Permit ,
CITY TIGARD MECHANICAL PERMIT
l�
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00004
^`'�" „l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/5/2005
PARCEL: 2S104AC-01400
SITE ADDRESS: 13090 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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: 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: Replace furnace.
Owner: FEES
WHITE, ELLEN E Description Date Amount
13090 SW WALNUT [MECH] Permit Fee 1/5/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 1/5/2005 $5.80
Phone: Total $78.30
Contractor:
CARSON OIL COMPANY INC
3125 NW 35TH
PO BOX 10948 REQUIRED INSPECTIONS
PORTLAND, OR 97296 -0948 Heating Unt lnsp
Phone: FAX 227 - 8521 Final Inspection
Reg #: CT6 - 8516 8388
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: Permittee Signature: -- _.s2.. (fir
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Jan 05 05 05:413p CARSON OIL CO 503 2242456 p.2
A Mechanical Permit Application
_ Date received: 5 5 permit no.:W jaf-p4 11 at
1 '':I'i, City of Tigard . R C E r E V project/appl.no.: - Peg -- Expire date:
City' o�gard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 l a pp � ,� issued: By: I Receiptno.:
Fax: (503) 598 -1960 ' L I,.,. ' Case file no.: Payment type:
Land use approval: CITY OF TIGARD Building permit no.: 1—Cr
T'I 11i OF PERMIT
• Sa'1 & 2 family dwelling or accessory 0 Conimercial/industr
e,v al 0 Multi - family • 0 Tenant improvement
.' '7, 0 New construction 0 Addition/alteration/replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: / 36 , d S u 1.. 4.. /k/Cr(� 5"7 . Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1 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: 1.4�i - - ' /) GA.J jurisdiction's fee schedule for residential permit fee.
City /county: 7;4A?0..Mi .,- / C)/70--...7.) 1 & 2FAMIL1' DWELLING PERMIT FEE SCHEDULE
Description and location of work o n premises: �'•F 'i iii. AND CO: MA]E12ICALWINDt STR11L EQUIIn ENTSC1IEDI.1..E
f 1 ��1F'A.i4i c_A . /V (--,,,de,‘„,...-.16 Fee(ert.) Total
. . Est. date of completion/inspection: Description Qty. Res.only Res.only
# - .Tenant improvement or change of use:
• ;/;:!,.,4 Air handling unit CFM
= :5 • ;p - Is existing space heated of conditioned2 0 No
; existing space insulated Yes ❑ No Air condidoniai (site plan required)
� :1),:s-, : g pa Alteration of misting I1VAC system
r3 ME(•ILANI('AL CON rRACTOR Boiler/compressors
psiness name: (',l C)/ OIL. �'0 Stateboilerpermitno.:
Address: % O Gig HP Tons BTU/}1 ;�. 3 �� /V %iL/ � .5 � .�� j C� Fur/smoke dampers/ducc smoke detectors
` City ::Pt -.T L•.4 i(y/N State: el J ZIP: Heat pump (site plan required)
r . r b! - : replace urner_
lfumace/bBTU/H % . /
W . i Phone, . -- 4 +s#, • 1 .q -mail: Y
Including ductwork/vent liner�'Yes O No
: -t z f MB no.: a „� lnstaWreplace /relocateheaters- suspen ,
':i-
:t F ` 4 lty/metro lid no.: ,S " . wall, or floor mounted
s7 .r, �� j- c- ' : , Vent Rance other than furnace
;_> aEN (please print): ,t.: r l -
µ ��i'^'?'Ti
`
•. z , (ONTA(`I- PERSON • Absorptlanunits BTU/H
r ;. a HP
-It} Na Chillers
i.;: Co • res sors HP
' ,; address: ' .
.' ' Environmental exhaust and vestilatioa: : -
; 4ity: .-- • • State: ZIP:. - • A fiance vent -
," one: • - Fax: . .. E -mail: ,•_ . ,• east •
,.' :` :. Hoods, Type 1/ 11/res. kitchen hazmat •
j4 •",' hood fire suppression system •
1;it , - ame: F,G (.i 117 - /? f':'IV i .6 ,t1'' .. . Exhaust fan with single duct (bath fans) • •
` $. M address: ('} r ti� / 64, • �' % E+ thaust rem a art from hearin or AC
-.. State ZIP: e C on up to 4 outlets)
`; ety // ci7 Z -7 TyPe LPG NG • at . *� .. ne: • Fax: - - U maiL • ; Fuel pipin$ each additional over 4 outlets •
f; ; 7 Proceaspfping (schematic required) • .
k5 v_, : : Numberofoutlets .
' / Other listed appliance or equipment:
" '
Address. -, ' Deco rative fireplace
' r(aty:'+: ' . • • ZIP: . . • . Insert - 1. • .. •
t PPlione: • Vii"!!' %�:' L'- mail: „,- ” • • • . tov • et stove
-„° :i • Applicant's si • e: /� _. Date: -4. =-a — t � -
1/4 ,i, , , "' Name (print)
it' ,=:. cards, piano Perm f ee $ iyi
,. i a . n too..oxpt credi piano can judo: loo for more information. Notice: This p application Minimum fee $ .
ovisa • otdaster ara
coedcumber
y:; / ! expires if a pemnit is not obtained Plan review (at %) $
: - �;, Expires within 180 days after it has been state surcharge (8 %) ... $
y ` ::-.� Nan of catdbordrr as shown on credit card accepted as complete. TOTAL $ 7..w - -
st
Catdboider alaoatute Ammo 440-4617 (610011'OM)
. Irk , ° [ ~ m -
z
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION, DIVISION Business Line: (503) 639 -4171 MST
U P
Received Date Requested t — -7 AM o ! C 53 PM BUP
Location / 30 � f 0 "l / Suite e d a QS- 06 6 q
Contact Person > Ph ( )2 4— dv PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC (NIGIA Q
Footing ELC
Foundation Access:
Ftg Drain 0S._• - :3 � ELR
Crawl Drain ; '` /' 11
Slab Inspection Notes: .c_ _ ri _ _/ __ -- - - -- - -- — SIT
Post & Beam -- - - :' " -./
Shear Anchors _ '. i
Ext Sheath/Shear C 1771 _
Int Sheath/Shear ( S3 .I�
Framing - ��►�
Insulation r _ • - •
Drywall Nailing \ I Q )� ' ° , °`' G. C ,e- , Cr ' I
Firewall
Fire Sprinkler l) 04--F-v) ' / / O /
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam 1
Under Slab - -
Rough -In •
Water Service -
Sanitary Sewer lbg-j
Rain Drains =� �_ _ _ -- Catch Basin / Manhole — I ��
• Storm Drain
Shower Pan _M, T
Other: —
Final •
PAS ART FAIL .
AL _ ,..
eam CA.
• Rough -In
Gas Line
e Damp r —
. PART FAIL
- TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Q Unable to inspect - no access .
Fire Supply Line /
6
ADA Date 1 / 2 �( � In actor ) c Ext
Approach/Sidewalk P
Other:
Final • DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL