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10629 SW Canterbury Lane
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\ MECHANICAL PERMIT
CITY OF
T I G A R("�
\\ DEVELOPMENT SERVICES PERMIT#: MEC2002-00564
13125 SW Hall Blvd.. Tigard, " Z 97223 (503) 639-4171 DATE ISSUED:
PARCEL: 2 2 S 51102
110AD-U0400
SITE ADDRESS: 10(')29 SW CAf`1TFRB(JRY LN
SUBDIVISION: LANG HILL ZONING: R-12
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE•. SF UNIT HEATERS: FENT FUNS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
_ F_UFL TYPES _ _ 0 ? 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: CLU DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: — 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas furnace.
Owner: �—__-FOES -- --
LONG, S CAROLYN Description Hate Amount
10629 SW CANTERBURY LN [TAX] 8%,StateTar. 12/12/02 $5.80
TIGARD, OR 97224 [MECH] Permit Fre 12/12/02 $72.50
Total $78.3n
Phone: ------
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 503-6r10-3607 Final Inspection
Reg#: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. 'This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may citain copies of these rules or direct questions to OUNC by calling
(503)246-66919.
Issued By: t1, 4L;cl —� Perm1ttee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the i,ext business clay
9-2002 02:09P FROM:HILLSBORO OFFICE 5036910793 70:5035981960 P:2�2 CL
Mechanical Permit Application
Patereceived: Permit no.:
� ."'
City of Tigard R EC E IV E f.n
oJect/appo:: _ Y F3xpircdet : �.
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dateisaued: _ Ry: Itecciptno.:.' t 1"
Phone (503) 639-4171 DEC U 9 200?
Fax' (503) 598-1960 Case file no.: _ Payment type: +
a Land use approval CITY OF TIGARD Building permit no.:
I !v 2 family dwelling or accessory ❑Commercial/industriat Q Multi-family O Tenant improyernent
CJ New •.onstruction f I Acldition/alteration/mplaeement Q Other.
Jub addre::,s:ft%, cc -r,cJ Indicate cyuiprnent yuanuties in boxes bolo++. Indicate the ddllarl
Bldg.no.: _ Suiten .: value of all mechanical materials equipment,labor,overhead,
Tax Ota tax lut/account no.: profit.Value$ _
Lot: Block: Subd�vision: _ *See checklist for important application information and
.Project n���,,; �� �� jurisdiction's fee schedule for residential permlt,fcc.
City/county: KIM! 71P:� --_-� _
41
Description and vection of work on premises: ��
Fee(ea.) Notal'.'
r,
Est.date of c ine tion: ;� /3 D a- tk AionT dt • Hes.onl Re�•'onfy
'tenant improvement or change of use. Air handling CFM T_
1s existing space heated or conditioned)#Yes O No it cont rUomng site Tan required)
Is caistinF'space insulatcd7 Yes U Noterat on o existi-n-gMVs stem A
Bulles,conirressora - -—
Stale boiler permit no.:
Business name: //4L-'►r ,/j/'MI: 94:011Aq IX —Tons__BTU/H +-{
Address' D _SeF R1d0_IQ ??V.*J9 _ r smo r_ am er uct smoke e'.ectors
Cil State:(9K I ZII: Beat pump site p an regwr ) _
Install/replaacc umac umer-
Phone: - li0 Fes: Bim' E-mail: Including ductwork/vent liner$Yes U No
CCB no:: -57 instalLrc�ocai leeaters-suspended,
City/metro lic.no.: 9 wall,or floor mounted
Nam-(please tint): OP'/1JfJ— iQ�'1 cat ora Lancother n furnace
eta n:
CONTACT P11-11SON- Absorption units _ BTU!H _
Name I r Chillers HP
`� NN-� Corn tersora HP
Address:'/Y&V so RplfKR4I—.O t r nmental exhaust and vent G on:
Clty: //$ /fa State ZIP:'�7/ Ai liance vent _
Phone: '�(D�'3G4 Fax:6g'/-07V E-mail: Utyerex aunt y
oods,Typeures. itc eWair at
/ hood fire suppression system
Name: w+, Exhaust fan with single duct(bath fans)
abs!systema art from heating-or AC t
A -TU-1 a�: OG. State: ZI Pp u� ut on up to outlets)
City: /
Type: LPG NO Oil •
Phone: fax; L mail: Fue t n cach additional over 4 oulels
20"lil 1011 cesspiping(Acernat crequ red) '
Number of outlets r
Name: l eFU _applian,e or equipment:
Address: ____ rxcorativenr ince
City: _ Estate- LIP: inert-type _
L.' - Woodstove/Pellet stove _
Phone: E-mail: O er.
