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3593 SW ASHBURY LN
CITYOF 1 I GA R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00566
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/17/03
PARCEL: 1 S133CO.03300
SITE ADDRESS: 13593 SW ASHBUR'r LN
SUBDIVISION: COTSWALD MEADOWS ZONING: R-25
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VEN FS WIO APPL: VENT SYSTEMS:
STORIES: F,OILERS/COMPRESSORS HOODS:
_
FUEL TYPES_ 0 3 HP: DOMES. INCIN:
I P(I _ 3 15 HP: COMML. INCIN:
I'9AX 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 insert,gas piping antl %rnnng Fur the unit.
Owner: FEES
VANBAEST, JENE + MICHAEL J Description Date Amount
13593 SW ASHBURY LN (MECH] Permit Fee ^9/17/03 $72.50
TIGARD, OR 97223 'TAX] 8%StateTax 9/17/03 $5.80
Phone: Total $78.30
Contractor:
SUBURBAN@HOME
6014 NE 112TH AVE.
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Phone: 503-257-5439 Gas Line Insp
Mechanical Insp
Reg #: LIC 143335 Final Inspection
This permit is Issued+, subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and a!i ott—r applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started vtithin 1 RO days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires YOU to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
13sued By: � Permittee Signature?( —
Call (503) 639-4175 by 7.00 P.M. for inspections needed the next business day
10/03/00 TIT 14:59 FAX 503 598 1960 CITY OF TIGARD 0 002
r
Idechanical Permit Application
Date received: 17 p jhermit n�te, s
t Cit Of Tigard City g ProjecU;.ppl.no.: date:
City cif Ti8 urd Address: 13125 SW Hall Blvd,Tigard,OR 97223
Date issued: B Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Paymenttype:
Land use approval: _ Building permit no.:
TWIPE OF 11"EILHIT
14 1 &2 family dwelling or accessory J Commercial/industrial J Multi-fancily J"Tenant improvement
❑New construction U Addition/altemtion/replacement J Other-
.1011
ther
1MMEACIIAL' VALUA 111ON SCHEDULE
Job address: C' k 1.14. Indicate equipment quantities in boxes balow.Indicate the dollar
Bldg,no,: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: 1131ock: _ Subdivision: "See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee
City/county: .�_1 ,x :7 ZIP: -7,X33 1SCHEDULE
Description and location of work on premises: 1 NSTA CL1 tii( L " 1 1' t sl I X11
Ahs 1 N`'t.1ZT. IFee(t:,l i IoUl
Est.date of completion/inspection: Desai on 01y.I Res.ordr 1 Ree.only
Tenant improvement or change of use: Alt hnndlinunit CPM
Is existing space heated or conditioned?:]Yes U Nu Air conditioning(site glan re utre ) _
Is existiog space insulated?U Yes O No Alteration of existing HVAC system
WTtTA7MrffTs1ors
Business name: el _ Statr h,filer permit no.:
("1oM� HP —Tons—BTU/11
Address: U t cl pCI A,4Eire/smoke dampers/duct smoke detectors
City: - Lt state: vd ZIP: 1aX u cot pump(site plan required)
'� E-mail: Install/replace mace urner
Phone: .: 7 I A' 3i Faz:.� 4 --- Including ductwork/vent liner U Yes U No
CCB net 1yo.: _. nstn rep ace/re ocale eaters-suspende ,
City/metro lie.no.: 3�j�11 _ _ wall,or floor mounted _
Name( lease dnt): 2 IL6 - r Vent ur a tuner,usher un urnat e
Refngerahon:
Absorpuonunits_ BTU/14
Name: Chillers HI' - - — - --
Address: —— Com ress0" Hl'
-- � r rotunenta ex must an rent atfmr:
City: _ _— State: ZIP:—V_ Appllancevent
Phone: Fax: E-mail: ryerex aust
odds, ype / /res. 'tc en/hazmat
hood fire suppre cion system
Name: l�t C N A EL r1,`1 f j ErrlCjj Exharst fan with single duct(bath raps)
Mailing address: 13��13 SvJ A`���� LN, aust system apart from eauag or t _-
Cit A � c 2 Fuc'p ping and d str ballot to 4 Hurlers)
Y T C Stnte:r7(` Z1P: �7. a 1'YPe: -----L1'Ci G j Oil ( e�Lit)
Phone:L'? Fac: E-mail: Juel tin each add ition a I o- r 4 outlets
t I roce"piping(schemnticrequired)
Name: Number of outlets
K IWIR-appilance or equipment:—
Address. Decorative fireplace
City: _ _ --- -- State: ZiP: nsert-type_ —
Phone: Fax E-mail: oo stW—c7 o�ellets
Uther.
Applicant's signature: r Date: Other.,
Nantc (print): Z A, L- VA P-ME 5 —
Not all junutictions accept ctedtt cant,.please call Jioiuliction N mare Inrtxmari,xc Permit fee.....................
7 visa U MastetCard Notice:This permit application Minimum fee................$ 7a
�Crufil card eamher
expires if a permit Is not obtained plan review(at %) $
�_� _•within 1 g0 days after it has been
Ftpints Y State surcharge(g%)....$ a �1
Nate of car r as shown on credit-c rd accepted as complete. TOTAL -71$ / . �r
Cardholder rigaatute Amount 4104617(6t0 rOM)
CITY OF TIGARD 24-Hour
BUILDING InspecCon lLine: ,(503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 BLIP _
Received _Date Requested___ r L— AM -- - PM - EJP --
Location MEC �.---���
-//- - -
- -
Contact Perso —_ g�� — Ph( —) --— -- PLM --- -
Contractor 0 � .4A Ph(AL2-�) Z J r"— ,S-g3FSWR -- --
-- Tenant/Owner {S IE.LC - -__ --
BUILDING w
Footing -- ELC - -- --
Foundation Access: f ELR
Ftg Drain -
Crawl Drain -------- — SIT -_
Slab Inspection Notes
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing -- - -
Insulation _ -
Drywall Nailing
Firewall --
Fire Sprinkler - -
Fire Alarm
Susp'd Ceiling
Roof —
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 l l
Other:
Final
p _ T FAIL
MECHANICAL— - -- ----- __ -
VLimpers ---
_AS PART FAIL
ELECTRICAL - -- - —
Service
Rough-In --
Ur/Slab
Low Voltage - -- - --
Fire Alarm
Final I 114-Inspection foo 0 --required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS FART FAIL Unable to inspect-no access
SITE L] Please call for reinspect', n RE: _
Fire Supply Line
ADA Dante C)�'
Approach/Sidewalk
Other. -----__---.
Final DO NOT REMOVE this Inspection record frorO the Job *Ae.
PASS PART FAIL