Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001 -00280
.,DEVELOPMENT SERVICES DATE ISSUED: 08/03/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S125DD-04600
SITE ADDRESS: 09785 SW V€N CT V
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 ZONING: R -4.5
BLOCK: LOT: 054 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of free standing fireplace.
Owner: FEES
STAN HALL Type By Date Amount Receipt
9785 SW VEMTIRA CT/ PRMT CTR 08/03/20( $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 08/03/20( $5.80 2720010000
Total $78.30
Phone: 503 - 721 -5935
Contractor: •
OWNER
REQUIRED INSPECTIONS
Gas Line lnsp
Phone: Final Inspection
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain •ies of theseles or direct questions to OUNC by calling (503)246 -9'B9.
Issue By: _ % f Permittee Signature: /d( 40P „,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
07/30/01 MON 09:02 FAX 503 598 1960 CIT1• OF TIC•1RD - , • • •- 11002
16 4.
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MechanicalPermt , ca ' ,� �.,_
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� ® Daterece M O I Permit no. a/ / / -Oba$D
1 *,yl C of Tigard �LECE /VE® Project/appl.no.: Expire date:
Address: 13125 SW Hall Blvd, Tigar 1, OR 97223
City of Tigard Date issued. Receipt no..
Phone: (503) 639 -4171 AUG ,
Fax: (503) 598 -1960 CO M '- ' 200 Case file no.: Payment type:
Land use approval; � EVE p,,, Building permit no.:
3 •i 5 ' 1. of. P ri i%IIT . i' ' „,,+ rl ,i t. ..f
I & 2 family dwelling or accessory 0 Comm :rcial/industrial 0 Multi - family 0 Tenant improvement
U New construction 0 Addititm/alteratton/replacement 0 Other:
” ,''JOBSITE;L\FORRIATION ,''` •• x, "CO111MERCIAI \'ALlATION SCHEDULE , '
Job address: /MS Sw VcN1-vtt4 Cr Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: J Suite no.: value of all mechanical materials, equipment, labor, overhead,
profit. Value $ I. -S 0
Tax map/tax IoUaccount no.:
Lot: !Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: T/0/)...0 64/ 4 (4 • ZIP: 6 1 7L2.3 - `$ /(o 0 ' s;' 2 FA'11ILY D\VLLLING PFRl1 ITT CE SCIIEDULI,1,
Description and location of work on premises: /A! CT1I // ANTI, COMM ERICAL /ISDUSI11141 EQUJ pML\TSCIIFDULF
� u e - Sr•m►OtAt5 C 4 � ' 1 2 e ( O I / J • c r Y ' Fee (ea.) Total
P J P y / / l & a / Description Qty. Res. only R es. only
Est. date of corn letion / ins action: IIVAC:
Tenant improvement or change of use: Air handling unit CFM •
Is existing space heated or conditioned? 1 s 0 No Air conditioning (site plan required)
Is existing space insulated? grles 0 No Alteration of existing IIVAC system
tt `MIFCII:ANICAI `;1 roller /compressors
� Y Stale boiler permit no.:
Business name: 0 IA, l .C/1.. C0 4."7 CT&li • _ IIP Tons BTU/14
Address: i smok ampers /duct smoke detectors
City: I State: I :UP: Heat pump (site plan required)
Install/replace fumace/bumer BTU /H
Phone: I Fax: I E-mail. Including ductwork/vent liner O Yes U No
CCB no.: Ins tall /replace/relocate heaters - suspended,
City/metro lie. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
ReMgendon:
, ,i . c COI� IA( .1 'PERSON . =`' ' - r' - -'•• Absorption units BTU/H •
�7 444 Chillers HP
Name: t Compressors, HP
Address: q 7Srs t4/ Vet V4-A -- CT Environmental exhaust and ventilation:
City: T15Rti.0 I State: 04- I t11 7 z z.3 Appliance vent
Phone: 503 — 7Z/ -S933 Fax: sva -i "- rf 1- E-mail: Dryer exhaust
PI' /h
Hoods, Type 1/ II/res. kitchenarmat
011TITi ` " hood fire suppression system •
Name: Acq G AS 4 L ' d V t3 Exhaust fan with single duct (bath fans)
Mailin address: _ - - . _ Exhaust system apart from heating or AC
g - Fuel piping and distribution (up to 4 outlets)
City: (state: iZIP: Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over outlets
.t, r + ' ENGINI•EIi 1. ••' • Process piping (schematic required)
• /A ' Number of outlets
�
Name: r Other listed appliance or equipment:
Address: Decorative fireplace
City: State: ZIP: Insert -type
Other: _rue llet stove �■�
Phone: Fax: / E (Mier: Frt4� ;hi-PAN ti�a S
Applicant's signature: , - 71 r h ate: /I ,2 Other:
Name (print): Si�40,1 14.11
Permit fee $ tea �
Not all juris 0 MasterCard
Ms accept credit cards, please talc jurisdiction for mote a formation. Notice: This permit application Minimum fee $
0 Visa ❑ expires if a permit is not obtained Plan review (at %) $
Credit card number: pitt — within 1 SO days after it has been State surcharge (8%) .... $ 6.. Name of cardlmader as shown on credit card accepted as complete. TOTAL $ 7 �)
$ Cardholder signature t oum 440.4611 (6JVWCOM)
CITY TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested V..- $ AM PM BLD
Location q7,5 tiavv Suite MEC J — .6 u Z-YO.
Contact Person 3 - /)41PPh 7Z / 3 � f PLM
Contractor Ph SWR
BUILDING Tenant/Owner 9/0 L( Ce-4( 4,(J/1".1 E LC
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 CMS ' i'r'e -{ T'T- TC ST = go FT °Z"F r s i Gfif�i�! v S
Insulation
Drywall Nailing C
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
PASS PART FAIL
W
Post & Beam
Rough In
moke Dampers
inall
�ASI 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
Other Date 9 5 �/ - Inspecto E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.