12030 SW QUEEN ELIZABETH STREET 12030 SUV Queen Elizabeth Street
CITY OF T'IGARD 24-Hour
BUILuING Inspection Line: (503)639.4175
INSPECTION DIVISION Business Line: (503)63 71 MST
7, BUP
Received _� _ :)eta Requested—___ S tU PM_ BUP
Location _ ��v�G -� Cyt- ,�C. �e a _- MEC
Contact Person Ph t _) Z PLM
Contractor. _ -.-- Ph(--) ___ SWR _
BUILDING Tenant/Owner _ ELC _
Footing
Foundation Access: ELC _
Fig Drain ELR —
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ocn. -- -- —
Firewall
Fire Sp•:.tk,..r - —
Fire Alarm
Susp'd Ceiling __ _ ----- --- Q—
Roof � �, I��� �C.J � t•-.G-�/� .n •Q I�
Other: —
Final
PASS PART _FAIL - -
PLUMBING
Post&Beam - — - ---------------- - ---�----
Under SlabRough.-In n,
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 ol
Wmpers
PART_ FAIL_ ------ -- - ------ — ——
CTRICAL _
Service
JG/Slab
Low Voltage
Fire klarm
Final Reinspection fee of$—_— required before next inspection. Pay at City Hall, 134.25 SW Hall Blvd.
PASS PART_ FAIL
SITE _ please call for reinspection RE: �� Unable to inspect-no access
Fire Supply Line /
ADA S/ Z2 /cri— v�..�
Approach/;iidewalk Ditto ___��_.__. lespedw�__._— tett
Other:
Final - -- --- DO NOT REMOVE thin Inspection record U(iA the fob site.
PASS PART FAIL
\ CITY OF TIGARD __ MECHANICAL PERMIT
PE�iMIIDEVELOPMEN�f SERVICES EISSUT#: M16/02 -40205
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2911 2
PARCEL: 2S110CD-06900
SITE ADDRESS: 12030 SW QUEEN ELIZABETH ST
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: 041 JUR:6DICTIUN. K;N11
CLASS OF WORK: ALT FLOOR FURN: FVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRE_SSORSHOODS:
_ _FUEL TYPES_ _ 0 - 3 HP: 1 DOMES. INCIN:
3 15 HP: CCMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOOD STOVES:
GAS PRESSURE: 50 + HP:
FERN < 100K BTU: _ AIR HANDLING UNITS
FURN —100K BTU: <= 10000 cfm: OTHER UNITS:
DRYERS:
> 10000 c:frri:
SAS OUTLETS:
Remarks: Installation of heat pump
Owner: _ ^ FEES
OPAL STAVINOHA Type By Date Amount Receipt
12030 SW QUEEN ELIZABETH PRMT RB 5/16/02 $72.50 KING CITY
KING CITY, OR 97224 5PCT 5/16/02 $5.80 KING CITY
Phone:503-639-2070 Tota! _$78.30
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanic_.n. Insp
Phone:620-5643 Final Inspection
Reg #:LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialt, 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 Canter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: : .x Permittee Signature.
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
05/08/2002 "2:56 5036393771 CITY OF KING CIT1' PAGE 02/02
TRI-COUN Y
4RA CE aNALR echanical Permit Applicatio
1 a rcce,ved ��j?/ Permit no..
Ity�__ I -r� JF- I I Prvjecu:ippl.no.: Expire date:
13125 SW Hall Blvd.
Tigard.OR 97223 Date issued: ElyW I Recaipt no.:
Clackamas phone: (503)639-1171,FAX: (503)684-7297 Caw file no: Payment type:--
Multnomah �1
Washington Building permit no.:
C U r t t t , Land use approval-
I & 2 family dwelling or accessory O CommerciallUtdustriaJ O Multi-family J Tenant improvement
0 New construction 9,Add ition/altenttion/replacement ❑Other ---- -
I 1 A 1 et M III1
Job address: Q' Sit), PN �-1 Srr — Indicate equipment quantities to buxeS bC10w. Inei,ate tlu doilai
l
oba. value of all mechanical rrat,�ttisls.equipment, labor,overhead,
profit. value S
Tax map/tax lot/account no.:
Lot: _ $lock: Subdivision: *See checklist for important application information and
Project Wattle: ST1{•V Iy 0 I`f/T Jurisdiction's fee selwtiule for residentia!p f!nit fee.
Cit /y caUnty_ UM Zi P: Cy7o� t , t
Description and location of work on premises: 1 /
Fee(ea.) Cowl
Descsipdoa I oty. Res.only Rea oulvi
Est.date of completiorOnspection:
Tenant improvement or change of use: Au handll,s unit CFM
Is existing space heated or conditioned?,Vies ❑No Air conditioning(site plan
is existing space instdated"*"Yes O Ne Alteradon of existU,g HVAU system
1 o er/compressors
State boiler permit no.:
15 Lis Ines � 6
s name: Lfa i* ! N _� �� � _ HP Tons BTU/14
Addrfts: ��1 _ .� t t !�1 ver Firel3moke am rWV uct stttoke etectara
City: jr !�' State: (� ZJP GJ 3 Heat pump(site plan required)
sea replace himace/burner
Phone: r-mail: tncluding ductwotidvent liner ❑Yes 0 No
CCB no.: tnsta Urep ace/tt:ocate cart,%-suspended.
City/metro tic, no.: / b 94 wall,or flour mounted
name (please r;nc): prI79/J N t L/il )'?fP ent or ap liana o er an ace
R- eh tgeratioont
CONTACT PERSON
Absorption units BTu�t
Chillers HP
Com t:ssors HP
\ddrtss: _ �G Envitoometttal exhattst Rnd vent
ity State- ZIP: _ Appliancr. vent
'hone: Fax: E-mail; ryer ex sunt
00 `u res. tchca—tttanat
hood rite suppression system
14arn yl ..._ -roLV I -1A Exhaust fan with duct(bath fins)
�tailtng address: /c�DsO 1?Q L !Q�lM Sr
Exhaust system an tom eating or AC
_ — -Tuel piping and ciLdribution i u
up to 4 oNers/
:ity: /yt l:lt Stat ZIP' �a.ell/_ Ty LPC} NO Oil
'hone; 'c0 Fax E-mail. ,ue i in each additions over s outlets
r Processpiplog lsc ematic require )
Number of outlets --
,ame Other listod appliance or equ penenV
Wdress: - _ --— Decorative fireplace
tty-• - State: ZIP' Insert-t pe
0o stove/ et stove _
'hone: I E-mail: ther. _ l
pplicdnt's 11grt<at re
,Llmc (Frim). -
Fcrmtt fes............ ........5 _
11i wiw-cuoas accept crash caul.masse csli tunvLcuon me mnreVortex: rhet permit application Minimum fee S
ti,,j 7 htasscrCrrd expires(/'a permit is nor obtained plan review(at _ %) S
�1,t=rd number _ --L—.L—
eaplm� w(thln 1d0 dm�r after u h-.:s been State surcharge(8%).....S accepted as as complete. TOTAL
Narht of oardPeldcr u tho+�n oa ctcJ��card ; ...........•....,�..•.� � -
Cadholder sle,ta,urc am°cnt AAO-"I rtht) COM