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12970 SW GLACIER LIL" CIR
MECHANICAL PERMIT
CITY OF TIGARD PERMIT#: ME C'2004 U00`,�,
DEVELOPMENT SERVICES DATE ISSUED: 21101041325 SW Hall Blvd., Tigard, OR 97223 (503) 639 4171 PARCEL: 1S133DA-06200
SITE ADDRESS: 12970 SW GLACIER LILY CIR
SUBDIVISION: AMART SUN,MERLAKF ZONING: R-7
BLOCK: LOT: 084 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VEN I"S W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORSHOODS:
FUEL TYPES 0 - 3 HP: 0 DOMES. INCIN:
j j 1()' 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS _ OTHER UNITS:
FURN >=1(10K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: �i;u;i}i Iuin;nrirhl,i ,!n nt
Owner: _ —_ FEES
BAUMGARI' ,.ER, ROBERT P +SUSAN K Description Date Amount
12970 SW GLA':'IER LILY C!RCLE IMEC'IIj Permit Fec 2110104 $72 50
TIGARD, OR 9(223
ITA X1 State S111hart 2/10/04 $5.8U
Phone- 503-5U! .1320 rota! $76.30
Contractor:
ABLE HEATING& COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED_INSPECTIONS
Heating Unt Insp
Phone: 503-579-2250 Fina! Inspection
Reg #: I_IC; 108535
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utilit'; Notification Center. Those rules are set forth in OAR 952-001-00
i1
Issued B Permittee Signature:
y�
.y
Call (503) 639-4175 by 7:00 P M. for inspections needed the next business day
Mechanical Permit_Application
Date recei vedt f Permit no.:M G 1
City Of Tigard Ptoject/appl,no.: Expire date:
City(if rigard Addretts: 13125 SW Hall Blvd,Tigard,Ok 97223 Uste issued: By: Receipt no.:
{'hone: (503) 639-4171 ,7 2
Fax: (503) 598-1960 1' Case file no.: Payment
Land use approval: Building permit no.:
Lp 1 &2 family dwelling or accessory O Commercial./industrial J Mulli-family U Tenant improvement
�j New construction ❑Addition/alteratioNn placement LJ(hhei
Job address: LI Inuit ate equipm(w (lo,omties in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,eq,, ment,labor.overhead,
l Tax maphuA lotlaccount no.: �— profit.Value$
Lot: Block: Subdivision: _ 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ', ZIP: c0aq3 _
Description anil focadon of work on premises: _
1'"(a.) Total
F.st.date o complelion/inspeclIon: _ — DMTi ion - Ress.only Res.onl
Tenant improvement or change of use: Air handlin unit _ CPM___ _
Is existing space heated or conditioned?U Yes U No Air conditioning(site plan required)
Is existing space insulated?U Yes :3 No Alteration of existiaLffVAC system
oiler/compressors
Business name: t State boiler permit no.:
-—--- HP Tons_,_BTU/H
Address: t C! f e v smoke am rs/ uct smoke detectors
city; State: ZIP: 7 cat urn (site an required)—
Phone: Fax: , - ,- jc E-mail: Install/rcptace urnacc/burner /
CCB no.: Including ductwork/vent liner (p Ves U No f
lnstall/replac re ocatehat� e- rs suspended,
City/metm tic.no.: wall,or four mounted _
Name(please pnnt): t s %lent for appliance other than furnace
Refrigenl a: - --
Absorption units
Nunc: Chillers___ --
Address: -�--' _ Com ressors_
v oaoe�ta a amt rued Ventilation:
Cit;: -- ---- _ Stele: ZIP: Atpliauccvent_ -
Pttone: Fax: E-mail. Dryerexheust _
Hoods,Type V l/res.kite leNhar:mal
hood fire suppression system
Name: Exhaust fan with sin le duct(hath fans)
Mailing address: \ , I I t :x aunts sy tem a�art min eattn ur AC
piping
7 k
City: Stale ZIP:,-\-)a2 — Fuel prpmg.ria aurnortuon(up to outlets)
T I.PG NO _— Oil
Phone: Fax: E-mail' T—Uel iipingeach odditional over 4 out ets
roce»p p (schematic require )
Number of outlets
Nettle: —— - ---- ---.- Other listed appliance or eq peens: -
Address: _ Decorative fireplace -
Cily: State: ZIP: 'Inserl-
Pfwne:-^ Email: — n stov letsiove _
Other:
Applicant's sigt�Ftz
Date: I( u t
Name( tint): �' _r
Nat W jIWYf.rir a a'x*o credit rands plrerr all itw!A4 W for"W"Irdatautlaa. Permit fee.....................s
U Visa J MasterCard Notice:this permit application Minimum fee................$ _
Credlr� number ' '"'r,�/ r . �JZ'i G� P� expires if a lermit is not obtained plan review(at , %) $
�r--,�,= willihi Igo days after it has been
accepted as State surcharge(896) .$
:v a ati edit cad f cep complete. —
TOTAL .......................S --
�, Crdbddet e;earWit w —AawM J 4404617(~-OM)
CITY OF TIGARD 24-Hour
BUILDING
Line: ( )639-4175
INSPECTION DIVISION Business Line: -341711 MST
BLIP
Received _ Date Requested —� v AM ' / / —7PM_ _ BLIP
1— Suite _ _ MEC
ontac�) d.0 15 Ph PLM
130tractor Ph SWR
BUILDING _ TenanUOwner -_ _ _ ELC _
Footing ELC
Foundation Access:
�' - - -
Fig Drain ELF!
Crawl Drain _
Slab Inspection Notes SIT
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 -- --- -- — --�-
Ce.tch Basin/Manhole
Storm Drain -— --
Shower Pan
Other:
Final
PASS "FT
T FAIL
CI4-0► J
o Beam
Rf
ough•In
Gas Line
Smoke Dampers -- -- —- ---_
ART FAIL �— -��-- - ---
EL TRICAL
Service --
Rough-In
UG/Slab
Low Voltagn
Fire Alarm
Final Reinspection fee of$ iequired before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
gITE Please call for reinspection RE.�_ u Unable to inspect-no access
Fire Supply Line
ADA
r
Approach/Sidewalk Date �� --- - Inspector _ext
Other:_
Final DO NOT REMOVE this Inspection recd-d from the jab site.
PASS PART FAIL