14255 SW 114TH AVENUE 14255 SW 114"' Avenue
CITYOF TIGARD __ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00182
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/10/03
PARCEL: 2S 110AB-03500
St'i E ADDRESS: 14255 SW 114TH AVE
SUBDIVISION: COLE'S ACRES ZONING: R-2
BLOCK: LOT: 016 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES: B_OILERS_/_CO_MPRESS_ORS_ HOODS:
FUEL TYPES _ 0 - 3 HP: W 1 DOMES. INCIN:
LPC; ~� 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
f IRE DAMPERS?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: IfJOOD
FURN < 100K BTLI: 1 AIR HANDLING UNITS CLO DRYERS:
— — --- OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Replace gas furnace and install exterior AC unit. AC ruirwt be placed in the rc+:,red setbacks.
Owner: FEES
JACK DETRA Description Date Amount
14255 SW 114TH AVE -------
TIGARD, OR 97224 I MI:('l l I Permit hce 4/10/03 $72.50
ITA X1 k"1,StateT'ax 4/10/03 $5.80
Phone: 503-039-1019 __—__ Total $78 30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 624-2704 Cooling Unt Insp
Final Inspection
Reg#: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work vIll be done in accordance with approved pians, This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001.00
Issued By: ��L' '�c?t�' _ �t Permittee Signature:+
Call (803) 639.4175 by 7:00 P.M. for inspections needed the next business day l
Mechanical Permit Application Permit no
�V
_ - Datereceived.f -
('ity of Tigarc1
ProjecUappl.no.: Expire date:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ByB Receipt nu
City of Tigard Phone: (503) 639.4171
Case file no.: Payment type:
Fax: (503) 598-1960
Building permit no
Land use approval' —
U U Commercial industrial
❑Multi-family
I &2 family dwelling or accessory ❑Tenant improvement
m
Wddition/alteration/replaceent U Other:
U New construction _
t �
f� Indicate equipment quantities to boxes below. Indicate the dollar
Job address: Vvalue of all mechanical materials,equipment,labor,overhead.
Bldg no.: Suite no.: profit.Value$
Tax map/tax lot/account no.: *See checklist for important application information and
Lot; Block; Subdivision:
jurisdiction's fee schedule for residential1,11 prnnit tee
Project name: _ l
City/county: / ZIP. �J 7� t s i
l t
Description and location of work un premises: Fee(ea.1 l„ .1
DOWri Res.unk 16, W
E ,date of completion/inspection: C;
Tenant improvement or change of use: Air handling unit _t-1'I'll --
is existing space heated or conditioned?U Yes U No Air con itioning(site p an require )
teration o existing A system _
Is existing space insulatcri''U Y a ❑No A os er compressors
tIN t & t '
State boiler permit nu. BTU/H
Business name: Hp _-Tuns-l�l�t Lr� cN6 w s _ __—
tr smo a ampers/ uct smo c detectors
Address: , eat pump(site p un require ) —-
City, _ State: IIT
nsta rep ace urnuc• timer
E-mail-Phone: Fax- 4 - Including ductwork/vent liner U Yes No
CCB no.: 07/_ 3 nsta rep ac re ocate eaters-suspen a �-
wall,or floor mounted
City/metro lie.
to.: j� ---- - — ern or a r tunce other t an unlace
c��
Name(please print) M, t h a C- / ABSa gerat on:
t e Absorpuonuntts_,�--- IIV —•--_._- _-.
N Ht'
UQ Chillers - - -
Name: P�,y09 4 Com ressors— —_--
Address: :nr ronmenta ex uswt an rent at on:
City: Stale: LIP: lienee vent
Phone: Fax: E-mail:
erex taust
0o s, ypc res. tic a azrnat
hood fire quppiession system -
Exhaust fan with single duct(bath tuns)
Name: ��
0L_ Exhaust
x east s stem a art rom eaun or At(up to �_--
Mailing address; i SY t l / �-' are p p ng an ,t art on Out ---
Stale:Q(_... ZIP: r' J'y e; 11'(1 __ NU Oil
_ .
City: --- -•ur 1 In eac a diuna over out ets --
Phone: Fax: Email: rocas piping(sc ernatic require ) -)----
Number of outlets --• - -
Name: t er app aace or e—yTmclit:
Dccorativefireplacc ---�— -
Address:_ nsert-ty e _ --
City: State: ZIP: _
0o t et glove
Phone: Fax: E-mail:
Applicant's signature: ,`
Date:
Name (print): {'enni�fey $ ---
Not ell J uirdictiutu 8cupt smut cud,,pleoe call JadtKtkuon lot more inrormauun. Notice:This permit application Minimum fee
U vise U Mastercard expires if a permit is not obtained plan review(at %) $ ---_
Credit card numbs. _ --- Aplrcr within ISO days after it has been State surcharge(8%) $ -
u r awn on credit c 3
accepted as complete 'TOTAL ............. . $
Name of cu 'o der _---------
C older ri`nature Ama+at
HEATING & COOLING, INC.
