Permit C ITY OF TIGARD . MECHANICAL PERMIT
� :�r t DEVELOPMENT SERVICES PERMIT #: MEC2001 -00161
��' I-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/16/01
PARCEL: 2S 115CB -04200
SITE ADDRESS: 17135 SW PACIFIC HWY
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE:. COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of 10' of LPG gas piping.
Owner: FEES
TUALATIN VALLEY FIRE & RESCUE Type By Date Amount Receipt
29665 SW BLANTON PRMT DEB 5/16/01 $72.50 KING CITY
ALOHA, OR 97007 5PCT DEB 5/16/01 $5.80 KING CITY
Total $78.30
Phone:
Contractor:
SUBURBAN PROPANE LP
10075 SW CASCADE BLVD
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 643 -6651 Final Inspection
Reg #: LIC 112216
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 -00 0 thro OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calli (503)246 - 91899
Permittee Signature:
:• / 1 .(/
Iss e B �
Call (50 • 9-4175 by. 7:00 P.M. for inspections needed the next business day
05/14/2001 09:52 5036393771 CITY OF KING CITY PAGE 02/02
SERVICE LATER Mechanical Permit Application OFFICE US E ONLY f
-. OFFICE USE
'r
CS:p., City Of Ding Clt • ti y ate received: 5 -,-Q I Permit no.:
•
13125 SW Flail Blvd. City . Project/and. no.: • Expire date:
Tigard, OR 97223 P
Clackarnas
Multnomah Phone: (503) 639 -4171, FAX: (503) 684 -7297 Date issued: 13y; Receipt no.:
Washington Case file no.: Payment type:
coun*ies Land use approval: Buildin
g permit no.:
TYPE OF PERMIT
* CI 1 & 2 family dwelling or accessory O Commercial/industrial 0 Mu
few construction Cl Addition/alteration/replacement 0 Oth i-family [3 Tenant improvement
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job addree ss: � �
Jo b a do l Indicate equipment quantities in boxes below. Indicate the dollar
Suite no.: value of all 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: jurisdiction's fie schedule for residential permit fee.
City /county: iif//(r ZIP: 1 & 2 FAMILY DWELLING PERMIT FIE SCHEDULE
9 ctjptio�d location of work on premises: ,e4 (iti j .. AND COMMERICAL/1N1)USTRI:IL EQ UIPiN ENT SCHEDULE
Es date of corn IedtVi
ons Pee (ea.) Total
pection: Desai • , a Q . R. oitl Res onl
Tenant improvement or change of use: LAVA
IS existing space heated or conditioned? O Yes 0 No Air handl ing.unit CFM
Is existing space insulated? CI Yes CI No Au conditioning (site •Ian = . aired)
Alteration of existing AC s stem
N1ECHANICAJ. CONTRACTOR :oiler /corttpressors
Business [tattle: / . 7 �, , State boiler permit no.:
f
HP Tons BTU/H
Address: /00 75 51.0 Cf}- -b ' L 1
Fire/smoke dampers/. act smoke detectors City: ' / Sta .j ! ZIP: 07 ,e3 Heat .um (site plan P (s� P required)
Phone:5. 4513 -G t'o 7 Fax: E -mail: Ins • /replace furnace/burner BTU/H
CCB no.; // 1a- 1 Including ductwork/vent liner 0 Yes 0 No •
City /metro lit. tin.; InstaWreplacehtelocate heaters - suspended,
wall, or floor mounted
Name (please print): ' ent for a..liance other than furnace
CONTACT PERSON Refrigeration:
Name: . l�r�i� / � Absorption units HP
�' Chillers Hp
AddrESS: `/ / Corn . setts HP
:It) e �/ / >• i En . emeata! exhaust and rem • don;
a EMI ZIP: r `�� A A. pliance vent
. hone: e rr ,�71 Fax: E-mail: + er ex aunt
OWNER Hoc. , Type UWres, kitchen/haanat / ..„," v ,
fame L � ere hood fire suppression system P fire t 4
eee- Exhaust an with single duct (bath fans) 1 ri
dailmg dress: / . ` Exhaust system = • art from eating or AC
t[y: / i Fuel mimetic' • budou (up to 4 outlet[)
T . ' ./` LPO NG Oil .
'hone:
Fax: E-mail Fuel
pipin: each additional over 4 outlets
ENGINEER piping (sc emetic requ' ... )
fame: Number of outlets
•
.ddress: •Wei •. ted appliance or equ • men[:
Decorative fireplace
it y: State: ZIP: Insert type
lone: all 5116M E -mail: ' Oodstove/. let stove
'plicanl's s1: • e : i 5 Date• Q'��> Other.
other:
ame (print): 41 D : er ° et. / / u
all jurisdictions eceepl air coda, please call jurisdiction for more information. Notice: Then permit application Minimum fee
Permit fee $ rf 1.
a MasterCard
„ o $
lit card °umber / 7 expires if permit is not obtained
Expires
when 180 days q/ler It has been Plan review (at %) $
Nam a
Name of cardholder as shown on adil card accepted as complete. State surcharge (8%) $
$ TOTAL $ lir-VI
CarOholdcr nominate Amami
440.4617 (6I00/COMI
•
y
CITY OF ,TIGARD BUILDING INSPECTION DIVISION MS7r
24- Hour4nspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested S Z3 AM PM BLD __''``
Location / 7/ 7 S� A C( �/ c� Ilk- 7 Suite MEC s c�� �-o U I G (
Contact Person IQ (I►'. ,71•61(;..-• Ph 7° I a a Z' PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
. Framing
Insulation Z / (_ /&
Drywall Nailing ll C•N
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANIC
rearr136am
Rough In
moke Dampers
Fir
PART FAIL
TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
. SITE
BackfilUGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] nable to inspect - no access
ADA
Approach /Sidewalk Date 4,7161 Inspector /Z //[ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.