Permit •
.9tal CITY' OF TIGARD MECHANICAL PERMIT
01 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00182
" J II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/9/04
PARCEL: 2S1 03C B -08200
SITE ADDRESS: 12345 SW QUAIL CREEK LN
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: OTR 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:
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: AC installation.
Owner: FEES
SUMMERS, DAVE & NADIA Description Date Amount
12345 SW QUAIL CREEK LN. [MECH] Permit Fee 4/9/04 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 4/9/04 $5.80
Phone: 503 - 590 - 4492 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 Cooling lint Insp
Final Inspection
Reg #: LIC 62196
•
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 -66
Issued By: Permittee Signature: 0
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr 08 04 Ol:Olp climate control 503 988 7224 p.l
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if Mechanical Permit Application OFFICE USE ONLY
City
Date S �Qj/ Permit no
A> . '. ' • C
' ity of Tigard oo -i aol
City of Tigard i
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Prole : no.: Expire date:
Phone: (503) 639 -4171 Dale issue d:
Fax: (503) 598 -1960 $Y' Receipt no
Case file no.: Payment type:
Land use approval: Building permit no.: T/4
TYPE OF PER /
AI & 2 family dwelling or accessory 0 Commercial /industrial
0 New construction 0 Addition /alteration/replacement 0 OtheC family 0 Tenant improvement
.IOR SITE INFORMATION COMMERCIAL. VALUATION SCIIEDULE
Job address: 4 � 1 SW i ( CrQ VI iC.
Blda, no.: Lt Indicate equipment quantities in boxes below. Indicate the dollar
° Suite no.: va!ue of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.:
profit. Value $
. Lot: Block:
Subdivision: *See checklist for important application information and
Project name: 15-p44070 _ 3uwhrru_if-5 jurisdiction's fee schedule for residential permit fee.
City /county: - - -
& 2 FAM1LY DWELLING .PERMIT FEE SCHEDULE
Description and to ion of work on premises: COALMER 1NDU5 .I7tI Al. l ?Q,IPAi ENT SClLEll11LE
t nbtoa ( /A /L
Est. date of completion /inspection; Fee (ea.) Total
Tenant improvement or change of use: Description Qty. Res. only Res. only
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
Is existing space insulated? 0 Yes 0 No Air conditioning (site plan required) 1
'MECHANICAL CONTRACTOR B tion of existing HVAC system
•
Boiler
/compressors
I ' rats. 61 1(6 Slag: boiler permit no.:
Business name:C
c (� -
Address: HP Tons B'fU /H
Ito S��Z c
City: '}7 \ Statetng ZIP: Firdsmoke dampers/duct smoke detectors
I G�� Heal pump (site plan required)
Lr5 ax:�{(p8 741 E-mail: �ns%.II /replace fumace/bumer _ _ $TU /H '
Phone:
CCB no.: lPa ( Including ductwork/vent liner 0 Yes 0 No
i
City/metro lie. no.: 1 y ‘9 nstall /replace/relocate heaters - suspended,
Name (please print): f e wall, or floor mounted
1 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Name: Absorption units BTU /H
Chill_rs HP
Address: Compressors HP
City: State: ZIP: Environmental exhaust and ventilation:
Phone: Fax: Appliance vent
E -mail: Dryer exhaust
OWNER Hood,, Type V II /res. kitchen/hazmat
Name: � � hood fire suppression system
Mailing address: Exhaust fan witlfsingle duct (bath fans)
l a.3 .4 SLV QU..Cq.t I. Creek, Lea. Exhaust system apart from heating or AC
Ci :`T - 1 �d State:C�(2 ZIP: q-ja — Iriping and distribution (up to 4 outlets)
Phone: :1,,„ ''0•4 Fax: E-mail: I Type LPG NG Oil
1'sNGlt\F.ER piping each additional over 4 outlets
Name: rocess piping (schematic required)
Number of outlets
Address: Other listed appliance or equipment:
City: Decorative fireplace I
I State: I ZIP: Insert •- type
Phone: I Fax: I E -mail: - Woodstove /pellet stove
Applicant's signature: Date: 1-/-8-04 Other:
Name (print): Gn , Other;
Not all jurisdictions accept credit curds. please call jurisdiction for more information
0 visa 0 MasterCard Notice: This permit application Pernmit fee $
Credit card number: / / expires if a v5 plg o ined Minimum fee $ !ff pl an review (at %) $ expires 1�0 �i: Name of curdhalder as shown nn credit card Id aJ�a/ State surcharge (8%) $ rj•�t�
TOTAL $ 7
c s complet:.
Cardholder signature $
Amount , APR 0 8 2004
s een 4 .�
440.46 11 rN(xVCOMI
CITY OF TIGARD
BUILDING DIVISION
Apr 08 04 Ol:Olp climate control 503 968 7224 p.3
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CITY OF TIGARD 24 -Hour
BUILDING Inspection ine: (503) 639 -4175 MST
INSPECTION DIVISION • Business Inc (503) 639 -4171
J 1/ / BUP
Received � � / Date Requested
2 ) — CJ< AM PM BUP
Location / Z 3 '/ ± (JaL.l% i , �e / MEC e.
) ry
Contact Person Ph ( ) y .� 3 -- <tf ? ZPLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain /
Access: / D / G k 5 ELR /at Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing T C 't< _ �=
Firewall Z y e)V R
` /
Fire Sprinkler - - Y
Fire Alarm d 4 Oar O c G
Susp'd Ceiling
Roof A .0 V/
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 A, .,� ��
e Dampers ' yd
P PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hal 3125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unabl to inspect – no access
Fire Supply Line , ht
Approach/Sidewalk Date C/ U Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL