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Permit 0 • C ITY OF TIGARD MECHANICAL PERMIT PERMIT #: MEC2003 -00471 13125 `E�I�' DEVELOPMENT H Hall Tigard, ) 639 -4171 DATE ISSUED: 9/30/03 PARCEL: 2S115CB -04200 SITE ADDRESS: 17135 SW PACIFIC HWY SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 0 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 0 DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: 0 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 0 AIR HANDLING UNITS FURN > =100K BTU: 2 < =10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 2 Remarks: HVAC renovations. Project value: $15,000 Owner: FEES TUALATIN VALLEY FIRE & RESCUE Description Date Amount 20665 SW BLANTON [MECH] Permit Fee 9/30/03 $72.50 ALOHA, OR 97007 [MECPLN] Plan Rev 9/30/03 $18.13 , [TAX] 8% StateTax 9/30/03 $5.80 Phone: Total $96.43 Contractor: RELIABLE HVAC 5915 NW 78TH ST. VANCOUVER, WA 98665 REQUIRED INSPECTIONS Phone: 360 - 693 - 7379 Gas Line lnsp Mechanical lnsp Reg #: LIC 145234 Duct Inspection Final Inspection • 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 Iss - d By: - � _ !� P ermittee Si Signature: Call (5 1 • 639-4175 by 7:00 P.M. for inspections needed the next business day 17135 SW PAO, Fri NwY • - 'ft/ F' A PPROyar) 9-29-03 Zs e Mechanical Permit Application OFFICE USE ONLY "`• s J h. I ` Cit of Tigard Date received: $ f 0 5 Permit no.: t —� �/ _ i ; i j 4 0 Project/appl. no.: Ex. • date: City of Tigard Address: 13125 SW Hall Blvd,�TiP O L2'7 2 Phone: (503) 639 -4171 I 111r••,iJ Date issued: It Receipt no.: Fax: (503) 598 -1960 �� rt Case file no.: Payment type: �1;� 0 Z P3-oa�alo Land use approval: Building permit no.: t ITV F I iC F.CitD TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory XCommercial/industrial ❑ Multi - family ❑ Tenant improvement 0 New construction 0 Addition/alteration /replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: 17 13s S w PAc. Ft C p (0 Y Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ 1j moo. 0c0 . Lot: I Block: I Subdivision: *See checklist for important application information and Project name: i v p 4 g lam jurisdiction's fee schedule for residential permit fee. City/county: krN6 cir( I ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: /r{tAc AND COMMERICAL /INDUSTRIAL EQUIPMENT SCHEDULE g gm* r(vou Fee (e .) Total Est. date of completion/inspection: SEpr 2 003 Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air Is existing space heated or conditioned? 12f Yes ❑ No handling unit y i 2 CFM 140 Z space insulated? es ❑ No Air conditioning (site plan required) Is existing p Alteration of existing HVAC system I MECHANICAL CONTRACTOR Boiler /compressors A State boiler permit no.: Business name: rEu Ag VAG �I�G• HP Tons BTU/H ' Address: Si IS NE 78 Y' 57' Fire /smoke dampers/duct smoke detectors City: C Fit State:. ZIP: t; , ( Heat pump (site plan required) Phone: 36003 73 n Fax:34003v 4 ' -mail: Ins • lfrep ace furnac .umer BTU '/ Including ductwork/vent liner 121 Yes Cl No CCB no.: 4S Z 3'7 Install/replace/relocate heaters — suspended, City/metro lic. no.: wall, or floor mounted Name (please print): 1/4/Z L OS/SQ147e Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: — p t c.c. c 2$ 6 cANE Chillers HP Address: 91_ 4_5 4/0V En ors HP Enviro iron exhaust and ventilation: City: e: I ZIP: Appliance ce vent Phone: 03 ' 1024 Fax: E -mail: Dryer exhaust OWNER Hoods, Type U lures. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC Fuel piping and distribution (up to 4 outlets) City: I State: I ZIP: Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets ENGINEER Process piping (schematic required) Name: Number of outlets Address: Other listed appliance or equipment: Decorative fireplace City: State: I ZIP: Insert — type Phone: Fax: � l mail: Woodstove /pellet stove �� Other: Applicant's s _ ,: fpl _ y .�. . . : 8 - 0 Other: Name (print): - D4 1 Q - 64,. p of •r: • - Permit fee $ Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ 7 Z �- ❑ Visa ❑ MasterCard Credit card number: / / expires if a permit is not obtained Plan review (at 2 %) $ 19 Expires within 180 days after it has been State surcharge (8 %) $ 5- -- 8 - 42 . Name of cardholder as shown on credit card accepted as complete. TOTAL $ 9 fo $ Cardholder signature Amount 440 -4617 (6/00 /COM) Site Address: / 7) J w f4 c 1 Fi c 14 w Y FILE COPY A ,,, Letter of Transmittal Building Division City of Tigard DATE RECEIVED: TO: BRIA? BLALoc,J' RECEIVED DEPT: BUILDING DIVISION 'AUG 2 7 2003 OF TIGARD FROM: R LCU -. ©S BAD E CITY N G DI BUILDING DI ION COMPANY: get -I AZLE a Ilk / 14. PHONE NO.: -1 ) (90 - (c `13 - )3 ? RE: %t fl & zoo3 -aog7/ 17136 Su) Ri iF,c ff «f/uakl (Case number, site address, etc.) c irfl Fite s elJ (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: I I Description: Copies: I Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): O DFF F,vcG ' REMARKS: ICTV GVT NcL, bF- For Office Use Only: - Routed to Permit Technician:. ' Date: - Fees Due: . $ Date: Initials: Reprint Permit (per Plans Examiner): Yes: No: > , Notified ,.Applicant: I Date: Initials: i :dsts\forms\LetterTransmittal.doc 02/15/02 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested / 0 — 7 AM PM BUP Location 1 7! 35 PA c- 4 c a -00 1 7°7/ � -'s !� -' 0 IGO Suite 9o7 -35 PLM Person ^^� Ph ( ) P M Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: n1 Chu q r.e CyGo cra.1 SI Post & Beam Shear Sheath/Shear �C� / Ext Sh _ eath/Se S e 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 _MECHANIGAL Rough -In Gas Line Smoke Dampers RT FAIL RICAL 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 /61 Inspector 7 - 2 5 - 7 — \ Ext Approach/Sidewalk Dat p Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL