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CITYO F T I f�A R® J,MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002-26007
DATE ISSUED: 9130/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111CD-07200
SITE ADDRESS: 15760 SW SERENA CT
SUBDIVISION: KERWOOD ESTATES ZONING: R-4.5
BLOCK: LOT: 01 G JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRE`: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BO_ILE_RSICOMPRESSORS _ HOODS:
FUEL TYPES _ 0 3 HP: 1 DOMES. INCIN:
LPG 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 >=10"K BTU: <= 10000 cfm GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas furnace and install A/C unit. Exterior A/C unit cannot be placed within the required setbacks.
Owner: FEES
JOHNSON, ROGER L + DONNA A Description Date Amount
15760 SW SERENA CT [MIJ I I I Permit Fee 9/27/02 $72.50
TIGARD, OR 97224 IMI;.e III Permit fee 9/30/02 $0.00
['TAXI K",,State'Tax 9/27/02 $5.80
Phone: 503-684-1658 [TAXI x StateTax 9130/02 $0.00
Contractor: _ Total $78.30
A-1 AIR CONDITIONING CO INC
2038 NW ALOCLEK
HIL.LSBORO, OR 97124 ^.EQUIREU INSPECTIONS
Mechanical Insp
Phone: S03-645-5900 Final Inspection
Reg #: 62102
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws All work will be clone in accordance with approved
plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100 You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699
Permittee Signature: CiAj
Issued By:
Call (503) 639-4175 by 7,00 P.M. for inspections neer'ed the next business day
FAX N0. : 6807435 Sep. 23 2002 11:48AM P1
Mechanical Permit Applicatir!,
—` - - Uatcreaeived: '�.? C Permit no.:P�f-CZOpZ- d b7
City Of Tigard Projcct/appI.no.: lixpiredatc:
Address: 13125 SW Hall f1lvd"ri atl l 371
4rh oj7rgnrd S tciasued; P; Rcceiplho.:
Phone: (503) 639-4171
Fax: (503) 598-1960G file no.: Payment type:
SEP > '' 1�)���I
Land use approval: Building permit no.;
U 1 &2 fantiiy dwelling or accessory U CommerriaVindustrtal O Multi-family O Tenant improvement
U New construction l]Addition/alteratiotr/roplacement U Other:
lob ariJn r;: /,�'1 G 544-> a i2 Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: - Suite no.:
- "� value of all mechanical materials,equipment,labor,overhead,
--- -- --
profit.Value,$
Tttx ma tux lot/aocount no.:
Lot; Block: Subdivision; •See checkllsl for important application information and
Project name: urisdiction's fee schedule for rr-sidenlial permit fcc
C It /county:
7-1 GR 7 ZIP: 7
Dowriptlon and location of work on premise.,' p woe 64S
F'e4Ne.A nt L� .A..C_ Fee(".) iol-i
Eat.date of compledoidina tion: Qty. !Is onl ttes,onlr
Tenant impruvrment or change of use: r
Is exislu! spare heated or conditione•Y)U Yes Fi No AirhattdUng ing CFM
ft ��Alican l on n site
Is existingspace insulated?❑Yea U Noexisting
E p
p A ter'T� at-lon of at ng NVAC system
or er/compressors
Business name: Slite boiler perndl no.:
�_I A I re- M&L.9—l �r� LAG NP Tons HTU/H I _
Address:7_6 AJW ,4 L b_G e- A. A7 2 a S- •iW)smo c em -eruct smo c olectors
City:.y:_i��- a--,tPa
-�S"Ic: 21P: /� cat um (site plan requt��
Phonr&vAr->3x���7Y F�mAi1: Instal/rep acefurnac urnerIncluding ductwork/vent liner Q Yes 17 No
CCB no.: QZ, �' � _ .-_ 1ns411T.pTa eeliilocs�eaters-suspen ,
city/retro lie.no.: _ wall,or floor mounted
Noma lease nQ: cntora lance other an furnace
Rdirigmuou..
Absorption units BTU/H
Name: Chillers IRP
Address: - - Compressors HP
_- _-_- -- _ ntnerta and ventilation!
Appliance vent _
Phonr.: Fax: Email: �ryercx gust
00 , vpe trs.kitchentimnat
hood fire suppression system
Name: 1 ;'' ! (Jf�/V Sa/�/ -- tixb•-•st fan with single duct(bath fans)
Halling address: `i rp y' system a art m ea n or C
City: State- gyp; b p an distribution up to ou ets)
_ _ Type: _LING Na Oil
Fax: &mail: Fuel pipingeach additional over outlets
piping( emat c required)
Numhrr of outlets
Name: - of errmfea ince or eq pias !
AdJtess: Ikeorative firepl acc
City: State: _ ZIP
Phone: Fax: -mail: oodsto pe et stove
Other:
Applicartt's si titre _ :
Name( nt): -a-61 _ G. oUIC
Irrlydk*M.e�ep coo card+.dam cora)tn Mft;ioc lar mac fetor Wm MiniPermit fee.....................
Nor an S
Q Visa ❑MastaC.acd Noti:c:'oris permit application Minimum fee................S
explrit s m mit is not obtained plat review(at _•, c.6) S
Cr«tl[card nvmlrar.-- _ ►a rc, µ;thin 180 days after It has been
accepted ar completo. State surcharge(8%)....$
.M u on TOTAL
-- cxdwft 4404617(GMWOM)
FRbM : A FAX N0. 6907435 Sep. 23 2002 11:49AM P3
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 BUP ---— —
Received -- Date Requested_ AM PM BLIP
Location __.--_-- l 26 W 1A ._--Suite - MEC -_ or .z�00
Contact Person -. - --- Ph( ) - �S- PLM _
Contractor - ----- -- - - Ph( ) — — SWR —
BUILDING TenantlOwner ELC -
Footing - - ELC --
Foundation Access:
Ftg Drain ELFT
Crawl Drain -- -- - _ - SIT
Slab Inspection Notes:
Post&B^am
Shear Anchors
Ext Sheath/Shear -------
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling V'
Roof
Other. _--._ --
Final
PASS PART FAIL
--
Post&Beam
Under Slab - --
Rough-In
Water Service
Sanitary Sewer
Rain Drains --` _---
Catch Basin/Manhole
Storm Drain
Shower Pan -- -
Other: -
Final -
PASS PART FAIL
E_CH ANICA - _ _- -- -- ------- ---- --
Post n Beam
Rough-In _-._--
Gas Line
SM91W Dampers �-
_ A PART FAIL -�-�
ELECTRICAL —
Service _-v-
Rough-In _--- --- ---�.-�
UG/Slab
Low Voltage ---- - -_— - -------- - -
Fire Alarm
Final F-1 Reinspection fee of$ -_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAILr ,
SITE F] Please tali for reinspection RE: - _J
- L Unable to inspect-no access
Z/A Fire Supply LineADA JG -G �--- ExtApproach/SidewalkInlpNtOr_ - _- - �_T
Other. ---__---- _
Final DO NOT REMOVC this Inspection record from the job site.
PASS PART FAIL