Permit A �iT OF TIGARD MECHANICAL PERMIT
4 DEVELOPMENT SERVICES
PERMIT #: MEC2002 -00551
.,� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/5/02
PARCEL: 2S115BC -09400
SITE ADDRESS: 16780 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: Furnace installation, duct and liner.
Owner: FEES
CHARLIE BULLIS Description Date Amount
16780 SW ROYALTY PKWY [MECH] Permit Fee 12/5/02 $72.50
KING CITY, OR 97224 [TAX] 8% StateTax 12/5/02 $5.80
Phone: 503 - 598 - 1972 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 624 - 2704 Heating Unt Insp ✓
Final Inspection
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699. /
Issued By: 4 /< -`; Permittee Signature: -
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
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_ 12/04/2002 10:01 5036393771 CITY OF KING CITY PAGE 02/02
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` - rr." • • OF KING CITY PAGE 01./ 02
CITY
r Kt /22/ 001 10:46 5036393771 •
SERVICE (INTER Mechanical Pe ion OF;. ICF. USE ONLY
7'''-' , \ City of King City C 4 2002 bate received; a.0 Permit no�171EC1 _ —OAs$/
,� C 0 y J' 13125 Hall Blvd. Project/appl, no.: Expire date:
Clackamas Pho OR 97223 23 171, FAX: CITY O 11 Date Issued: liy;� Receipt nu.:
Multnomah Case file no.: Payment type: _
—
Washington .
o N T t e s Land use approval: Building permit no.; •
TYPE OF PERMIT
Cl I & 2 family dwelling or accessory Q commercial/industrial 0 Multi - family O Tenant improvement
CI New construction ,, Addition/alteration/replacement Q Other
JOB SITE INFORMATION CON1MERCIAI.
Job address: '7 , _ ../ 'o _ A. � . // _ Indicate equipment quantities in boxes below, Thdicate the dollar '
Bldg. no.: Suite o.: I • value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value S — •
Lot: Block Subdivision: *See checklist or important Inportarlt app(Icatiort information and
Pro ect name: Jurisdiction fee schedule jbr residential permit fee.
City /count : C__„.. ZIP: . 1- I & 2FADMILV »WE 'INC PERMIT ITC SCHEDULE
Description and location of work on premis44: AND COMMERICAL/IN 1 IS'1'ItlAl. [QUIP:MATSCIIEDULE
Fee (ea•) ' Total
Est. date of completion/Inspection: Des rlpdoa Qty. leas. only Ras. only
Tenant improvement or change of use: HVA,GI
Is existing space heated or conditioned? O Yes 0 No Air handling unit, CFM
Air conditioning (cite plan req
Ls existing space insulated? 0 Yes 0 No Alteration 'of existing HVAC system
N1EChIANiCAI, CON'T'RACTOR • Boiler/compressors -
— i
State boiler permit no.:
3usirtess name: _. , , , I P Tons BTIJIH
%ddress: , 0 6,26, ,4 1 7 I Fue/smo pets/QU smolee dotector9 •
:ity: Al State:* ZIP: �, Hut porn • (site pledrequired
'hone: � Fa : f! ak a E-mail; tall/rep ace fit .urner.`
,.,�� B'I•tiU
:CB no.: �(� 3 $ f icltulin ductwork/vent line • H Y Cl N —1
' Iota repl relocate eaters — suspended.
:sty /metro .lio, no.: / '74,Z wall, or floor mounted
lame (please print): zo M, ` - ) vent fora hence other than #lttnecm .
CONTACT PERSON efrigeratdoa:
Absorption units _ BTU/.H .
'acne: PAL/11 C 4 f by Ch illers _ HP
ddress: - Compressors B HP I
• Environmental exhaust and ventilation:
ity: =NM ZIP: Ap • fiance vent
Corte: G Fax :5j • . 1r - mail; Dryer ox east
OWNER • Hoods, Type I/ II/res. kiteTten/i
�l a hood fire suppression system W _
A
ism: C ell, L / Exha fan with single duct (hash fans) _ J
ailing address: , .. �/i a ds / x suet system - •srt from hcs- ing or AC
ty: c.. State, 6 , i MP:
Fuel pip ag and distribution (up to 4 outlets)
Type; LPG NO. oit
one: 42, 'y am E -mail: Fuel • 1.111 ; each additional over 4 out ets
ENGINEER Process piping (schematic req•aia ‘._ 1
me: Number of outlets ,
than te app ac or aqulpmeot
dregs: • Decorative tireptuce
y: State: ZIP: insert w type q
'ne: Fax: E-mail: oadstove/pe et stove — I
'lit:ones sigmature411 � Date: Other. _
�■ - �� Other: • _
ste ( print): / w, ii ,`
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' ..1
i i ) urlsdtclioes accept credit cards, Pfwa call Jurisdi ;oo for throe inrortruiltm. Permit fee.. ,,,,.. $ 70? . eD
Nottae: Thi ermu location Minimum fee $ _ � (
to A MasterCard P a PP Di
bb
seta umber _ f _a erPrres if permit is not obtained plan review (at %) $
-- -- E pires . within 1 d4 days after it hat been Ci ratr, 4 :m-e ., . • !poM,\ C '
CITY O D 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received O Date Re uested ! ° // AM PM BUP
Location / 7 !� O ez.1 �/�-W Suite MEC 2 J bo 5757
Contact Person pa4ri Ph ( )
6,2 � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes:
Post & Beam �Shear Anchors / Ext Sheath/Shear �r•�
Int Sheath/Shear /
Framing 40 L.:C GY - %:C)1 z liu - e 37g/Co
Insulation
Drywall Nailing
Firewall
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
PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl 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 ! t_ G 2 -_
Approach/Sidewalk Date , Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL