Permit CITY ' OF TIGARD MECHANICAL PERMIT
,414.',411 I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00297
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/20/2004
PARCEL: 2S 105DD -07100
SITE ADDRESS: 14665 SW KLIPSAN CT
SUBDIVISION: PACIFIC CREST ZONING: R -7
BLOCK: LOT: 047 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 DOMES. INCIN:
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: Add a/c unit.
Owner: FEES
AMY MAUSS Description Date Amount
14665 SW KLIPSAN CT [MECH] Permit Fee 5/20/200/ $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 5/20/200 $5.80
Phone: 503 - 579 - 6963 Total $78.30
Contractor:
OREGON COMFORT HEATING INC
HUGHES, RON
PO BOX 355 REQUIRED INSPECTIONS
EAGLE CREEK, OR 97022 Cooling Unt lnsp
Phone: 655 - 0221 Final Inspection
Reg #: � 2933 fax 00042519
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24. - .•
Issue. By: !! , /../i Permittee Signature: ,
Call ( 03) 639 -4175 by 7:00 P.M. for inspections needed the next business day
05/18,72004 11:16 5036502933 OCH PAGE 01
Ail
Mechanic pplicaiion
Datereceived: 5//'/o(/ IF it no.: 11E4 spa -, op e19 7
;;i"4: C >i o igard 4
. g ,J 1 ipP Project /appLno.: - Ex ire date:
City of Tigard Address: 13125 SW,f�Hall Blvd, Tig O 97223
y f T S and Phone: (503) 639 - 41.71 i kaP, Date issued: By Receipt no,:
Fax: (503) 598 -19jft DN� \V \ 9 \O Case file no.: Payment type:
Land use appreeVa Budding permit no.:
TYPE OF PERMIT '
U I & 2 family dwelling or accessory lil Commercial /industrial U Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition /alteration/replacement ❑ Other:
!Oil SITE INFORMATION COMMER('IAL VALUATION SCiIEDULE
lob address: \) , • Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Sun - no.: value of ail mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit- Value $ .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: r 11 - O jurisdiction's fee schedule for residential permit fee.
City /county: r(",' ZIP: 'Z 1 & 2 FAMILY 1)4VFLi.iNC PERMIT FEE SCIILDU.LE
Description an' .cation of work on premises: AND COMMI.'.RICAL /INDUSTRIA! I<:QUiPMENTSCUF.i)ULE
Pa Pelc . Fee(ca.) Total
Est, date of completion/inspection: Deserilptdon Qty. lies -only Res. only
Tenant improvement or change of use: VAC:
Air handlin unit CFM
Is existing space heated or conditioned? 13't'es ❑ No Air conditionin: (site plan require. , . Lb
Is existing space insulated? 9:"Yes ❑ No Alteration of existing 1-IVAC system
ML('1IANICAL CONTRACTOR Boiler compressors
Business name: • State boiler permit no.:
�� t ... .� _. Hp Tons BT1.1/F1
Address: a �,. MEMO= , a Fire/smo a •am•ers /duct solo edetectors
State: Ot, at pum • (site p an required)
Phone: ,. E Install rep ace furnace/burner BTU /H
Including ductwork/vent liner ❑ Ycs ❑ No
CCB no.: jae Install /rep ac relocate heaters suspended,
City /metro lic: no.: wail, or floor mounted
Name (please print) . / , _ . Vent, or a. 'bane an furnace
CONTAC: � I' �l'.FASON R gerarom • - ..
Abs Absorption units _. BTU/I.1
Chillers_ HP
Com • ressots HP
Address: nv ronmenta exhaust and vents at On:
City: State: ZIP: Appliance vent
Phone: Fax: E-mail: Dryerex suit
OWNER hoods, Type 1/ Wren. kitchen/hazmat
hood fire suppression system
• �� Exhaust fan with single duct (bath fans)
.01 • Mailing address: K Bx Must system a • art from heatin ' or '
ZIP' ye p ng . st ''r" on to 4 out
City: 4 lope: : LPG NO Oil
•
Phone: - - Fax: E -mail: Fuel, . i •ing each additional.over4outlets
iNGiNEER I'rocessp pug (schematic required)
Number of outlets
Name: - Other listed appliance or equipment:
Address: Dccorntivefirepiacc
City: State: ZIP: insert -type _ .
Phone: I Fax: 1 F„- alai!: Woodstove /pellctstove
Other. .
Applican signature: Date: 5 - . Other:
Name (print): s r s .
Not nil jurisdictions accept c Lt cards, pie= call 'unsdlctlon for more information. Permit fee $ c•d•4
Notice: This permit application Mi fe $ _7�,
-aVsa g6,A, : � ' 5 . .. —
r� , '' y1 -- expires -if a.pertn i s -not o
Plan review
at °k} $
Credit yard Hunt. ^ / l within 180 clays a fter it h be
— .e. , � expires �' State surcharge (8%) .... $ 5- gb
nme o c: • r ns'rhown on ctcdil card accepted as complete. TOTAL $
�. .. .it, signature Amount 440.4617 (6r00 /COM)
05/18/2004 11:16 5036502933 OCH PAGE 02
•
' CITY OF TIGARD ( 24-Hour
BUILDING Inspection Line (503) 639 -4175
INSPECTION DIVISION ._ Business Lin 3=
(50639 -4x171 MST
BUP
Received Date Reque t-d . '// AM PM BUP
Location - - % 5 - - A �_��� ` - -� Suite
aoo 4--/-60 a ?
Contact Person A. '' h ( ) b ' s 0 a ( PLM
Contractor / Ph ( ) SWR
BUILDING ` Tenant/Owner pYritir _a3 L/ 3d , k
Footing ELC
Foundation Access: ' 4-/vb ?., l/ e, , 6 '.
Ftg Drain ELR
Crawl Drain - �_ - ,.
Slab Inspection Notes: SIT
Post & Beam - - - - --
Shear Anchors ---r. = _ -- i ^
Ext Sheath/Shear i � - e' --- %- i
Int Sheath/Shear W'
Framing
Insulation A' k--- - A I Drywall Nailing T"'l /� 6
Firewall 171
Fire Sprinkler 0 A r_,/ ` <
K P
Fire Alarm
Susp'd Ceiling
Roof -
Other:
Final
PASS PART FAIL
,..,- ' C
Post & Beam
Under Slab t
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL `:- "' :a`
Post & Beam
Rough -In
Gas Line
Smoke Dampers
j;
PART FAIL
' ECTRICAL,'_ T ''',:;',: ,
Service
Rough -In
UG /Slab
Low Voltage
Fi : Alarm
i `L'' E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
r- ' PART FAIL
. :''! Please call for reinspection RE: ❑ Unable to inspect - no access
Fire. Supply Line y
ADA Date /0.//ra
Inspector Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection reco i rom the Job site.
PASS PART FAIL