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10265 SW GREENLEAF TERR
CITY OF TIGArRD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00227
13125 SW Hall Blvd.,Tigard, OR 2727 (503) 639-4171 DATE ISSUED: 613/02
PARCEL: 2S 111 CC-19900
SITE ADDRESS: 10265 SW GREENLEAF TERR
SU 3DIVISION: SUMMERF'ELD NO.5 ZONING: R-12
BLOCK: LOT:258 JURISDICTION: TIG,
CLASS OF WORK: At T FLOOR TURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS_/COMPRESS_ORS HOODS,
FUEL TYPES _ U 3 HP: DOMES. INCIN:
L_PG _ 3 - 15 HP: COMML. INCIN:
MAX INPUT: STU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE- 50 + HP: CLO DRYERS:
FURN < 100K b I U: 1 AIR HANDLING UNITS C
OTHER UNITS:
FUKN >=100K BTU: <= 10000 cfn :
GAS OUTLETS
> 1000C cfm '
Remarks: Replace gas furnace.
Owner: _ FL'ES
BOTTOMS, SARAH C TRUSTEE Type vBy Date Amount Receipt
1026E SW GREENLEAF TERR PRMT CTR ri/3/02� $72.50 2i2002000GI
TIGARD, OR 972:4 5 P C T CTR 6/3/02 $5.80 2.720020000
Phone: �_�� ^_Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 77ND AVE
PORTI AND, OR 972.24 RECUIRED INSPECTIONS
Mechanical Insp
Phono:453-4822 Final Inspection
Reg #: LIC 62196
EXPIRED
Th,s permit is issued subject to the regulations contained in the Tij jrd Municipal Code, State of Ore.
Specialty Codes and all other applicatle laws. All work will be done in accordance with approved
plans. This parmit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 1r30 (lays. A-fTENTIOri: Oregon law requires you to follow rules adopted in the Oregon
Utiiity Notification Center. Those rulas are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rui is or direct questions to OUNC by calling
(r;0-A)?A _01M) 1 /
Issue By: ,��-'a - , — Permittee Signature: °n/ ,°/'�C / �!� i iK,
Call (503) 1539-4175 by 7:00 P.M. for inspections needed the next business day
J
May 2E 02 U6: 26p cl i n,atp c.-+rit.rc,l 503 968 7224 p. 2
Mechanical Permit Application
y ` i Uale received:,$ ',� Permit no./ g("' '' -
City Of liga1rd y/C V E Project/appl.no.: Expire date:
Citvnl rigard Address: 13125 SW Hall Blvdj igard,OR 97223 —
Phone: (503) 639-4171 MAY R ?l'0? Date issued: $y [teceiptno.:
Fax: (503) 598-1960 Case file no.: _ Fayrnent type
Land use approval: CIA Y UN IWAKKD Building permit n(.,,.
1 &2 family dwelling or accessory O Commercial/industrial ❑Multi-family ❑Tenant impicivenlent
0 New construction J Addition/alteration/mplaccnienl. J tither.
Joh address: �O (,(/ G/e� "_ pp� Infusate equipment quontidw,iu hoxe,,ht-low. lydicate the doKar
Bldg.no.: Suite no.: value of all mechiurical materials,equipment,labor,overhead,
Tax map/tux lot/account.no.: � prolit.Value$ _
Lot: Block: r Subdivision: T *See checklist for important application information and
Project name: — ----_ --- iuri:,dietion's Per whruulr fur rc-•:idential peiiiiil fec.
City/county: 'LIP: 9 7.2 2!i�
Description and location of work on premises: Riltift 6'_ l
Est.date of completion/inspection: S-Z$eU 1114-ccription Qty. Rm.unly Rrr.md)
Tenant improvement or change of.ise: A.r aondling unit CFM
Is exit;ting space heated or^anrlitioned7❑Yes ❑No -,r.ou ru�i'�orring(rs ie +an re uire ) _
Is exisdng space insulated'!',J Ycr• U No tation of existIng HVAC.system
1-ba cr�ressors
Businessnarne: G /rnATA COAIROL- Stetsbotlerprrmftnu.:
i'P Tons
�I1TU/
H
Address: 16 4E;-00 SGJ 72 i_smoc am
City; pr@r� tWQ _ oetors
(site plan require
7 istret ace Limace�ner1ux: Inclaajn,
4uctwerk/vent liner U Yea No
CCB tto.: Ttisti 56 iace/relorale heaters-suspended,
City/meuu lic.no.: IA-fl q wall,or fluor mounted _
Name(pleaseprint): O�J�ZL� — ent fur a d ranee ottler t alifurnace.
e bra od:
Absorptionunils BTU/11
Name: 117AWJK; f10eA)d9t C'hillcrr• _ HF
Addr.,ss: - f'c m uessnrc` lip
ry nrnenta erhnnst and ventkin
City: "tate: 'LIP: Aprlinnccveut
Phone:5o3-Y 3-y$22 Fax: E-mail: ryerex tmust—--�
9or4s.Typell/res. ltcheldhazmat
hoof fire suppression system _
Name: _L ,BoT�/l!5 Exhaust fan with single duct(bath fans)
Mailing nddress: /02 6!S' Shv G it/(F>`jf TSR.
__ �State:OZIP: 72Z 5� uell_p1 psi�tsteamftd n distributionart rani,actoinp toor4 A o
utlets
City:
Ty e: LPG ____ NG oil
Phone: o/ Fax: E-mail: uef n eac a itional oher4 ou- tTeth- --
ce p p nr(sc ematicrequire )
Narne: Number of outlets
— -- -. _ urrl"i edapplianceoregTpfnefiti
Address: Ur�,rratryefireplace
City:__-----_.. ---- State: Tnstn-type -- --
phurie. F I l __ ___ o-o stovelpe et stove
Applicant's signature, 4 Dnte:5t2 OZ ar
Not ail judidletions accept credit cert@,)tease call judrdiction for mar infonnarien Idemut fee.....................
U Visa MnslerC.r1U1 Notice:This per;nit application Minimt..n fee................$ 72.5-0
credit card numler _ �1 expires if a pemdt isnot obtainett Plan review(at %) c
— !tpirar within 190 days after it has been
State surcharge(89c) ....$
-- -- —
Name of c�nr�ii Im��lrnwn nn credo curd accepted as cnnm ete.
9 'rQl'''(.•All. ........... ........._A _
Cur toldc innaturr nmounr EXPIRED .1q)-4617 la(xll('nr 1