The URL can be used to link to this page

Case File P j. y N C` (1) U) D a 0 v i 1210' SW Anton Drive i CITY OF T I G A R D - MECHANICAL PERMIT — PERMIT#: MEC2003.00201 DEVELOPMENT SERVICES DATE ISSUED: 4/22/03 13125 SW Hall Blvd , Tigard, OR 9722? 1503) 639-4171 PARCEL: 1S134CB-13600 SITE ADDRESS: 12109 SW ANTON DR ZONING: R-7 SUBDIVISION: ANTON PARK NO " BLOCK: LOT: 063 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: VEN r SYSTEMS: STORIES: .-----BOILERS/COMPRESSORS---- HOODS. FUEL TYPES �0 3 HP: DGMES. INCIN: --- ----�– _ 3 15 HP' ;; )MML.. INGIN: 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: <= 16000 cfm: — GAS OUTL =TS: 1 > 10000 cfm: Remarks: lustall I I' Insert. Owner: _ --�____-- — FEES _ LEWIN, KAY F + JAMES S Description _ Date Amount 12109 SW ANTON �MECHI Permit Fee 4/22/03 $72.50 TIGARD, OR 97123 TAXI Staic;ax 4/22/03 $5.80 Total $78.30 Phone: 503-524-5933 -- Contractor: JACOBS HEATING +A/C 4474 SE MILWAUKIE AVE PORTLAND. OR 97202 REQUIRED INSPECTIONS Gas Line Insp Phone: 503-234-7331 Mechanical Insp Reg#: LIC 1441 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ori Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001 -0100 You may obtain copies of these rules or direct questions to OUNC by calling (503)246--6699 Issued By: Permittee Signature: Gai! (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Apr-21 -03 07 : 351' P.02 Mechanical hermit Application P received!Ied! ePcroslt no.. ? City of Tigard Projecl/appl.no.: RApircdatc; I �!Tignil Address: 13125 SW Hull Blvd, ,,OIt 972Qntcluucd: n ;,..3 �� Receipt no.; r . � Phone: (503) 631,'-4171 - -- — Fax: (503) 598-1960 CaeC Me no.: Paylneld type: Land use approval- Building permit no 1 2 fnmih dwelling;or accessory ©Commercial/industnal a Multi-farnily U Tenant improvement O New construcliuu a Ail,litirm/alteratiutJreplacement O Other: .1011 SITE 1 r job address: (( � J ,- _ indicate equipmcnt qunnliliea In L•<txes below. Indicate the deillm Bldg.no.: Suite no.: value of all mechanical materials,equipment,labur,overhead, Tax mal✓la✓tax lot/accoum no.: - prufa,value$ -_ Lot: filock:-- 18041lvialon: *See checklist for impurtanl application information and Project n,tne ( �j_,� - juriedictlon's lice schedule for residential permit fee, cal Icuull �. ,�< zire t Dcscril. c.n d locAtiot work on preutise.s: KIM 101111 U IN Fil h2l#z9Z=iaW11 Uft1 Eat,date ofOmwel ti thimpection: floscription qty. R".otily Rrs.ouiy Tenant improvement or chatlge of use: TACt Is existing spare heated or conditiuned?❑Yes U Nu Airhondlln unit _—_—CFM_ Is existing space insulated?O Yes O No A,con n oi-ex if tc as re a raT �f�sttng H VAC aystentMECHANICAL CONITRACI-014' - -- 0 Cr C(mpref.Sbt's Business name- State boiler permit no _ G1 HP ....-Tons RTIMI _ Address �"s. i_ � Fire/sm— okeeliMPperc/ductsuto ctcclors City: St A(M I ZIP ��- ' cat pump(site pian r u err -- Phone i;,x !;-mall Instalitreplacclurnec urntn_ CCB tto.: - Including ductworldvent liner Cl Yc.t 0 No _ nsta rcp a re ocate caters-susperi cx, City/menu tic.no.: well,or nwr mounted Name( Rase print): - (/�-y C� tom-.,C Vent or appliance other t tun w nate CONTACT cc Ae geralioni Ahvorplion units 11TU/11 Name• Chillers _- HI' - - r.qm ressur _ lip ?utltronmen a cx +tui,andrent gal on: -_ Appliance vent Phone: !a I-, nt;til )r ot'cx taus--` - - — s, r r rTTT'�iTeNhaztnat h(wxJ fire suppretslon syctcm Name: Le L_,)' _ A Cxhaust fan with single duct(bath fans) Mailing address: xxEi ust system m 89311 from hcating 6r AC ' Cit 1 State ZIP:G I ..L„1 tie p�°C an .t t ll up to out cls y: t C y Typc; LPC NU Oil Phone—c—'.11-- Fax: li-ntail: Huai n t n wch a3�1111 anal a�putlets – rocesspiping(schemdticr711e ) _ Name: Number of outlets __- Other listed apll;inee or equipment: Address: Decorative fireplace City: - --- State: - ZIP: Insert type pepc - - •---- --- Phone: tax: E-mail; , licd_wZ1X-_tO_VwP_CUetstnvc Ulhcr. Applicant's sig it u r: Cl EW 114 - Name(print): - Na J1lartadiAiar r.<xyt nrd�t cud,,pltue till juriuxLtSun ru awrc infa+ua,ion. Pcrmil fee ....$ - l .................. O Visa Cl MasterCard Nulire iltis permit application Minimum fee................$ expires Ifs permit is not obtained Plan mviewal — % r'a'dii card number.. .. �. . -�—�— ( ) within 180 days oiler it has been State attrchargc(9%)....$ --t7in,e nr a ee..,�lw,,Won ercTitems- accepted at complete. TOTAII. .......................$ -- C.n,a,olOn rlfnunre —�� 410617(MttK.'uMt �t�b7 C CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50,,)6:19-4175 MST INSPECTION DIVISION Business Line: (503)659-41171 BLIP _- Received _� _ / _ - Date Requested s ��_—AM__ PM BLIP Location Suite MEC -- Contact Person -- — Ph( ) _— __ PLM — Contractor — --- _ ph(_---) ----- -- SWR ---- --- BUILDING Tenant/ ELC ELC Footing i S l ELC Foundation Access: Ftg Drain ELF! Crawl Drain -- Slab Inspection Notes: SIT Post&Beam Shear Anchors Fxt Sheath/Shear - Int Sheath/Shear Framing ---- - Insulation Drywall Nailing _ — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -— — - — Root Other:-- ---- — --- -- --- Final — — -- PASS PART FAIL - PLUMBING --- Post& Beam Under Slab Rough-In — Water Service ---- - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain — --- Shower Pan Other: _ -_- Final ----- PASS PART _"AIL _MECH_ANICAL - Post& Bearn Rough-In --- - -— -- -- ---- Gas Line m Dampers -- -- - 'F' P PART FAIL -- — -------_----- -- Service Rough-In — — --- ----- — UG/Slab Low Voltage -- ---- - --------— -- — -- Fire Alarm Final Reinspection fee of$ require!uefore next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL gI - n Please call for reinspection RE: Unable to inspect-no ar�:ess Fire Supply Line / ADA Date Inspoator _ ___-- - ---- Ext Approach/Sidewalk ✓ Other: anal DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL