Permit .CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001- 00.139
� DEVE HO BMEN SERVICES R E ) 639 -4171 DATE ISSUED: 04/30/2001
PARCEL: 251 10C D -03900
SITE ADDRESS: 15645 SW ROYALTY PKWY
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: 034 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:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Electric furnace to gas conversion
Owner: FEES
BOTTINELLI, HELEN Type By Date Amount Receipt
15645 ROYALTY PARKWAY PRMT JMT 04/30/20C $72.50 KING CITY
KING CITY, OR 97224 5PCT JMT 04/30/20C $5.80 KING CITY
Total $78.30
Phone:
Contractor:
D + R HEATING + AIR COND
PO BOX 1292
27251 S DAVE RD REQUIRED INSPECTIONS
CANBY, OR 97013
Gas Line lnsp
Phone: Mechanical lnsp
Reg #: LIC 84489 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 -• ! ! thr• - , t a R 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OU ■ by c- o t . 246 -9189.
Issue By: i9 J Q Permittee Sign . �/
Call (5 06) 639 -4175 by 7:00 P.M. for inspec ions needed the next business day
04/30/2001 10:32 5036393771 CITY OF KING CITY PAGE 02
Mechanical Permit Application
Iii411111111111111‘111.1111111
_ Datereceived:i 3p -O/ Permit no:: a.$6 I - DO l 31
._.1,1-"':'.11_1. City of Tigard Project/appl. no.: Expire date: •
CtryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 -
Phone: (503) 639 - 4171 Date issued: By: I Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: . . Building permit no.:
'1111: OF I'I:R\11
Q 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family • ❑ Tenant improvement
Q New construction i' ddition /alteration/replacement 0 Other:
JOB 31'I'L INFUR11:1'l'ION (:O IIVILIttIAl. VALUATION SCllLUUI.E
Job address: ' ' f ,,f,tWarill Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Sul o.: value of all mechanical materials, equipment, labor, overhead,
Tax m • . tax lot/account no.: profit. Value $ , .
Lou Block: Subdi vision: *See checklist for important application information and
Preect name: Jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: i c 2 FAMILY 1)11'FLLIN(, mum r I'I'.I•, SCHEDULE
D r , o, :i , 1.•.•:.. . k • . � ,. %NI) ('t)Il'lii'II 1 11 '.11./INI)li%'I•RIAI. EQl!Il 1EN1'SClIl in cI,I; •
-- I • Fee(ea.) Total
Est, date of completion/inspection: : OQ/ Descri .. on El Rea. onl Res. only
Tenant improvement or change of use: HVAC: ■ _�
Air handlin 1 unit CFM
Is existing space heated or conditioned? lirfes Q No tr con • ttonmg site • lan , uired)
•
Is existing space insulated? F '?es 0 No Alteration o existing ' ' • system MEM. —
Nll I I ANI( :1I, CON 'I'R ;1('7Y)R tedcompre
Business name: - _ � al State Boiler/compressors
ate belle; Permit _ no.: /7)....5-1.
J^- HP Tons BTU /H
Address: 0 _ 2 • ` Fire/smoke • ampers/duct smoke detectors MI
1 .a Heat .um. (site • Ian •uired) —
Phone,. , 1 ofilim .. E -mail: note l' ep ace ma tuner BTU/H - -�
Including ductwork/vent liner O Yes 0 No
s . rep ac relocate heaters - suspended,
City /metro lie. no.: _ ,' wall, or floor mounted � --
Name (please print): Vent for • • •fiance other than furnace —
CONTA( PrItSON Absotptlonunits BTU/H
�.... Chills HP M
Address: O1 a 12G _ Corn . :ors '" HP
y roan= a an vents anon: ■
EMErtil ZIP' ` Appliance vent
Phone: _ , , )4, 1 , B - mail: D erexhaust —
OWNER oods, ype I II /res. kitchen/hazmat III
. hood fire suppression system
Name: Exhaust fan with single duct (bath fans) -
Mailing address: - aust system a • art from heatin: or AC NM
City: MIMI ZIP: p p ' . an' ' ' u on u • to • out ets FA •
Phone: Fax: ]email: Type: GPO 4i Oil
Fuel .1. ing each additional over - out ets — . Nom
ENGINEER ' meta prpmg schematic required) =�
'Number of outlets IIIII Name: Other r F. , app ,: pre or equipment: ■ -
Address: Decorativef — 'lace
City: • State: ZIP: nscrt •e - - 1.1=1
Phone: /' '- mail: Woodstover/ llet stove NM • e
' ' ,. �• .� r _
Applicant's sign / � Date: b�'l�- • , i er: - -�
s — -
Not all Jurisdiction accept credit cards, please call jurisdietion for more 4.thnaapon. Permit fee $ 7...2 . S
O Visa O MasterCard Notice: This permit application minimum fee $
e if a permit is not obtained
Credit sue number: / I Plan review (at , 90) $
Expires within 180 days after it has been State surcharge (8%) .... $ .5 , P v
Nave of cardholder as shown on credit card accepted as complete.
$ TOTAL $ '2 'l
,+� /
Cwdholder sil aatare • Ataotuµ 440-4617 (6IO0ICOM)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested .- / AM PM gL
Location Y ) 5 w To a try y w4 7 Suite MEC --e /.3
Contact Person AAi (4 ^ Ph G37. 7 Z Z U • PLM
Contractor Ph Zjz -,V. 4 ) SWR
BUILDING Tenant/Owner Pk" 1 -c. c( )•it • 2-col
Retaining Wall LR_
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam l
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing i
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING ✓
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
VIECH
Post & Beam
Rough In
Gas Line
Smoke Dampers
Fig ..
th ;.
_;RT FAIL
. RICA
ice
Rough In
UG /Slab
Low Voltage
Fire Alarm
41 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 ,/ Inspecto ' ` l Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.