Case File 12240 SW Alberta Avenue
CITYY O F TI GA R D MECHANICAL_ PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00165
13125 SW Hal! Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/23/02
PARCEL: 2S103BC-03100
SITE ADDRF'SS: 12240 SW ALBERTA AVE
SUBDIVISION: CANOGA PARK ZONING: R-4.5
BLOCK: LOT: 005 ,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/COMPRESSORSHOODS:
_ FUEL TYPES _ 0 3 HP: 1 DOMES. INCIN:
I-PG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BT�J 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
CLO DRYERS:
FURN < 100K BTU: i AIR HANDLING UNITS
- --- O-(HER ULJITS:
FURN >=100K BTU: <- 10000 Cf m: GAS OUTLETS:
> 10000 cfm:
Remar'Rs: Replace gGs furnace and add on central alc.
Owners _ --- — FEES
MIKE= CONN Type By Date�v Amount Receipt
12240 SW ALBERTA ST PRMT CTR 4/23/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 4/23!02 $5 90 272002000C
Phone: 503-590-6566 _ _Teal $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REOUIREG INSPECTIONS
Heating Unt Insp
Phone:453-4822 Cooling Unt Insp
Fag #• LIC 62196 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal C Ae, State of Ore
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 clays of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notiffcaticn Center. Those rules are set forth in OAR 952_-001-0010 through OAR
952-�Cf-Q080. You may obtain copies of these rules or direct questions to OUNC by calling
tr;ni�19an_01u4
Issue By: IL- -i I Pc+rmittti�e Signature: _ .- t l
-- Call (503 39-4175 by 7:00 P.M. for inspections needed the next business day
02 03: 34P climate contrnl 5U3 968 7224 p •
Mechanic B Pe6'91I' .,ppjic.,afl op, i
fi
City 4111 Date received: c/ ,?j Permitno.:��f('
P1 oj=sct/appl.no.: Bxpiredate:
Citycfl'lgard Address: 1312: S'Jv hall Blvd,Tigard,OR 97223 /Nx _
Phone: (503) 639-4171 Date issued; By: Recciptnn.:
Fax. (503) 598-1960 '""It..'J Case file no.:
n�f.Sr,To- !Nr,'V"'10V Payment type:
Land use approval: — Buildingpermitno,: _
�1 &2 family dwelling or accessnry J Commcrcial/industrial Q Multi-family ❑Tenant improvement
Ll Ncw r_on,^.truc:ior ❑Addition/altrratioaireplacement ❑Other:
job address: /?l (� �� Indicate equipment quantities in boxes below.Indicate the dollar
Dldg.no.: _ Suite uo,: Wi�le of all tnechaniced materials,equipment,labur,overhead,
Tax rnap/tax lot/account no.: profit. Value$
Lot: Biook: Subdivision: �5:ee checklist for importunt application information and
Project name: iurit.' don's fec•schedule for residential hermit fee.
Cityicounty: ZIP: , 1
Descri don and location of work on premises: „
Oil
VJ
Est.date of completion/inspection; F`es.only
T•r1a1 ,
_- Deep] on 91y.. Res. Res.only,
f euwtt improvement or change of use: _ i rUt—
Is existing space heated or conditioned?O Yes 13 No Ali handling unit CFM
Is existing space insulated?O Yes ❑No Au-conditioning(site p an requ )
�i Ticrauon
of-e-0-
t n�g-HVAf_'system -
Boiler/comp ressots
Business name: (r/�,q? �1� � Stat boiler permit no.: 1
Address: �rdv' q _ -.- HP _-Tons BTU/Fi _
--
Ci _ �Y smo o amps ductstnoke ores'
ty: Statc_� ZIP: I7 ort pump ate plan requires
Phone:5o5-y5 - Q Fax: mail: nsiall/rep aceurnac anter iiTUllr-
CCB tio.. 6;2 Gj�_�_ Including duetwork/ven,liner CJ Yen 1.1 No / QIJ M
9 �tfora
City/trtetro Its,no.: ,urtlonrmounleriName(please print): ranee other thou fyrrnace ton:
d�n Absorption u nits- BTU/H
Name: �p�,6LL Chillers- _ HP
Address_: Cotrpmssors _ !IP
Cit rUonmeota ex must an veotirauow
Y _ State: ZIP' 7777:A fiance vent
f'houe:S Z.Z Fax: E-mail: ryexexhaust
A F�� 0o Yc peTfl>c Zutc a hazmat
Name:
hoor fire suppression system
/�L �L1 SSf} C�OiVi1/ F.xht,ustfan with single duct(bath fans)
Mailing addross: /' Zed �� > ST x a.usts stem apart from ea n or C "-
City: G State: K. Zfl': f y e P p g an st u as up to nut eLa
-- T e LPD NO Oil
Phone:5p - $(,( }.;ix; E-mail: ue tin each additional over 4 outlets —"
t' td rocessp p g(sc rematicrequirc
Name: Num Ser of outlets
-- - - er7IdappiGnce or equ ptuetrt: - -
Address: _ _ Deco rativefireplace_
City: _ State: _ ZIP: ?naert
Phone: _ F E-t L oocfs'tnv pe r•.tstove -
Ap��_rf�iI,tlature• Date:-y_ �-
Nance (print):
_-__ - ------- -' .�1
No dl iwisdlenonr lccepr c,rdu r^_,,ts,pie telt i,ui dicrinn for more WOMW00o. Permit fee....................
vua ❑Mssi Notice:This permit application Minimum fee................$
ex ices it a permit is not obtained plan review(at _ ) 9. _
CraiU cud numb-.f.. ; p�,� ..Rp m� within 180 days af.er it hog been State surcharge(896) ,...$
cuo o iot a-diown ";in CRI11 - pp ZZaccepted as complete. '
TOTAI .....................
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Fi;or 22 02 03: 35p climate control 50A 968 '7224 P. 3
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