Permit d4
CITY OF TIGARD MECHANICAL PERMIT
ry i DEVELOPMENT SERVICES PERMIT #: MEC2001 -00391
.� �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/5/01
PARCEL: 2S 103 DA -04000
SITE ADDRESS: 10860 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: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS DRYERS:
FURN > =100K BTU: < =10000 cfm: OTTHH ER UNITS: 0
> GAS OUTLETS:
10000 cfm:
Remarks: Woodstove insert
Owner: FEES
EPENETER, FREDERICK J + BEVERL Type By Date Amount Receipt
10860 SW PARK ST PRMT CTR 11/5/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 11/5/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
HOT SPOT FIREPLACE + PATIO
11525 SW CANYON RD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503- 626 -9138 Final Inspection
Reg #: LIC 00071782
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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling
(11R19aa -Q1 RQ
Issue By: Permittee Signature: ` Q-lL
q
Call (5 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
A •
• ' Mechanical Permit Application
AW: RECtivt® Date received: it - - i Permitno.: ce , 39,
''..hy. City of Tigard Project/appl. no.: Expire date:
City of Tigard' Address: 13125 SW Hall Blvd, rCriAt , 9 Date issued: By: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 COMMUNITY DEVELOPMENT Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
V
l & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
• New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 08(6o t.c.) • y C. • 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 $ .
• Lot: (Block: ISubdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: J i a ki 6 I ZIP: q,7 1 S iF1 M1LY DWELL( \G PERMIT FEE SCHEDULE
Description d I ation of work on premiss: AND COMMERICAL/INDUSTRIAL EQUII'iMEN hSCIIEDLLE
WO I n-& •WI i h t✓ / Fee(ea.) Total
Est. date of completion/inspection: j/ ,2O -O/ Description Qty. Res.only Res.only
Tenant improvement or change of use: ' HVAC:
Is existing space heated or conditioned? U Yes 0 No Air handling unit CFM
space insulated? 0 Yes 0 No Al conditioning dn of existing plan HVAC system Is existing P Alteration of existing HVAC system ,
MECIIANICAL CONTRACTOR Boiler /compressors
�^Q A . - �� , State boiler permit no.:
Business name
{CT`s op . Il': F'rtp ac-e-. HP Tons BTU/H
. Address: /($ - 5/...0 (favuibV Fire/smoke dampers/duct smoke detectors
City: � mot, I State: CV" I ZIP: Q ✓jcioS Heat pump (site plan required)
Phone: (9 a(p- rhea►- IFax :' , - mail: Install/replace BTU /H
CCB no.: S ��q Co Including ductwork/vent liner 0 Yes 0 No
Install/replace/relocate heaters - suspended,
City /metro lic. no.: 4 515 wall, or floor mounted
Name (please print): j - OVvt A : 610 . Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
• e u, v. ,, �jj Chillers HP
Address: (1 .51.4) � ICO cit Aos✓P/ Dv Environmental exhaust and ventilation:
City:' ea-v . >n I State: Q/I ZIP: e7 2O.S Appliance vent
Phone: ,, ,- __Fax: ( .-q( fA E -mail: Dryer ex haust
OWNvit Hoods, Type 1/ it /res. kitchen/hazmat
hood fire suppression system
Name: E)De h Q ) l>eue At e /Prie QI' - 1 • • Exhaust fan with single duct (bath fans)
Mailing address: Q; . o SG.) • . Exhaust system a. art from heating or AC •
Cit St ZIP: Fuel p p , g and drstnbut on up to 4 out ets
Y // Qr Y Q Type: LPG NG Oil
Phone: Fax: E - mail: Fuel i ing each additional over 4 outlets
rocess piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace .
O
City: I Stat • I ZIP: Insert - type UJ 4d.11V� I /
Phone: E-mail:
Woodstove/pellet stove
Other:
Applicant's signature. Date: /0J3 /lv (' Other:
Name (print)! (jte. t i.va C
Not all jurisdictions accept credit cards. please call jurisdiction for more information Permit fee $
O Visa ❑MasterCard Notice: This permit application Minimum fee $ 7a. 50
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8%) .... $ 5 R
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7 R 3c7
Cardholder signature Amount i 440 - 4617 (6C OM)
•
_ CITY OF TIGARD BUILDING INSPECTION DIVISION
• 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / —'7 AM PM BLD
Location - D a (20 fat _ , . Suite MEC --bv / 00 3 ej ')
Contact Person Ph , 2-C (Q,s'2 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing ceSs:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspectio Notes:
Slab SIT
Post & Beam /� — /2
Ext Sheath /Shear /
Int Sheath /Shear —
Framing
Insulation
Drywall Nailing
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
MECHANICAL
Post &Beam n
•
Rough In �,�
Gas Line
Smoke Dampers51-01/-4„..
Imo'•' -
'ASS PART FAIL
- RICAL •
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
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: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.