8900 S.W. 13URNHAM ROAD, SUITE El 10
TIGARD, OR 97223
(503) 624-2704
FAX (503) 598-0270
I
.JOB ADDRESS:
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD
BUILDING 24-Hour
Inspection Line: (50.3)639-4175
INSPECTION DIVISION
Business Line: (503) 639_4171 MST
Received .�� 4, Date Requested
"/'2 SUP
Location / oZ S,S" Jou �' AM
BLIP
— - --------- ----
PM
Contact Person ---- Suite _ MEC
Contractor PLM
rFtgDrain
G Ph --
Tena —wne ------ SWR
n - Z-7- ELC
Accen , � EL.0
---
Post& Ream Inspection Notes: n - - `"J ELR
Shear Anchors SIT
Ext Sheath/Shear j --
Int Sheath/Shear ri'S r
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ----
Fire Alarrn ---.---
Susp'd Ceiling --- --
Roof
Other: _ --
Final ----PASS PART FAIL
PLUMBING
PnsI$ 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
F' ` --
PAS PART FAIL _
_ CTRICAL —"--
Rough-In
UG/Slab ------
Low Voltage
Fire Alarm ------- - -
Final -----`-___---- ------ -`_ _
PASS PART ❑ Relne ction fee of s-
SIT
"__- FAIL required before next inspection. Pay at City Hall, 13125 SW Ha
SITE I-
Fire Su j L� Please call toy reinspection RE:--___- II Blvd.
ADA PP Y Line _ -_4- El
Approach/Sidewalk OaRa LJ Unable to inspect-no access
Other:- -` ��• -L--- Ins ect ,
Final / r /
PASS PART FAIL �� NOT,
REMOVIE this Inspection record from the o Ext
job site.
CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICESPERMIT#: ELC2002-00550
DATE ISSUED: 10/17/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4111
SITE ADDRESS: 14255 SW 1 14TH AVE PARCEL: 2S110AB-03500
SOBDIVISION: ZONING: R-2
BLOCK: LOT : 016 JURISDICTION: TIG
Prcject Description: Installation of new 200amp service
RESIDENTIAL UNIT TEMP SRVC/FEEDERS
SF OR LESS: MISCELLANEOUS
1000 0 200 amp: PIIMPlIRr21GATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp:
MANE FIM/SVC/FDR: SIGNAL/PANEL:
601+amps - 1000 voits: MINOR LABEL (10).
_—_ SERVICE/FEEDER _ _ BRANCH CIRCUITS ____ ADD'L INSPECTIONS
0 • 200 amp: 1 W/SERVICE OR FEEDER_ PER INSPECTION: +�
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC:
6101 - 1000 amp: IN PLANT:
1000+am /volt: --�-- -- — _ PLAN REVI-W SECTION
p 4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR >=225 AMPS: C_I.ASS AREA_!_SPEC OCC: _
Owner: Contractor:
JACK DETRA PHIL'S ELECTRIC
14255 SW 114TH 6600 SE CHARLES ST
TIGARD,OR 97223 MII.WAUKIE,OR 97222
Phone: 503-639-1019 Phone: 659-0303
Reg #: ELE 3-2170
FEES
Description Date Amount
[ELPRMI'j ELC Permit 10/17/D7 Required Inslacctions
$80.30 — -- -------------
[TAX]8%State Tax 10/17/02 $6.42 Rough-in
Elect'I Service E'V a R��,
Total $86,72 Elect'l Final //''�� f( e J
��/
This Permit is issued subject to the regulations contained In the Tigard Municipal Code,State of OR. Spedalty',;Wesehd ah-otbe(applicable la
All work will be done in accordance with approved plans. This permit wi'I expire if work Is not started within 180 days of issuance,or if work is
suspended for more than 180 days. ATTENTION: uregon law requires you to follow rules adopted by the Oregon Utility Notification Center. This
rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules ordirect questions to OUNC at(503
246.6699 or 1-800-3X.2344. �/
Issued By: Permit Signature: '
OWNER INSTALLATION ONLY `
The Installation is being made on property I own which is riot intended for sale, lease, or rent.
OWNE=R'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 1 DATE:—___.
LICENSE NC: —
Call 639-4175 by 7:001im for an Inspection the next business day
til
LA
V
BUP - Building Permit ELC - Electrical Permit _
Inspection Description Date Passed By Ins ection Description Date Passed--'—By
Footing/Setback _ _ Underground cover
Foundation walls — Wall cover
Footing drain Ceiling cover _
Waterproof bsmt walls Electrical rough-in _
Slab _ Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural_
Shear walls/anchors ELR - Resirieted Energy Permit
Roof nailing Inspection Description Date Passed _ By
Firewall Low voltage _
Tilt-up panel Electrical final
Masonry/Reinforcement -
Framin - — --_
MFG-Structure set-uMEC - Mechanical Permit
Insulation _ inspection Description Date Passed By
Drywall nailing
Suspended ceiling Post/beam mechanical
—
Engineered soils Gas line
_ Welding Lab Final Mechanical rough-in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector —_
Fireproofing Lab Final Mechanical finalH—
PLM
Final ins ection ----- Plumbic Permit
BUP— Fire Protection System Permit Inspection Description Date Passed B _
_ � Inspection Description Date Passed B Plumbing underslab
_
Sprinkler underfloor/slab Crawl drain_ _ Crawl
plumbing
_
Sprinkler rough-in Post/be_
Sprinkler final Plumbing top-out
RP/backflow preventer
Fire alarm final Rain drain
— Storm drain
Water service
SIT - Site Permit Sanitar sewer
ins ection Description Date Passed B Culvert/catch basin
Footings Pum /fill se tic tank
Foundation walls Plumbing final
Sprinkler supply lines —
S rinkler underfloor/slab —
Catch basin/Manhole _ SWR - Sewer Permit _
En ineeree soils _ Inspection Description Date Passed B
Engin rring acceptance Sanitary sewer
Final inspection _ Final in ee tion
Inspection Record - BUP, PLN/1, SWR, ELC, ELR, MEC, SIT' Permits
i:\dol3\formiHnspRecurdBUP.duc 04117101