Permit ► , C OF TIGARD MECHANICAL PERMIT
a l't DEVELOPMENT SERVICES PERMIT #: MEC2001 -00124
-- „� - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/18/2001
PARCEL: 2S 115BC -12100
SITE ADDRESS: 16860 SW QUEEN ANNE AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: H7 VENTS WIO APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: 75.000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:. WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 0
> 10000 cfm: GAS OUTLETS:
Remarks: Replace furnace in garage.
Owner: FEES
JERRY WANDELL Type By Date Amount Receipt
16860 PRMT BFB 04/18/20C $72.50 KING CITY
SW QUEEN ANNE 5PCT BFB 04/18/20C $5.80 KING CITY
KINF CITY, OR 97224
Total $78.30
Phone: 503 - 620 -8648
Contractor:
SERVICE NOW OF ORE
404 S. BEAVERCREEK RD.
OREGON CITY, OR 97224 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 503- 655 -7558 Final Inspection
Reg #: LIC 110214
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 opies of these rules or direct questions to OUNC by calling (503)246 -918 .
Issue By: V �,(fj�,..- soZebt.. Permittee Signature:(J)') a40.0€ e;Z l -
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
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04/18/2001 10: 23 5036393771 CITY OF KING CITY PAGE 02
V4 /11 /LUV1 LUDO YAA auaOe4TL87 City or Tigard / 11002
• • KA 0 \ I .....
■
Mechanical P 't Application.
-` � ' Qr1 RECEIVED Daes,mod od 41 hankno. ; /( % . 1 ooL.2
City of 7'�Y
Li.. 1. Ptolea/apPl. eo.: Enke date;
ChyofTrgard Address: 13125 Sw Bl 'I • N •+ 23
A N , 2001 Dare issued: By: tZereiytno.:
Paz: (503) 598 -1960 Cue mo no.: Paytoent types
Land use approval: \ COMM DE ' 10, w Botlalag permit no.:
k $4 & 2 family dwelling or accessory fa Commercial/industrial 0 MU1G-
0 New construction O Addidodalterad nt CI Ohm:
�y O Tenant improvement.
.108 SI II: 1 \I 111011 ( ON) N1I11( I \I. 1:A1.II:I I ION - S(.111:111.11
• lob address: I(D • l �� ,�,�� Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: u no„ value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value S
Lot 1131odt: Subdivision: 'See checklist for important application information and •
Project name: ' • jurisdiction's foe schedule for residential permit f>:e
Ci /carpe : Z a p : I .l ' _ I . O n t1 A l ll I : I , 1 I' I : t ' r ll \ I T I 1 1 1 . \(1 ) .
• • . ea._ ®�wlare. ',a At ;T ,.' , , \T► (()1pIIa ! .11 1 \i)T. I. L 1_UU1i'mtN1. *.A.X ;
Eat. date of com Ctiott/m Faroe.) TOW
!�) apection berates Qtr. S,ra, aaty Bar, oalZ
Tenant Improvement or change of use: • '
•
Is Wades space heated or conditioned? O Yes O No Air handling unit — . CAM • , •
Is twisting apace insulat ml? O Yes O No �Tir eetld(epaln riittepTan requited)
Alteration of edweg HvAt system
%IL( ,1t. (YO\ I It \(.l1)It e1@CeI esters
BY9ft1e8s Dame rj �"�
�/RL,/!f P Npw e 1- State boiler permit no.:
Addteas: r '
- - _ p r /' Um 11111/11 Ci(y; - State: . . b Jt ! 7x'rT -+° - pooh • etaetars
/ � 4 ?G t . ■ .., sp r-
j t9 3 Phone: /,LT Fax: E- Ina ' -, .. - ft ZMt..Z BTU/H `
r
CCB no.: „ /- MO / fachdln : ductwork/vent Lnar D Yea o Pia)
C /IneQplfc. no.: i ro eatNy 9Y4pop• •
wall, or neer mounted
Name (please print;): ' ant • appliance ether t un tutwce
(: 8 \ 7,1(7 1 lt t l,N Rettig widow •
Absotpdon BTUFII
Name: /- t/tl_ y Chinon HP
Address; c e .. .. — HP
;,
Clir State: ZIP: Applienco _ 1l00 .
Phone 5 s =,7 s' T Fax: B- retell: D axhaurt
O{l\t.lt •0,...nu r TTrii..,,..t
rffilltlaWITIMIE hood fire . suppression system
:•r . Exhaust tan whit ale a due • taps • •
- address: , , ., ■ =nr�-+ . , m , ..,. . or '
State: ZIP! '' ' ' ... ; r r 1 r,7 . • up to 4 a eta
: • _ Fax: T . .• LPG NG Ofl
vlis aw - a• .. o - Oil -Li
1-N (: l \' I:. It aeeppiPSIS - ' ' requir .1
Name; Number of oodles
Other listed appliance or mpripmenh
Addsese: Decotadvo$roplece
Ci, : Stare: JIM Yuen- ,,• • •
Phone: Fez: bite .. • 0 • 7 11ctr1010e
A . • lfcant's apaturt:: Dare: O
Name (print): _
Q t The haleakate• aat� plum m11 a far wow p►(ra ow ems: This permit application remit fee S
cleat care mane; Obtained Plan r* mi fee S 7 erpites i f a permit Is net ebleine
within 160 days atter it h4 been P1a11 mviow (at 0316 46) S S .SI D
Haw er mnstoldor • ewe m and • . ' 'meowed tia complete. State z ..... tge, (896) _ E
"e � " ��,,, TOTAS+ ....._...._ S M04611 01112C041
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location ) 1p r GO /(C Suite MEC /�� v r
Contact Person Ph 6- 7 7 J PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
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 ./A)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer % ? j e j)(
Rain Drains C
Final
PASS P RT FAIL
H
EC ANIC
— Rost & Beam
Rough In
Gas Line
Smoke Dampers
PART FAIL
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
Other Date Dl Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .