Permit ` I CITY OF TIGARD MECHANICAL PERMIT
,,,, PERMIT #: MEC2003 -00096
DEVELOPMENT SERVICES DATE ISSUED: 3/11/03
~-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 103DA -03700
SITE ADDRESS: 10865 SW PARK ST
SUBDIVISION: ZONING: R -3.5
BLOCK: LOT: JURISDICTION: TIG
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: 1 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:
<= 10000 cfm: OTHER UNITS:
FURN > =100K BTU: GAS OUTLETS:
> 10000 cfm:
Remarks: Install gas furnace and AC. AC cannot be placed in the required setbacks.
Owner: FEES
DICKINSON, WAYNE A + TRACY M Description Date Amount
10865 SW PARK ST [MECH] Permit Fee 3/11 /03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 3/11/03 $5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 - 640 -3607 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 66578 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 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699
Issued By: �� ` .4 ,61 Permittee Signature: Ar /�I /! , _ / •
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
Mar 06 03 10 :lOa Specialty Heating 503 598 0718 p.2
Mechanical rermit,Appilcation IIIIIIIMMIINIIIIIIIIIII
I�
City of E Datereceived3 -1 I -03 Permit no. OC7
„ '`I'it Tigard CEI V
Address: 13125 SW Hal161vd, Ti P�tojecrlapPl.no.: Expiied
CiryofTigand gard, OR 97223 —
Phone: (503) 639 -4171 Date issued: Sy :gg I Receipt u,,;
Fez: (503) 598.1750 0 61003 D Case file no.; "`
CIT AR pF / Payment type: Land use approval: 8011 -D►►v TIGA� Building permit no.: —�`
GD
TYPE OF PERMIT 1 NMI
,)1 & 2 family dwelling or accessory Q Comumen:iaVindustrial
Cl New construction Q Mold- family Cl Tenant improv( meat
Addition /alteration/replaccmc 0 Other.
J013 SITE INhOR111ATION — _---
COMMI:flCIAL VALUATION sum) 'pi:
Job address
/ D 6 SW l a4,(i - Indicate equipment quantities in boxes below. Lndicat the dollar
Bldg_ no.: l owe no.: , value of all mechanical materials, equipment, labor, o 'erhead.
Tax map/tax lot/account no.: — • profit. Value $ •
Lot: ist for im
• Project trams• �lC+rlNS � $lock: j Subdivision: � *See checklist important application information t nil
jurisdictions fee schedule for residential permit fee.
— - City /coon • . R .. ., ZIP:- - .,.�
.� I S 2 FAMILY 1#1'L•'LLJNG PERMIT FEE SC EMI LE
Desc and location of work on premises: _ i i ;A.�ND COM NI :1210 IVINDUSTRIAL EQUIrniE•'NT, CIIEAULE;
Est date of compledonrutspection: Fce(e a.) Total
cif / /c7J on Qty. Res.osly Res.ody
Tenant unprovemeat or change of use: 'AC:
•
Is existing space heated or conditioned ?? Yes 0 No Au handling unit CFM
Is existing space insulated? � Yes Cl No Air condidotung(siteplanreq,circd)
NI[C. CONTRACTOR s g �ao rsngHVAC _
Business name: 'i0 , ,® State boiler permit no.:
Address: i , pi •,,E — we g 04-D HP Tons BTU/H
City: _ Fi smoke • ampers/• uct smo • detectors
States / ZIP:: g in ..$ - eat pump (Stir plan required)
Phone: , ✓ 3 G G 7 azr r/ E-mail: instal replace . , user: • g I /
Cal no.: 578' Including ductwork/vent liner'iYes l] No
• City /metro lie. no,;/ 7 wall, or r floor mounted
l, o floor ounted
Name (please print): Nara? , ,,, , 4411 e.LS ant fora .. ' aace o er than furnace —
CONTACT PERSON R ' = on:
Absorption units BTU/H
Name: •KAItI Q-e N S'ie/tYN -P/ Chillers HP
Addle= ott,i $� RIUCl • ROIL -.D 5, ... p� ---
City: /l5 1 Ststc e �: Q'7 /z3 a ' � �, • exhaact and venni* • . u:
Phone: 6 -3Gol • Fax:4gy -07e4 E-mail: Drye xhaust
Dryerexhaust
OWNER Hoods, Type U 11/ms, och azmat
Name: r �!/d 5 �s'l/ hood firesupp,tasioa
l,J� Al -e /
Na Exhaust fan with single duct (bath fans) •
• Mailing dress: f Og'( ' SO • Aor.t ,�� ST 1r, ht aunt system a . from heating or AC • _
City: ! / lr ClilG(� • State .d �p T'" , 11. , :.an. 't 1 . n (up to • ou ece
Phone: Fax: E -mail: ' • • [.PG • NG Oil (
net • i . i . _ each a . • none] over 4 outlets
ENGINEER ' ...-- p (schcmaticrtquired)
Number of outlets
Address: h er 1 - r. app . . • or -. ■ , meat;
•
Add Decorative fireplace
State: I ZIP: . - _type • •
1Plhone' g: ,, rte . 11[ttail� • - • • Woodatovelpenetstovc . .
Applicant's sigma L-� !a,�� Date: 14 p fir
Name (print):'
Not art ju is"alls accept acct cam Fleare call jwrirdk3im for mo'' +m Pedmit fee $
CI Visa 0 MasterCard Notice: This permit application Mi fee $
Credit card number expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days atop itbas been State Stlrt (8%) —
Name of ca as shown oacredit card as complete Be ( ) $ '
TOTAL $
S
ca�dhdder signs me amount
440461 1 (alum)
Mar 06 03 10:1Oa Specialty Heating, 503 598 0718 p.3
SITE PLAN
PL
5
PL . PL
PI.
STREET
Specialty Heating & 'Cooling, Inc
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640.3607 Fax 503.681.079 :i
CITY OF TIGAR D 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received Date Re nested ` BUP
AM PM BUP
Location / 0 5 " Suite MEC 3 -00 ?
Contact Person fittAtheAl Ph ( ) � O Lid ,34 0 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing #� N 6 -i- '4Q-/ ZC .! �v2�A
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 Dampers
PSS )PART FAIL
ELECTRICAL
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. El Unable to inspect - no access
Fire Supply Line
ADA 3 /� 3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL