Permit M
I
CIT OF TIGARD MECHANICAL PERMIT
CIA DEVELOPMENT SERVICES PERMIT #: MEC2001 -00463
..�II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/01
PARCEL: 1 S125DB -06500
SITE ADDRESS: 07045 SW SHADY LN
SUBDIVISION: SHADY DELL NO.2 ZONING: R -4.5
BLOCK: LOT: 038 JURISDICTION: TIG
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas fireplace insert, gas piping and outlet.
Owner: FEES
SCHNASE, KIM ELIZABETH Type By Date Amount Receipt
7045 SW SHADY LN PRMT CTR 12/18/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 12/18/01 $5.80 2720010000
Total $78.30
Phone: 503 - 245 -5656
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 620 -5643 Mechanical Insp
Reg #: LIC 66578 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 -0010 through OAR
952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling
rnfl»aF -cai R•
Issue By:,_ 40./r Permittee Signature: ' ? �.erY L
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Dec 17 01. 04:31p Specialty Heatrfig 503 598 0718 p.1
f .
t
Mechanical Per ' _• _ ' •
r IS Daterere.ived: )/6' t'cmiitczu.: /� v / "� 3
,, �:J I City �t Tigard
A 13I35 SW Hall Blvd. Tic Project/appl_no.: Expire date:
City of1°igard b it1 R I I LULI1 Date issued:
Phone: (503) 639 -417I By: 1 Recei e1.
Fax: (503) 598 -1960 an OF n�-��� Case a
�A'altrir ase file no.: Payment type:
Land use approval: BUILDING DIVISION Su
uilding permit no.: .
• • TYPE OF PERMIT I
•
1 & 2 family dwelling or accessory • Commercial/industrial ❑ Multi -famil
0 New construction Addition/alteration/replacement 0 Other y 0 Tenant improve :rent
. JOB SITE INFORMATION COMMERCIAL VALUATION SCHED II
.Job address: p / `
. J 4 Indicate equipment quantities in boxes below. 1ndieat : the dollar
Bldg. no.: Suit no.: value of all mechanical materials, equipment, labor, o t erhead,
Tax map /tax lot/account no.: profit. Value $
•
Lot: , Block: Subdivision: 'See checklist for important application information , .•td
•
Project name: A/4-$ -✓ jurisdiction's fee schedule for residential, permit fee_
City /county: -r e . - _ :.... . ZIP: 0 ' 7 ( 9., .1--3 1 & 2 FAMILY DWELLING PERMIT FEE SC I EDULE .
Description a d ocatio i f work on premises: , , _ , rL iv[
; AND CartiZ) N °1tilCALIINDUSTI�IALEQUIPl11ENT l HEDULE
4 /'/P
• �
Est. date of completion/inspection: /•A , 0 I)esc i Fee(t :c) Total
nptiott Qty. Iles. c tJy Res. only
Tenant improvement or change Of use: E[YA
Is existing space heated or conditioned? ] ' r Yes L7 No Air handling unit CFM
•
Is existing space insulated? g ' es O No Air conditioning (site plan required) M
Alteration of existing 1 AC system '
MECHANICAL CONTRACTOR Boiler /compressors
Business ram 0....t._ y {Z L ¢ 3 State boiler permit no.:
Addc> ss: _ HP Tons eTU /H •
� / f - ai e S f- F ire /smoke dampers/duct awoke detectors - .
Cit y: I 'a,) Q State:O,e ZIP: y 7b a 3 • • Heat pump (site p an required) w
•
Phorte_,�p3 6k14 Fax598 E - mail: nstall/replace furnace/burner U/I-I
CCB no.: C,...5 7 Including ductwork/vent liner 0 Yes ❑ No
/_ �• nsta ►rep - suspended, •
City/metro lie_ no.: I K � (, ! wall, or floor mounted
Name (please print): s r pt --j-( .1-.5 Vent for a p Lance other than furnace 0
CONTACT PERSON Reinge oa
Absorption units BTU /I-I
Name: a A - L' N 4 tie Chillers HP -
Address: sa• $-- /8/1' S • � Com•ressors HP
City: 7 i ZIP: ?ems3 —' Appliance onnav exltattWYana vent anon: -
GI' Stn e:Q
: ppliancevent e;nt
Phone. .• 3 6.20 £' Fax: 59C-01/8 E -mail: Dryer exhaust MI
•
OWNER lion. s, 'ype I/1 res, kitchen /h:rz„tal
/? Qi hood fire suppression system - Exhaust fan with single duet (bath fans)
Mailing address: 7•0 .„,_5(.4) • S!7 et .e� ai.t Exhaust system a. art from heating or AC '
.
City: l - Cl State y,t ZIP: q 7a ,A,,3 Ty pup ' g • an dis4i ,uu (t to ouuets) - •
�
Phone: Type: LPG /[ . NO O .
Email: Niel • iping • each additional over 4 outlets -
: y4 - S ( Fa • ENGINEER • ' recess piping (schematic required ) ` .
Name: Number of outlets
•
Address: Other listed appPiaoce or equipment:
•
Decorative fireplace
.City: _ State: ZIP: Insert — type' S
Phone: E-mail: _ WOO tove/pellctstove •
Applicant's sign ire: f r Other.
A
pp g ) . F . Date' e /1 0/
Name (print): •,1 !1�'��f
• ' wixticuanc nccept emdit can ig. please Coll jusi for morC infonnuion' Permit fee `S S
No j! i
Asa ❑ Niaste . Notice: This permit application $
Credit cans ,t..e,,, y ' r . ` _ ,J. , ` :., , a ,, ,,, x if a permit is not obtained Minimum fee _ .
Plan review (at _ co $
_Sher ! j R . L? 1,1 E spites within 180 days rifler it has been Sine ch 8% surar c t >F a a,. , ea—.---,7,--1 accepted as complete. K ( ) $
Nagle 5-
.. .i shown on cst.'t Ca ll,... , s TOTAL - $ 70. 3v
. older signature Amount ,
4 t7 (5/00 /COM)
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
Date Requested / � - oZ Co AM a =P =• BLD
Location �
D . ag Suite MEC ?V l - O4 <t( 3
Contact Person Ka - c'i,,,.,_.i Ph PLM
Contractor Ph 6 7 S? 3 SWR
BUILDING Tenant/Owner ELC
Retaining Wall _ ELR
Footing � /_
Access: rr''�
Foundation Cc/ �) I �' c f „ ; � 6f (z - / / -- - - �RP
Ftg_Drain c/ > GN
Crawl Drain Inspection o tes: (C/G-
'
Slab SIT
Post & Beam •
Ext Sheath /Shear - '
Int Sheath /Shear
Framing .
Insulation
i
Drywall Nailing /
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
PP1:- RT FAIL
l a HANI ._'' L
Pos • =e am
ough I. C P- 5 iz r 7t/q L-
,. ✓
Dampers .
`�� _ 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 / / j G ( ;�
Other ;. Date 7 / ? L Inspector Ext
Final
PASS BART FAIL DO NOT REMOVE this inspection record from the job site. '