Permit 1
, CI OF TIGARD MECHANICAL PERMIT
�r DEVELOPMENT SERVICES PERMIT #: MEC2003-00006
� �' DATE ISSUED: 1/9/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110CD -03200
SITE ADDRESS: 15795 SW ROYALTY PKWY
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: 003 JURISDICTION: KIN
CLASS OF WORK: ALT 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: DOMES. INCIN:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Replace gas furnace.
Owner: FEES
SCOTT FISCHER Description Date Amount
15795 SW ROYALTY PKWY.
KING CITY, OR 97224 [MECH] Permit Fee 1/9/03 $72.50
[TAX] 8% StateTax 1/9/03 $5.80
Phone: 503 - 598 - 9798 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 66578
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: ,,� rz LJ Permittee Signature: e-2 er nJ A4,I
Call ((5 639 -4175 by 7:00 P.M. for inspections needed the next b y
01/06/2003 10:04 5036393771 CITY OF KING CITY PAGE 02/02
RI- COuy.TY. ig. OFF USE ONLY
ERVICFCENTER - chanical Permit Application
Date received: /_tj— Permit no.: /L y�r 10000
City of King City cE ` � Ep
. ' 13125 SW Hall Blvd. QE (� _ Ptvjt>zdappl. no.: Expire date:
Tigard, OR 97223 •� ° �v Date issued: By: Receipt no.:
Clackamas Phone: (503) 639 -4171, FAX: ($4'1$
?t6 24 type:
Multnomah I Jp►f`ILO�� Case file no.: Payment t
Washington O V N 7 t Land use approval: IGABO Building permit no.: •
f S
TYPE OF PERMIT
ix I & 2 family dwelling or accessory Q Commercial/industrial Cl Multi - family ❑ Tenant improvement
❑ New construction ■' Addition/alteration/replacement ❑ Other: .
JOB SITE INFORMATION • COMMERCIAL ,; ALUATION SCHEDULE
Job address: L 1Q,! SW ' t , 4 7 / indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 7 Suite no.: value of all mechanical materials, equipment labor, overhead.
Tax map /tax lot/account no.: profit- Value $ •
Lot: 'Block: J Subdivision: 'See checklist for important application Information and
Project name: 1 5.4€/1_ jurisdiction's fee schedule for residential permit fee.
Cicylcormcy: A ; _,� ZIP: ., , . 1 & 2 FAMILY DWEL 'G PERMIT FEE SCHEDULE
De 'ption and location of work on premises: .' . i.., _ i AND COMNIIERICAL/IND a RIAL EQUIPMENT SCHEDULE
�L ' / Fee (ea.) Total
•
r_ date of c , . pled •, inspection: in y !Qty. Description Res. only Res. only
Tenant Unproven or change of use: HV.S,C'
Es existing space heated or conditioned ?,$ Yes 0 No Air handling unit +3FM -
Air conditioning (site plan required)
Is existing space insulated? Yes Cl No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: S, , f ,. ^ .4- j , j, . „, . c. State boiler permit
HP Torts BN/H
Address: •• ( )IE _ 'l6/ / /4 _
City: ,- Fire/smoke dampers/duct smoke detectors
; " .:7 ..) ‘90 ‘90 I State: d. Fi/ k d /d k d t
ZIF: f 74,) a Heat pump (site plan required)
Phone: 6 iiir-36o 7 I Fax: 41 E -mail: Enstall/replace furnace/bumer(24 ea 3 13TU/14 t ,
:.. no.: s -- y--.' • a vent Iirter l-Yes ❑ No f
LnstaUireplace/relocate heaters -- suspended,
City /metro lic. no.: / 6 wall, or floor mounted
■ame (please print): Oree444 /Z/4_e,/_5' " Vent for appliance other than ftunace
CONTACT PERSON Refrigeration:
Absorption units _ BTU/H
vame: - IA jl, . ' Sem bt Chillers _ HP
Address: Sai19_e ad , 1„ 6., Compressors , HP
Environmental exhaust and ventilation:
icy: State: ZIP: . Appliance vent
'hone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 11 res. kitchen/hur
Iu t:at
hood fire suppression system
vame: ,ttj 77 r1 3C #84 Exhaust fan with single duct (bath fans)
via ding ad ess: /5 7q-5 '''')(1) i i, Exhaust system apart from heating or AC
:ity: 0 (/1 State• I Z IP: 7,9jsei Fuel piping and distribution (up to 4 outlets)
1
Type: LPG NG Oil
'hone: ' 'p - ' ; Fax: l E -mail: Fuel ••ing each additional over 4 outlets 1
ENGINEER Process • piping (schematic required)
Yame: Number of outlets •
. Other listed appliance or equipment:
address: Decorative fireplace , _
:icy: I State: ZIP: Insert - type _- _
'hone: I ax: LE -mall: Woodstove /pellet stove
. ppliCant's signature: i• , ., , , , . Date:// /a3 Other:
time (print): .. /,.� • v� . ,
•t a+I ivrisdicuoos accept credit cads. please call jurisdiction for more information 41 Permit Zee ...... $ 'IA ,SO
Notice: This permit application minimum fee $
Visa 0 MasterCard -
miii card number; expires if a permit is not obtained
/ / within 180 days after it has been Plan review (at %) $
Expire ihi 1 d State surcharge (8%) S , ,c -&
Namc of cardholder as shown cm credit card accepted as complete. TOTAL. $ �� / f, --
5
Catdholderc+gnaure Atniwnt - - 440- 1617 0/00:COM)
CITY OF TIGARD . 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPE -CTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reque / — / AM PM BUP
• Location i 1 ,C % I Suite tt MEC : 7200 3 60 CO
Contact Person Ph ( / ) 7 "�� U PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ate
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam L�Y1
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler 7
7" i
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
Smok- tampers
S PART FAIL
ECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final J 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 /07
Approach/Sidewalk Inspector ���� !/ Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL