Permit ' . - r te,.. _ 3 ∎• , ■ .. H.
CITY OF TIGARD
"� MECHANICAL PERMIT
r Arn DEVELOPMENT SERVICES PERMIT #: MEC2002 -00416
-- -- ' �' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 D ATE ISSUED: 9/20/02
PARCEL: 2S110CA -01600
SITE ADDRESS: 15355 SW ROYALTY PKWY
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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: Replace unit heater.
Owner: FEES
KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt
15245 SW 116TH PRMT BB 9/20/02 $72.50 KING CITY
KING CITY, OR 97223 5PCT BB 9/20/02 $5.80 KING CITY
Phone: Total $78.30
Contractor:
MILWAUKIE HEATING + COOLING
9961 A HIGHWAY 212
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 557 -5562 Heating Unt Insp
Reg #: LIC 104102 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: �, J Permittee Signature: (y/ aloft/
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busvnessda
09/17/2002 08:25 5036393771 CITY OF KING CITY PAGE 02/02
TRI- COUNTY
sERvla a8TEir -- "Meth 1 a ical Per cl_Apdigation _ OFFICE USE ONLY
�'a t Date re
D ivedFif a O y m��) Q Permit no.: /4
City of King City `� y
' Project/appl. no.: Expire date:
13125 SW Hall Blvd. ,K -
Tigard, OR 97223 SEP 17 2002 Date issued: ByD3 Receipt no.:
C lackamas Phone: (503) 639-4171, FAX (503)
Multnomah e � y - �y yl�ililr�r4 C ase file no.: Payment type:
Washington BI Y -
TE�D'F;VT+O d1.'� i +�d'n i
C O U N T I E S Land use approval: B permit no.:
TYPE OF PERMIT
G 1 & 2 family dwelling or accessory 0 omlmercialiodustriai 0 Multi - family O Tenant improvement
0 New construction ❑ • ddition/a.lteration/replacement 0 Other
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: • , � s 5.'"' .S Jn). ' , 1 q Vi— Paw t,_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite o.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ _ .
Lot: I Block: I Subdivision: *See checklist for important application information and .
Project name: jurisdiction's fee schedule for residential permit fee. ,
City /county: Kt p, p ( ZIP: r '12 2.2, 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and log tion of Ark on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
Fee (ea.) Total
Est_ date of completion/inspection: 9- q1- G 2• Description Qty. Res. oily Res. only
Tenant improvement or change of use: � HVAC:
Is existing space heated or conditioned C<Yes 0 No Air handling unit CFM
Is existing space in sulated? Ye 0 0 Air conditioning (site plan required)
g Alteration of existing 1-1 system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: r : N State boiler permit no.:
HP Tons BTU/H
Address: • • _ 1. a p AA Fire/smoke dampers/duct smoke detectors IIIII
City: ,. „ - - ci"■ rl ZIP: t G i kteat Ure (site plan required)
n acdburne BTU/H
Phone: s , E mail: Includ' work/vent liner ❑ Yes O N.
CCB no.: 1 f Li 6 I, instil locate heaters — s • • nde •►
City /metro lic. no.: 3 ;j O • wall, or ..r mounted ,. .nell
Name (please print): 4,y, 1101 Vent for appliance other than ace
CONTACT PERSON
Refrigeration:
Absorption units BTU/H
Name: --+,e rr y ll 4 t t j Chillers HP
• Address: 5 Compressors HP
Environmental exhaust and ventilation:
City: State: I ZIP: Appliance vent
Phone: Fax: B mail: Dryer exhaust
' OWNER Hoods. Type res. itchen/hazmat
hood fire suppression System
Name: m r . - A 1061 4 toy Exhaust fan with single duct (barb fans)
Mailing address: L 6, A _ 41 1- Exhaust system apart from heating or AC
State: ■ ZIP: C11.124
Fuel piping and distribution (up to I outlets)
City: R
y' 1 h Type: LPG NG Oil
Phone: , 3g •b$ ' • x: E mail: Fuel . i. ing each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: • Number of outlets
• Address: - , Other listed appliance or equipment:
Decorative fireplace
City: State: ZIP: Insert— type
Phone: Fa : Et ail: ' Woodstove /pellet stove
Applicant's siRna FM1 Date; - Qom. O p .
Name (print): /
lot all jurisdictions accept credit cards. plc call jurisdiction for • e information.
Permit fee $ 7' .s.S )
7 Visa 0 MasterCard Notice: This permit application Minimum fee $ ,
/ / expires if a permit is not obtained Plan review (at %) $
cedit card number: - Espires within 180 days after it has been
accepted as complete. State surcharge (8%) $ '
Name or cardholder as shown oil credit card P TOTAL $
$
Cardholder signature Amount , 440 4617 (G•OCC'OM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
•
INSPECYiON DIVISION' Business Line: (503) 639 -4171 MST
BUP
Received ' Date Requested 74 — 1 AM PM BUP
Location / 5 ,SS fX'w p - Suite MEC a — 4 7 1 / /
Contact Person C Yl ) 940 Ph ( ) 6 3 9- 6.0 PLM
Contractor A.1-6-14 itet.c..0 Ph ( ) .5.5"7 _ S � Z- SWR
BUILDING Tenant/Owner � � Si ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR-
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
LIA)**).
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
Gas Line
Smoke Dampers
na _
PASS PART FAIL
TRICAL
Service
Rough -In
UG/Slab
Low Voltage
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 /! Z .7/ Inspector Us
�j/ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL