Permit CITY OF T I G A R D MECHANICAL PERMIT
A I DEVELOPMENT SERVICES PERMIT #: MEC2000 -00450
��! DATE ISSUED: 11/16/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1156C -09800
SITE ADDRESS: 16625 SW ROYALTY PKWY
SUBDIVISION: ZONING:
BLOCK: LOT: 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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of furnace.
Owner: FEES
MCDONALD, JACK M + BETTY L Type By Date Amount Receipt
16625 SW ROYALTY PKWAY PRMT DLH 11/14/20( $72.50 KING CITY
KING CITY, OR 97224 5PCT DLH 11/14/20( $5.80 KING CITY
Phone: Total $78.30
Contractor: .
TRI TECH HEATING
6603 NE 137TH AVE
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 360- 891 -2002 Final Inspection
Reg #: LIC 101873
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 obtai co•- . of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: I' T i Permittee Signature: 6it7 l C' } -776n1 �!f ,c
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
11/14/2000 11:41 5036393771 CITY OF KING CITY PAGE 03
Silivia NTER Mechanical Permit Application OFFICE USE ONLY
c M". r City of King y ' : to tecel ved:
Y City
i - Permit no.:// _t 13125SWLallBlvd. I) r" 00 SO
i rojecvappl. no.: Expire date:
'Tigard, OR 97223
Multnomah Phone: (503) 63 9 -4171, FAX: (503) 6847297 B y'
Washington Payment type:
C O U N T I E S Land use approval: Building permit no.:
TYPE OF PERMIT
1 = 1 & 2 family dwelling or accessory 0 Commercial /industrial
CI New construction 0 Addition t:ration/ lacement 0 Other:
q Tenant improvement
rnP O Other:
JOB SITE INFORM.%1'ION COMMERCIAL VALUATION SCHEDULE
Job address:
Bldg. address: ~ _" c... L � t"' Indicate equipment quantities in boxes below. Indicate the dollar
uite no.: value of all met
Tax map /tax lot/account no.: profit. Value $ .jequrpment, labor, overhead,
Lot: IBlorlc 1 Subdivision: '
Project name: -- *See checklist for important application information and
jurisdiction's fee schedule for res/denrial permit fee.
City /county: ZIP:
I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE.
Description and location of work on premises: AND COi1I11ERICAL/INDUSTRI: 'IL EQUIPMENT SCHEDULE
Est date of cord • legtrri
ons • _ don: Fee (ea.) Total
Tenant improvement or change of use: AC;� don gir Res. oil Res. onl
Is existing space heated or conditioned? ❑Yes 0 No Air handling unit CFM ■ ��
Is existing space insulated? p Yes 0 No Air conditioning (site Ian required)
MECHANICAL- CONTRACTOR Bot er / Alteration pr existing 1IVAC system � =
wntpressors
B usiness name: State boiler permit no.:
`
— HP Tons BTU/H II
Address: a
City: - �;: ,�� l; _smoke am .. ts/duct smoke detectors -�
y� � , wit. State: ZIP: .r 67�
Phone:
%) - E-mail: l -m ail: Ins • replace . urner ;ice BTU • �
CCB no.: I t7 �7 Includin _ ductwork/vent liner 0 Yes ti(No 1 r�
City/metro lie. no.: �' J wall, replace o elocate heaters , suspended, Ill -
Name lease wall, or floor mounted
P� ` ( Vent or a • • ranee other an furnace MI
CONTACT PERSON Rehr _era n: ■ ��
Vane: - - Absorption units BTU/FI
Chillers
\ddresS: . • . < k Compressors HP _ _�
,icy - ZIP nvirogmental exhaust and ventilation:
'honet 0841 - _ ECM i i q • •li vent MINIM
•ra' E -mail: l�rjer exhaust _ � r
OWNER Hoods, ype U res. ache azmat ■
lame: (LL hood fire suppression system
a� Exhaust fan with single duct (bath fans) -�
tailing address: ,
ity: • , •xhaust system apart from heatin: or AC _
liaison - �� Fuel piping and . . tion (up to 4 outlets) ill
i yal r F ax: E -mail: Tom' LPG NG Oil -�
ENGINEER
Fuel • r • in. each , • ditional over 4 outlets _ ��
Process piping (sc emu% requumd)
arils: Number of outlets M
idress: • her f . ted appliance or equipment:
ty: • ZIP: Decorative fireplace
-- __ State: Insert
type
.one: Fax:
E -mail: ` oodstove/• net stove
Other
�plicant's signature: Date:
me (print). Other: 11111111 VI jw;adietions accept credit cads, please call juriadktjen for more information. �
isq 0 MasterCard Notrce: This permit application Permit fee $ ?oZ - 5
• and Dumber. / / erpir+es ll a peradt is not obralned Minimum fee $
[:spires within ISO days after it has been Plan review (at %) $
Name of cardholder ere shown on ardit card accepted as complete.
State surcharge (8%)..... $
Cardholder denature S - TOTAL $
Amount
440-4617 (baOACOM)
02/01/2001 17:42 3608911910 TRI TECH PAGE 02
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Litie: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1— 7i AM PM BLD
Location Z 3 w Z) G,�it w Suite MEC "OP — e �S
Contact Person / 8i' / y Ph 4r1`1 3/ 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation PI2O / ^ �j �, , Drywall Nailing _ 1� �7 qt e FU-y, 6 g
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART AIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS BART FAIL
MEC�IANfEAL7
Post & Beam
Rough In
Gas Line a
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
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 Date ? ° /
Other Inspector g Ext Z
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.