Applicant's signature: �yrlTi Date/oi 3'7_7
er: v ��
NoW Juidkruro ne( sdt udptencall Jurirdierion fa mmWln
Permit fee.........
Notice:This permit application Minimum fee...•......................$$
O Visa U MasterCard expires if a
.
permit is not obtained Plan review(at __ %) $
critic cod wIin a: --- --/ ; within 190 days after it has been
w i car - accepted m complete. State surcharge(R46)....a
Now of cateow"
: TOTAL .......................$'
Oro Ar aunt NOM:1(6%=M)
CITY 0-F TIGA RD 24-Hour
BUILDING Inspe-tic ri Line: (503)639-4175
MST - --
INSPECTION DIVISION Businnss Line: (503) 635-4171
i-sUP --- --- --
Received _._ _ _Date Requested. __.__� �AM_ PM —__ BUP� -00(e4--
Location _ _�� Suite_ —
Contact Person C-^-Z, Ph(_ �) G8'i 3 c�l PW
Contractor Ph %o SWR - _--
BUILDING Tenant/Owner _—_— _ ELC _ —
Footing EL
Foundation AccAS8: ELR
Ftg Drain - —
Crawl Drain"- --
Slab Inspection Notes. C SIT -
Post&Beam
Shear Anchora
Ext Sheath/Shear -- -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing �'�`��"� �— � �� -
Firewall
Fire Sprinkler -- `-
Firo Alarm
Susp'd Ceilin,. -
Roof —__-
Other:. _ —
FlnAs _
PASS PAG#T FAIL
PVJMBINf3_--.__— ----- — _—
Post&Beam -
Under Slab ---- -- --- --- --
Rough-In
Wate;Rervice --- ---- -- — —
Sanitary -p-+er
Rain Drains - -- -�--- ------ - ^-----
Catch Basin/Manhole _
Storm Drain -- —
Shower Pan
Other:
Final
PASS PART FAII
MECHANICAL
Post&Bearn
Rough-In U ��r _�--------- --- --- --—
Gas Line
Smoke Dampers — —
PART FAIL _
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage —
Firs.Alarm
Final Reinspection fee of$-_— required before next inspection. Pay et City Hall, 13125 SW Hall blvd.
PASS PART_ FAIL
SITE _ F� Please call for reinspection RE:—_— u Unable to inspect-no access
Fire Supply LineADA —
App oath/Sidewalk Data -- ' `r' �� _ Inspector Ext
-
Other:
Final DO NOT REMOVE this Inspection record from the Jobs site.
PASS PART FAIL
CITY OF TiGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received Date Requested _� AM _-_ PM _--- BLIP
Location -70 _1.��? #Suiite_([ /' MEC c7 —V0,5
Contact Person _____— __ h( ) �) �o-,? PLM
Contractor Ph(--) EWR
BUILDING T ant/Owner _-_ -_-- _ _---_- LC _._--
Footing ELC -
Foundation Access:
Ftg Drain ELF! - - --
Crawl Drain _
Slab Inspection Notes: - SIT - _ -
1 Post&Beam
Shear Anchors
Ext Sheath/Shear __-
Int Sheath/Shear
Framing
I Insulation
Drywall Nailing -__ - -----
Firewall
Fire Sprinkler -
Fire Alar-:
Susp'd Calling
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
Other:
Final
PASS_ PART FAIL --- — ---� ----�- -
MECHANICAL ----
Post&Beam
Rough-In -- - —
Gas Line
Smoke Dampers
he
PASS PART FAI
ELECTRICAL
Servic6
Rough-In -_--__--_-- --
UG/Slab
Low Voltage -
Fire Alarm
Foal � Reinspection fee of$�—_--__required before next inspection. Pay at City H 125 SW Hall Blvd.
PASS PART FAIL
SITE L] Please call for reinspection RE:, ___._ _— nable to inspect-no access
Fire Supply Line
ADA Datw � Ins ec4orApproach/Sidewalk Ext
-
Other
Final DO NOT REMOVE this Wtpection record from the Job site.
PASS PART FAIL