Permit CITY OF TIGARD MECHANICAL PERMIT
t in DEVELOPMENT SERVICES PERMIT #: MEC2000 -00471
��' I � 13125 SW Hall Blvd., Tigard, OR 972 (503) 639 -4171 DATE ISSUED: 12/6/00
PARCEL: 2S115BC -17800
SITE ADDRESS: 16682 SW QUEEN ANNE AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
<= 10000 cfm: OTHER UNITS: 1
FURN > =100K BTU: GAS OUTLETS:
> 10000 cfm:
Remarks: Intallation of heat pump and duct system.
Owner: FEES
WINDECKER, ROBERT D AND Type By Date Amount Receipt
REEVES, MAE PRMT JMT 12/6/00 $72.50 KING CITY
16682 SW QUEEN ANNE AVENUE 5PCT JMT 12/6/00 $5.80 KING CITY
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
AIR PRO HEATING + A/C
7405 SE POWELL BLVD
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 771 -7871 Duct Inspection
Reg #: LIC 00072086 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 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246 -9189.
Issue By: f Permittee Signature: VLO—d_e__,L,
Call (50 ) 639 -4175 by 7:00 P.M. for inspections needed the next business day
12/04/2000 13:17 5036393771 CITY OF KING CITY PAGE 02/02
T RI -C OUNTY
s ERvft: cE wm Mechanical Permit Application OFFICE USE ONLY
y King City Date received: _L0.-1.-0 Permit a� -e v ?i
City of Kin
-;
'0 13125 SW Hall Blvd. ` � `'roject/appl. no.: Expire date;
Clackamas Tigard, OR 97223 Date issued: By: I Receipt no.:
Multnomah Phone: (503) 639-4171, FAX: (503) 684 -7297 Case file no.: Payment type:
Washington .
C O U N T I E S Land use approval: Building permit no.:
TYPE OF PERMIT
JBt. l & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction Q Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIA1. VALUATION SCHEDULE
lob address: gog2. $W /{seen Ann Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ •
Lot: I B lock: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: I ZIP: I & 2 FAMILY DWELLING YER-MIT FEE SCHEDULE
Description and , [ion •f work on • mi :■ND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
. x_ "'•`_' .. f`� Fee (ea.) Total
Est date of completion/inspection: /).1.2. /.2. v / O Description _ Qty. Res. only Res. only
Tenant improvement or change of use: ! d HVAC:
Air
Is existing space heated or conditioned? 0 Yes 0 No handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No
Alteration of existing HVAC system
MF :CHANICAI. CONTRACTOR Boiler /compressors
Business name: A ,6 1 r , _, 4 � State boiler pennic no.:
HP Tons BTU/H
Address: ��
7 ,SS f� "" ,1 . ' d = c • n0 • - •.. _
City: a,.,. ,� I State;. ZIP:1I20 ' eat pump (site p . requited) VII
Phone: 7 7/- 7i7 / Fax77/ -3.579 E- mail; tall • ace • umer :TU III
CCB no.: Including ductwork/vent liner 0 Yes 0 No
- , mounted Install/replace/relocate ate heaters — suspen • •
wall, lic. no.: wall, or floor moun
Name (please print): r 7c4 . .0 s Vent for appliance other than furnace M
•
CONTACT PERSON a += _eratba: .��
Absorption units BTU/F{
Name: A, c- ha-+,4 t, 2921.6 Chillers P MI .
Address: Compressors HP
Environmental exhaust and venttietlon:
City: State: ZIP: • . fiance vent
Phone: Fax: E -mail: Drjrer ex aunt
OWNER Hoods, Type U II/res. kitchen/haanat ■
�f hood fire suppression system I -
Name: b tit I ►7tlG:G�L°ir Exhaust an with single duct uci (bath fans)
Mailing address: 1la/Q ?. rid 4$ ue,� J h Exhaust system • r art from heaiin _ or AC
City , ,; a State: ,,,, - Z I' -'74z
Fuel p p eg and distribution (up to 4 outlets) ■ -
Tr :• • LPG NG Oil
Phone: .. Z0— ; MA Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name:
Number of outlets
• Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert — type
Phone: ax: E -mail: Woodstove/pellet stove
O r
Applicant's signature: �i �, ,� 2
Date . , a Other: I ____
Name (print): ' i c&,.,-4. Co one'
lot ail jurisdictions accept credit cads. please can jurisdidioa for more information. Permit fee $ It O
Notice: This ennit application
l Visa O MasterCard P a QP liti Minimum fee $ r 72. S O
redjl card number: / / expires (f a permit is not obtained Plan review (at %) $
Expires within 180 days after It has been
State surcharge (8%) $ S- e0
Name of cardholder as shown oa credit card accepted as complete.
$ TOTAL $ 3 P
Cardholder signature Amount
440 -4617 (6NOICOM)
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST 4%1
24 -Hour, Inspection Line: 639 -4175 Business Line: 639 -4171 111. _ BUP
Date Requested / AM PM BLD `\ /
Location Suite / 2 -cd e(7(
Contact Person Ph 4 Zp - gO17 PLM
Contractor Ph SWR
BUILDING Tenant/Ow er '� Ube ; � ;�1 ( 1
Retaining Wall ELR
Footing Access:
Foundation
; S% �� _ FPS
Ftg Drain �' `
Crawl Drain Inspection Notes: - SGN
Slab SIT
Post & Beam /6 / z _ � / 1 J &# IN/tiC
Ext Sheath /Shear (q 2J
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall t "PC / �/ C� 4241.. / / LJ Fire Sprinkler � S
Fire Alarm
Susp'd Ceiling /55 L /jt'!it 4-5 /1 CO .
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab 0/9 , l/ iL/
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PAS PART FAIL
Post & Beam NPa i f7
Rough In
Gas Line
• ke Dampers
4I» PART FAIL
E CTRICAL
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 9 — 3 -
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.