Permit CITY TIGARD MECHANICAL PERMIT
srr� DEVELOPMENT SERVICES PERMIT #: MEC2000 -00454
nrs
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/21/2000
PARCEL: 1S133AD-06800
SITE ADDRESS: 10875 SW SUMMER LAKE DR
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 112 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of gas fireplace insert and gas piping.
Owner: FEES
HARPER, JAMES P AND Type By Date Amount Receipt
PATRICIA J PRMT CTR 11/21/20( $72.50 2720000000
10875 SW SUMMER LAKE DRIVE 5PCT CTR 11/21/20C $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
G P + W SYSTEMS INC
732 MARBLE RD
WASHOUGAL, WA 98671 -9601 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 360- 835 -3516 Mechanical Insp
Reg #: LIC 00108176 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 of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: f ' i - Permittee Signature: 1J /9/ AM-f eZ
CaII (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
11/14 /00 TUE FAX _ Kent . & Lynne Kettering RI 0 0 1
•
I .
r - A A Mechanical Permit Application
•
Date received: /00,--d Permit no : : /iE6' 0 -0,0 `IS
� City Ti and
s: �l�' :_„ � g Ptoject/appl.00.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building pemutno.:
TYPE OF PERMIT
1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi- family ❑Tenant improvement
4 New construction ❑ Addition/alteration/replacement ❑ Other.
JOB SITE INFORMATION COi1 VALUATION SCHEDULE
. Job address: /0175 S(.i J .f tJ"n'ut4_. A Drupe Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ •
Lot: Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: / ' ZIP: 97ZZ3 I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: /rzJin '&1 :AND COMIMERICAL/INDUSTRIAL EQUII'MEN'TSCIIEDULE
Gin and ,4,e /ace insert- Fee(ea) Total
Est. date of completion/inspection: /Z /' /a6 Description Qty. Res. only Res. only
HNAC:
Tenant improvement or change of use: Air handling unit CFM •
Is existing space heated or conditioned? 0 Yes lli No • Ai conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
1IECIIANI(:AL CONTRACTOR Boiler /compressors
Business name: G P '-&J S s kMIs G State boiler permit no.:
r f HP Tans BTU/H •
Address: 73 Z. m G,.4 /e /Q erad Fire/smoke dampers/duct smoke detectors _
City: U.k.Sitast 4� �/ I Statet4i-I ZIP: e 7/ Heat pump (site plan required)
Phonta0 4s3S /(o I Fax: n:5 Install/replace furnace/burner BTU /H
Including ductwork/vent liner O Yes 0 No
CCB no.: iOr/ 74 Instal lreplace/relocateheaters- suspended,
City /metro lic. no.: 3715 _ wall, or floor mounted
Name (please print): "£TYA Vent for appliance other than furnace
CONTACT PERSON Refri
Absorption units BTU/H
Name: G y,, of c Xe 'llercit5 Chillers HP
Address: Comyressors HP
So oM t e ° Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U II/res, kitchen/hazmat
hood fire suppression system
Name: J/ /71 7 ~e Exhaust fan with single duct (bath fans)
Mailing address: A , 4 f St - (, Exhaust system a . an from heatin : or AC
City: State ZIP: 9 Z e p p i g an • ' istnb to 4 outlets
Phone: Fax: E -mail
Type: LPG Oil S• y0
Fuel piping each additional over ' out ets
ENGINEER Process piping (schematic required)
Name: Number of outlets
( Other listed appliance or equipment:
j Address: \` Decorativefirep e
City: State: ZIP: - Insert -type / /)
Phone: Fax: E -mail: Woodstove/pellet stove
Other:
Applicant's signature: I Date: Other:
Name (print):
� Not all Jwi.d_u co s accept information credit cards, please call jurisdiction for more ioforatiot
Permit fee $
0 Visa MasterCard � Notice: This permit application Minimum fee $ 70'1 • 50 Credit card n miser: !ri YZy Zd 13 AZ4Z /OM 6 7/ 0/ ex pir es i a permit is not obtained Plan review (at _ %) $
_� w 180 days after i t has been State surcharge BOO . _ 5. B
ofc •own m credit card accepted as complete. TOTAL •
_ _. _ $
■ Cardholder algaatwe Amount
CITY-6F TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1—.5 —.S AM PM BLD
Location /O Y 7s SW $W,,, -en 4/4 Suite MEC Zjov v c/ °(
Contact Person // Ph 3 o - 83> l> I PLM
Contractor / A4kfr-e"- Ph SL y _J3 23. I✓ SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain • SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear /
Framing `ii ? �/ b
Insulation
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
PAS PART FAIL
Post & Beam
Rowab In ih fI. l'
C . 0_2_ 1 1 ine�
Smo a Dampers
CFi
P S PART FAIL
T RICAL
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 I` K/ / Inspector QS/ Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
-4 Inspection Description Date Passed By I Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural -
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing J Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing 4 Inspection Description Date Passed By • Post/beam mechanical
Suspended ceiling Gas line S / 0.1
Engineered soils Mechanical rough -in 12/ (f,D
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final [3(4/71
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP — Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils J Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP PLM, SWR, ELC, ELR, MEC, SIT PERMITS
CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2000 -00454
.,41,1-'7''J DEVELOPMENT SERVICES DATE ISSUED: 11/21/2000
=-� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S133AD -06800
SITE ADDRESS:_ 10875.SW. __SUMMER_LAKE..DI
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 112 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas fireplace insert and gas piping.
Owner: FEES
HARPER, JAMES P AND Type By Date Amount Receipt
PATRICIA J PRMT CTR 11/21/20C $72.50 2720000000
10875 SW SUMMER LAKE DRIVE 5PCT CTR 11/21/20C $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone: -
Contractor:
G P + W SYSTEMS INC
732 MARBLE RD
WASHOUGAL, WA 98671 -9601 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 360 - 835 -3516 Mechanical Insp
Reg #: LIC 00108176 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 • of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: Permittee Signature: e fi /��i�_ /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day