Permit r { U
CITY OF TIGARD MECHANICAL PERMIT
a }l� DEVELOPMENT SERVICES PERMIT #: MEC2002 -00202
I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/15/02
�
PARCEL: 2S104DA -13100
SITE ADDRESS: 13065 SW SECA CT
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 117 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of a/c unit.
Owner: FEES
ERIN RETSINAS Type By Date Amount Receipt
13065 SW SECA CT PRMT CTR 5/15/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 5/15/02 $5.80 2720020000
Total $78.30
Phone: 503 - 789 -6200
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 503 - 281 -0752 Final Inspection
Reg #: LIC 8897
EXPIRED
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 th - • : • • ays. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility . ification Ce te Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 -0'4 1 -0080. You ma o• =i• c• vies of these rules or direct questions to OUNC by calling
(fl .4.R -A1 - A �� -
Issu> By: r ! ! J �� � � , Ao!/ Permittee Signature: ,,,
•
Call (503) • '9-4175 by 7:00 P.M. for inspections needed the next . usiness day
rNcTIL Heating & Cooling PHONE NO. 503 2825722 Ma 10 2002 03:11PM P1
Mechanical Permit Application
Date received: 6 ,0 O%Z Permit no.: fire capop
41 city of Tigard , �_„ `, g Project/appl. no.. Expire date:
City of Tigard Address: 13125 SW Hall BIvd,1'igaYd OR 972 • Date issued: By 1/ I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 591 -1960 `,` L, 1 '') Case file no.: Payment type:
Land use approval: (• • i , $.( (, } ; 1• J : � Building permit no.:
q
1 Y 1' l:: 01: 1' r:I l 11'
1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction 0 Addition /alteration/replacement Cl Other.
JOB SITE INFORMATION CO\IMERCIAL VALUATION SCHEDULE
Job address: e7 ( SLA3 S e or Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suit no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ •
Lot: (Block: ( Subdivision: - "See checklist for important application information and
Project name: 2 { (02.1 •
jurisdiction's fee schedule for residential permit fee.
City /county: T j c Act • J ZIP: it1-7 ZZ3 I & 2 FANIILV DWELLING PERMIT FEE SCHEDULE
Description and Iocation of work on premises: A ND CO%Ii11ERICALIINDUSTRIAL EQUIPi\IENT.SCI(EDLJE
511C.t_ Ma_ to&1o; ttilaa- Fee(ea.) Total
Est date of completion/inspection: Description Qty. Res.otdy Res.only
Tenant improvement or change of use: HVAC:
space heated or conditioned? 0 Yes O No Air handling unit CFM
Is existing P �Circonditioning (site plan required ) le{.
• is existing space insulated? 0 Yes 0 No Alteration of cxistrng 11VAC system
1%1E(:II CONTRACTOR Boiler /compressors
Business name: 1 - 1., , - -7 1 t l 'l. S t a te b H permit no.:
BTU /H
Address: Lis zo )3 . L l Iv A S , Fue/stnokc damper d uct s moke detectors
City; 7p State. ZIP: Z( Heat pump (site plan required)
Phone: 2S[ Yf75Z. J Fax Z$Z - j7Z -mail: nstalVreplacefurnacc/burncr BTU /H
Including ductwork/vcnt liner 0 Yes 0 No
CCB no.: g g ns t cplace/relocateheaters suspended,
City/metro lie. no.: • wall, or floor mounted
Name (please print): i Z S , - "er C it` Vent for appliance of cr than furnace
(ONT;ACT PERSON — fierattnn:
Absorption units BTU/H
Name: 1 ec c-1j3 Chillers HP
Address:
Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust _ OWNER Hoods, Type 1/ 1Ures. kitchen/hazmat
hood fire suppression system ,,
Name: e:03 4R€'f S 10 it S Exhaust fan with single duct (bath fans)
mailing ddress. Exhaust s stem` apa�{'Pi ruin heating or AC
g : 13obS StrJ Sc C �'
Ci State: ZIP: Fuel piping and distribution (up to 4 outlets)
ty: ; ' C�At#l� \ Type: LPG NG Oil
Phone: , — faxi0 Fax: E -mail: Fuel . i . in • each additional over 4 outlets
ENGINEER ' • ess piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment -
Address: Decorativefircplace _ •
City: I State: I ZIP: Insert-type ,
Phone: Fax: E-mail:
tether:
Applicant's signature: Date: -/6-eiL Other:
Name (print): d ¢
'Na an juraaicuans axge ae li Oil% pleura c211 j nrisdrctian rc'r mare inf Permit fee $
�.Yrsa 0 MasterCard Notice: This permit application Minimum fee $ ell .
/ / expires if a permit is not obtained Plan review (at 3b) $ to
c3°4it card Bombe. w ithin 180 days after it has been
P °°a State surcharge (8%) $
N erdQ owe pee card � as accepted as complete. TOTAL $
e� • EXPIRED 3o OM)
78
FROM-: ANCTIL Heating & Cooling PHONE NO. : 503 2825722 May. 10 2002 03:12PM P3
,ate ti. y
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15'
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Erin Retsinas
13065 SW Seca Ct
•
Tigard, Oregon 97223
W/O 21621
EXPIRED