Permit A i CITY OF TIGARD
MECHANICAL PERMIT
'_t„,� i A� DEVELOPMENT SERVICES PERMIT #: MEC2001 -00199
'�I �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/07/2001
PARCEL: 2S1 09 D D -03600
SITE ADDRESS: 12530 SW PRINCE PHILIP CT •
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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: 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of new gas furnace and (1) outler. Replaceing existing.
Owner: FEES
GILLIS, . ERNESTINE P Type By Date Amount Receipt
12530 SW PRINCE PHILLIP CT PRMT BB 06/07/20( $72.50 KING CITY
KING CITY, OR 97224 5PCT BB 06/07/20( $5.80 KING CITY
Total $78.30
Phone:
Contractor:
DAVE FITZPATRICK HEATING + REFRIGTN
7615 SW CHESTNUT STREET
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
• Phone: 245 -3870 - Final Inspection
Reg #: LIC 00052335
•
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 (503)246-9
Issue By: / „AI / Permittee Signature: /1& ' I /
— - - -
Call (503) 639-4 75 by 7:00 P.M. for inspections needed the next business day
06/07/2001 08 :55 5036393771 CITY OF KING CITY PAGE 02/02
• tt:I-t.UUry IL
SERVICEZNfER Mechanical Permit Application OFFICE USE ONLY
r King City 4 ''L B� Permitno.: II � •
µc., " City of Kin y , V i ' te received: - d �91 7 0l7 d /
�'' )3125 SW Hall Blvd. �• ect/appl. no.: Expire date:
Clackamas Tigard, OR 97223 Date issued: B ► Receipt (503) 6394171, FAX: (503) 684 -7297
By 1pt no.:
Multnornah Case file no.: Payment type:
Washington
C O U N T I E S Land use approval: Building permit no.: • I
TYPE OF PERMIT
CI 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL. VALUATION SCHEDULE
Job address: ��, -
�tin t c` Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: ' profit. Value $
Lot: !Block: I Subdivision: *See checklist for important application information and
Project name: — jurisdiction's fee schedule for residential permit fee.
City /county: - ` I & 2 FAMILY D«'EI_I.INC PFR \117' FEE SCHEDULE
Description and I. : , on of we • on premises: - M.' '�, • . AND COMM1•:RICA 1./1N[)USTR1 ; 11, EQUIPNtI.NT SCHEDULE
Sa. 1 (n4 C e , Fee (ee.) Total
Est. to of completion/inspection: 1a .- - G) Description Qty. Res. oi1y Rte. only
Tenant improvement or change of use: H VAC
Is existing space heated or conditioned ? '0 Yes lo Air handling unit Cl[
Is existing space insulated? 0 Yes vi, o Air conditioning (sire plan required)
Alteration of existing HVAC system
MECHANICAL CONTRACTOR =otter /compressors - -
Business name: t f rck • a
State boiler permit no.:
s: Jr L rG W 1 �' - HP Tons ' BTU/H
Fire/smoke . ampers/duct smoke detectors
City: - , i. .IIIMIIIIMII State J ZIP: - 'eat
PPhone: '0 — sZ_ n
T • urn • (site .fan •aired) .
L - 7 Fa <'— 1E -mail: Install = , *' , urner L>!.l -l: TU/1•I
CCB no.: .).3_5_ Including • uctwork/vent liner 0 Yego
City /metro life. no.: Install/replace/relocate heaters - susperiiled.
Wall, or floor mounted
Name (please print): N 1 4 i t - ' ent or app lance other • an furnace
CONTACT PERSON Refrigeration:
l' { C k Asorption units _ HP lI{
Name: a�i 11 Chillers '
Address: _ Compressors _ .. HP
City: I State 17�p Environmental exhaust and ventilation: -
Appliance vent
Phone
a a F ax: E-maiL Dryer exh aust
OWNER Hoods, Type U res.. kitcheti/hazmat
hood fire suppression system •
Name:
h a - 4' 'A • , t `t Exhaust fan with single duct (bath fans)
Mailing address: , - I �r b ' r� - v - \ Exhaust system apart heating or A
City: �� - State: •'I ZIP: On?, piping and distribution (up to 4 outlets)
Phone: / ,, • , i - : : �— E-mail: !
Fuel .1. n each additional over 4 outlets Oil
ENGINEER Process piping (sc ematic required)
Dame: Number of outlets
- Address: - - . Other listed appliance or equipment:
Decorative fireplace
City: [State: [ZIP: Insert - type. -
Phone: Ain [ Fax: [ E-mail: V.00dstove /pellet stove
4pplicant s sig �. �i�� D am: Other.
Ja�!i � _ i Other:
game (print): - k
of all Jurisdictions accept credit e. please call jurisdiction for morn information. Permit fee $
I Visa D MasterCard Notice: This permit application Minimum fee -
ant card number. I I expires if permit is not obtained $
Enoires within 180 Plan review (at _ %) $
days after it has been
Name of cardholder as shown on credit card accepted as complete. State surcharge (8%) a-
S TOTAL .. $ "28=45
Cardholder signature - Amount ■
440 (600/COM)
Case Activity Listing 11/10/2004
11:19:43AM
TIDEMARK Case #: MEC2001 -00199
COMPUTER SYSTEMS, INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MECA007 Application received 6/7/2001 None DONE BB 6/7/2001
BB
MECA008 Create Permit 6/7/2001 None DONE BB 6/7/2001
BB
MECA715 Mechanical Insp 8/15/2001 None PART RDP 8/15/2001 1. B Vent requires 1" clearance at
RDP ceiling
2. Firestop all openings where new
gas line has penetrated
MECA799 Final Inspection 8/15/2001 None PASS RDP 4/28/2003
RB
MECA060 (F) Issue permit 6/7/2001 None DONE BB 6/7/2001
BB
MECA705 Gas Line Insp 8/15/2001 None PASS RDP 8/15/2001
RDP
MECA800 Case Finaled 4/28/2003 None DONE RB 4/28/2003
RB
Page 1 of 1 CaseActivity..rpt