12447 SW EDGEWATER COURT e
12447 SW Edgewater Court
/\ CITY OF T I G A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00542
'13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1212/02
PARCEL: 10-134C13-10600
SITE ADDRESS: 12447 SW ED )EWATER CT
SUBDIVISIGN. ivIll-LVIEW ZONING: R 4 5
BLOCK: LOT: 006 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: VENT SYSTEMS:
STORIES- BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES _ Y 0 3 HP: — DOMES. INCIN:
I_Pc;T 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS.
FIRE DAMPERS?: 30 - 50 HP:
OD S:
GAS PRESSURE: 50 + HP: CLO DRYERS:
TURN < 100K BTU: AIR HANDLING UNITS C
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas insert, gas line existing.
Owner: ----- --------FEES ----- -----
FELLOWS, JEREMY L + PATRICIA J Description Date Amount -
12447 SW EDGEWATER CT I\1FUII) Permit Fee 12/2/02 $72.50
TIGARD, OR .97223
� I \!iI x'%,StnteTnx 1212/02 $5.80
Phone: Total $78.30
Contractor:
SHAMBURG HEATING LLC
23975 SW BOONES FERRY RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone: 503-692-5563 Mechanical Insp
Final Inspection
Reg#: LIC 126881
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for mere than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
UtilitN Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100 You may obtain copies of these rules or direct questions to OUNC by calling
(503)2466699.
Issued By: Permittee Signature:
Call(503) 639-4175 by 7:00 P.M. for inr-pections needed the next business day
Dec 02 02 01 : 46p Scott 503-691 -6655 p. 2
MechLaical Per on
Vatereceived: Permit no.:
City of Tigard
�. � �ry )n� ProjrcVnppl.no.: 6zpirodate:
r u,..t 75f-,u./ Address: 13125 5W Hull Blvd, R 8721 -_
Phone: (503) 639-4171 U
G1-�, Date issued: By t; Rcceipino.:
Fax: (503) 598-1960 Q�01,4 S10�1 Case file no.: Paymentlype: -_
Lend use approval: __;al_7___.- Building permit no.:
1
f�'f St 7 Camily dwelling or accessory U Commercial/indushial U Multi-family U Tenant improvement
U New construction 0 Addition/altemtion/mplacemeni t_7 Other:JOB SITE INI-011MATION
CON110FIRCIA1.VALUATIOASCIIEDUEL
Job address: /jQ /y�� ) / ' ,,���r Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: profit. Value$
Lot: _ Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for rt•sideittiai permit tcc
City/county: c�� �! UP: �J �7, 3 t
Description and location of work on premises: 122 's 4- !lAherntion
s t
Fre(ea.) Total
_Est.date of completion/inspection: /,a -� _ Descri on Qty. Ree.only Rr_%onl
Tenant improvement or change of use: lin unit CFM
Is existing space heated or conditioned?U Yes D Noition n (site an requ r ) -�
Is existing space insulated7 U Yes 0 Na
o exlsun system
o er compressurs
Business"AMC: ' 1 7 /'' '' �G G St ate boiler permit no.:
lit' Tons BTUM
Address: /7-c A-; Firelianoke dampers/duct s;n-oke detectors
City: Slate:4-"�ZIP:,q1 - eat u�m (sitcp nnrequired) — -
Phone: '..r- -. > 31 Fax: E-mall: nstt aivrel,lacerurnnc urner_..
CCD no.: /,!a„r,}"`}.' Including ductwork/vcni liner U Yes U No
__ nsta rep ac rc ocate eaters-suspen
City/metro lic.no.: wall,or Door mounted
Name lease print): ,;•� ,j ,?t;r�, r�_ Vent oro ancc of ter than furnace-
e sera n:
Absorption units_ BTUM
Name: ^ ) /-9[ � Chillers HP
Address: c - Com ressurs,.--_-- Pip
' rotrmeut ez ust and vest nation:
City: State: ZIP: Appliance vent
Phone: Fax: &mail: f-ryere -u.-`
__H s_Fype I/Wres. tc�:lxmnl—
hood fire suppression system
Name: fe'// rc'//Gc _ _ T _ _ Exhaust fan with single duct(bath fans)
Mailing addren . ;' q ,_ C' ,.c Z.. 1?x6i t systema art from heaUng or AC
Ci11-ae piping andistribution(up to outlets)
ty: ;:l -' S tPn e: ;,/AZCP: 2
Phone: --2 - c E-mail: type _ LF'c; I f0 (HI
ucpiping each additional aver out e8
Ogg Process piping(schematic requre _
Name: Number of outlets
Address: ^--- - Z i ber I F.W ad app ante or eq pi e-a
Ltc,.nrtivefireplace
City: Staic: I ZIP: nsert-ane
_ '-
Phone: F -7—L gin�pe'fTetstovo -
Applicant's signature: j Dslte: �'�„ t�-
Name(print): _--
Nm dl pulaticllons wcepl credit canis,ptem all iurlullcaan tar use information. Permit fee.....................$
0 visa u Muteward Notice:'Hila permit application Minimum fee................$
Cmdu n,-d numbtr. rrpieas if a permit is not obtainc,i
Pion review(at _ %) $
p ma wuhln 180 days after it has beer State surcharge(8%)....$
ie ore ioa inshownon cn�t,i t� '"-- accepted es complete. r C
Ceudltn r a nature — — — -�Amount 4*,)4617(&MCOM)
CITY OF TIGARD 24-Hour
BUILDING "nspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-x: 71
BUP
Received -__— Date Requested. Z dZ AM_____— PM _ __ BUP _—
Location Z 4/a-7 EA�4u ti 22ti -te__ __ _- MEC
Contact Person __ — Ph( _) _____--- PLM
Contractor - _ _ Ph SWR
BUILDING Tenant/Owner _ ELC -_
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain _�—
Slab Inspectioti Notes: SIT
Post&Beam -- -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing � � r�e�.�� E`d[Si 1-� C l-
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 Servicc
Sanitary Sewer
Rain Drains
Catch Basin I Manhole
Storm Drain
Shower Pan
Other: -
Final � —
PASS PART FAIL ------- - --- -.__._....---- ---- --- --- -- ----------
M_ECH_ANICAL _ _ —__- -.--.--_-- _—— - --_.._ _---- ..------___.--- --
Post&Beam
Rough-In
Gas Line
Smoke Dampers
PART FAIL - ------- - ---_ ---- --- -- __
E_LE_CTRICA
Service
Rough-In ------ --- --- -
UG/Slab
Low Voltage
Fire Alarm
Final U Peinspecffon fee of$_— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
BITE r] Please call for reinspection RE:_ [] Unable to inspect-no access
Fire Supply Line
ADA Dots lZ ,(�_ 4 zr Inspector Et
Approach/Sidewalk -_"-
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL