Permit CITY T MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2003 -00209
rl I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/24/03
PARCEL: 2S103CB -10400
SITE ADDRESS: 12192 SW QUAIL CREEK LN
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 062 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS WIO APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior AC unit. Cannot be placed in the required setbacks.
Owner: FEES
MIKE GADBERRY Description Date Amount
12192 SW QUAIL CREEK
TIGARD, OR 97223 [MECH] Permit Fee 4/24/03 $72.50
[TAX] 8% StateTax 4/24/03 $5.80
Phone: Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 - 557 - 2220 Cooling Unt Insp
Final Inspection
Reg #: LIC 72623
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: AZIL&Zeill Permittee Signature: ALI, ! S .
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
MechanicalPermitApplication ( )I, I (, : I (►\ I ,
Date received: a /' Permit no.: . ,i y - }
.�.1,1 .. i l City of Tigard Project/appl. no.: Expire date:
City of Tigard
Address: 13125 SW Hall Blvd, Tigar
Phone: 503) 639 -4171 RECE Date issued: ��. Receipt no.:
Fax: (503) 598 -1960 i . ' 6, 1 Case file no.: Payment type:
Land use approval: 2 3 2003 Building permit no.:
❑ 1 & 2 family dwelling or accessory igliliclaiiit4 O Multi - family O Tenant improvement
❑ New construction 'non/alteration/replacement 0 Other:
Job address: 0,/ 7 5 t� U t (Y r-r/•L Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: -r value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: l9 profile Value $
Lot: IBlock: I Subdivision: •See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: -- 77jita6 IZIP: q 33 ( I .1 2 F \\IIL\ IM FI PI:It,11 r I:1.1 III MI II
Description and locpi nof work onpremises: / „ 4_. , _ `•ND(MIMI- RI(.,L /INI /1', I ‘1.1 11'1 [AI's( 11101 IJ'
1 wo I i rl
Fee (ea.) Total
Est. date of completion /inspection: Description Qty. Res only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or c�o ned2 Ye ❑ No Air handling unit CFM
is existing space insulated? J ❑ No Air conditioning (site plan required) /
Alteration of existing HVAC system
l l 11:, N I (. I. 107\112 A ( 1012 Boiler /compressors
State boiler permit no.:
Business name
T ri County Temp Control HP Tons BTU/H
Address: 1 31 50 S. Clackamas River Dr - Fire/smoke dampers/duct smoke detectors
City: Ore on City [ State: QR I ZIP: 9 7 n 49 Heat pump (site plan required)
Phone: 557-222 0 Fax: 557091 E-mail: Install/replace tumacc/ umer BTU/I-I
CCD no.: 72623 Including ductwork/vent liner 0 Yes 0 No
Install/replace/relocate heaters - suspended.
City/metro lie. no.: 1 126 wall, or floor mounted
Name (please print): Giesele Saha • on Vent for appliance other than furnace
(O I - 1'1a2.1O\ Refrigeration:
Absorption units BTU/H
Name: Giesele Sahagon Chillers HP
Address: Same As Above Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: 557-2220 FaxS 5 7 0 91 9 E -mail: Dryer exhaust
Hoods, Type I/ 11/res. kitchen/hazmat -
, • hood fire suppression system
/t
Name: ee Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel i in each additional over 4 outlets
Process p p (schematic requt )
Name: Number of outlets
Address: — Other listed appliance or equipment:
Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: Fax: • , E -mail: Woodstove/pellet stove
her:
Applicant's signatur IMEIRTMRIB Date: iffL o ther
Name (print): fir ?> "/ ri d -
r
Not all juris accept credit cards. please call jurisdiction for more information. Permit fee $
0 Visa /M aste rC ard Notice: This permit application Minimum fee $ ��'f
Credit car • miter S H • • ire,
/ / t� /' ie / ; ' ,i expires if a permit is not obtained Plan review (at _ %) S
, within 180 days after it has been
- .L 0(Y�i f r oo -• t - -.. �J, accepted as complete. TOTAL hie (8 ° /u) .... $ S J. A.
C *Ida a • . -i Amo /J y nu', T ll
,,,,,,,,d a ��L"° v b � / 440-4617 (6/00/COM)
4/4/_f .— 161-7-ni_yi 55? -1) 9,7
... .— . .
,- el 6 -LSS (SOS) uo2eyeg ejaseTo eoi :ii CO ea udd
Rpr 23 03 11:10a Giesele Sahagon (503) 557 -0919 p.2
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
�f BUP
Received Date Requested ' O AM V PM BUP
Location / - t ` 7 a Suite MEC 3 - O Off- 6 7
Contact Person Ph ( ) PLM
Contractor \ 1 \ Ph ( ) _ 557 SWR
BUILDING Tenant/Owner � 'S — 7 9- (f-S-3 0 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: k 3 �� SIT
Post & Beam .
Shear Anchors
Ext Sheath/Shear i (4
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
MECHANICAL
Post & Beam
Rough-In
Line
, —
Gas Line
Smoke Dampers
,•�l�Y�a
; • FAIL
Service
ough- In , ^
Rough-In ,"y(� (J 1N Q �
UG /Slab
Low Voltages 1 4 f C n_ may(
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
Approach/Sidewalk Date _ ,,_ C '� C I Inspect . /%/ — Ext
Other:
Final DO NOT REMOVE this Inspection record from t e Job site.
PASS PART FAIL