei piping and distribution ( up to 4 outlets)
3 F Tyjc: LPG _ Nt„ Oil
one' E "mail: A ' Fuel •i•iin ch addiuonal over a outlets
ENGINEER Process piping (se ematic required) I
me: _ Number of outlets
t er liste app yin ie ur equdlprnv
et:
dress: I T - 1
- Deco Oe rnttve tir epta
y: • State: ZIP: men - tY Pe _NM
[rte; Fax: 8�rtta1l ' oodsJove /pe of stoxe� �___ -- i - --
9licant's signature: thcr
_
Date: / , ' Otherr
ne (print): , f ji, . - _ i J
.!;41.1.4icoots accept crexiit card, please call juri,dietion for Moen Information. Permit fee S - 7d ° 3 v /, —
,a ❑ hi gffen :4 td Notice: This permit application Minimum fee , '5
,qrd ,„ expires (J'a permit is not obtained
— v I / within / ?t d, v,e dicer Ii tinc h...w plan rc.vie w (at 7 °) r_ P /1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested ) — 1 AM PM BUP
Location / Z Z d ff t r .4 i d Suite MEC 2)
Contact Person <' Ph ( ) Lt �21" PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation
Ftg Drain ,®►LC SSA _.._ - - _ - ELR
Crawl Drain - � :� •
Slab Inspection - Notes: SIT
Post & Beam - _ ` ,
Shear Anchors d (�
Ext Sheath/Shear ` - 1 0 ! i rb
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 l ampers
i0
AS PART FAIL
CTRICAL
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 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line —
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL