9400 SW LAKESIDE DRIVE coo
0
O
r
D
m
(7n
65
m
v
�11
P
i
V9400 SW LAKESIDE nR
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00601
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: I l ln3
PARCEL- LS111DB-12801
SI'.E ADDRESS: 09400 SW LAKE SIDE UR
SUBDIVISION: SUMMERFIFLD NO.12 ZON:NG: R-7
BLOCK: LOT: JURISDICTiON. TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLER';-
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: B OILERS/COMPRESSORS _ HOODS:
FUEL TYPE, 0 - 3 HP: DOMES. INCIN:
_PG 3 - 15 HP: COMML. INCIN:
MAX INP,'T: BTU 15 - 30 HP REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 ► J: WOODSTOVES:
GAS PRESSURE: 50 HP:
CLO DRYERS:
FURN �- 100K PTU: 1 _ AIR HANDLING UNITS
FURN >=100K 'J: � <- 10000 0m: -` OTHER UNITS:
>
GAS OUTLETS:
10000 cfm:
Remarks: lteplacc cati t'urnac
Owner: _ _ —_---� FEF
ALLEN, MARJORIE E TRUSTEE Description Date Amount +I
ALLEN, MARJORIE E [MEC'Fli [lei nii Icc 10/15/03 $72.50
9400 SW L AKESIDE DR
TIGARD, GR 97224 [TAXj f{" St,rc'1++x 10115/03 $5.80
Total $78.:+0
Phone: 503-684-3063 -- --
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
8900 SW BURNHAM #E1110 REQUIRED INSPECTIONS
TIGARD, OR 97223
nsp
Phone: 503-624-2704 Heating I
Final Inspection
Reg#: LIC 76359
This permit is issi:ed subject to the regulations contained in the Tigard Municipol Code, Slate of Ore. Specialty Codes
and all other applicabie laves. All work will be done in accordanc,o with approved puns. This permit will expire if work is
not started within 180 days of issuar e, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notifica+ion Center. Those rules are set forth in OAR 952-001-00
Issued By: Permittee Signature
Call (503) 639-4175 by 7:00 P.M. for inspection; deeded the next business day
n MechanicalPern-it,kpplication
!Da!teivedV0 / ;-h7) Permit no.:
City of Tigard 4 r Projcct/appl.no.: Expire date;
City ofTigard Address: 13125 SW Hall J'vd,Tigan 9aj 3 C�
Phone: (503) 639-4171 ! Date issued_ I Receipt—no,!
Fax: (503) 5A-1960 r)t V1. r7., M03 Case rile no.: Payment type:
i
Lan: use approval. :: _ Building perrnib nr,
U 1 &2 family dwelling or accessory U C,inunerlial/industnal U Multi-family U Tenant in:�rovement
U New construction14;;/Addilion/alteration/replacement O Other
ANR -ION
Job address: i ) Indicate equipment quantities in boxes below. indicate the dollar
Bldg. no.: I Suite no.: val de of all mechanical miimrials,equipment,labor,overhead,
Tax map/tax lot/account no,: prc fit.Value S
Lot: Block: Subdivision: •See checklist for Important application information and
Project name: jurisdiction's Ne schedule for residential permit tee.
City/county: 7lP
Description and loca ton of work on premises: k1id
F(c(ea.)I 'Total
Est.date of completioNinspection: Description Qr , Res.only Res.only
Tenant improve,uent or change of use: 7Arhand
i�existing space heated or conditioned?U Yes U No ing unit CFM i
Aircon itioningsite Ea
Alteration
Is existing space insulated?U Yes 0 No tare ono exist ng H VAC system
Boiler/compressors
Business name: State boiler permit no.:
,�f11,(� w_ �L1N/._- Tn�- HP __Tons_ BTUtH
Address: Q D d O}� J sJ 03 Ir smo ce am erss/doct smoa electors
City: State: 7_IP: eat pump ate an re erre -
Phone: ' Fax E-mail: nsta rep ace urnac urner >:_ --�"-"-
CCB no.: tG 3 -- Including ductwork/vent liner 0 Yes ,)
--..----- _ nsta /replace/relocate heaters-suspended,
City/metro lic.no.: 7 — wall,or floor mounted
tNamnlplcasepnnt). n'1r'Chae o�.f�IS ant ora tanceother an urnacea gerat on:Absorption units BTUIH
���L ��� ON OChillersHP
Com ressors _ HP
nv onmenUTex laust an vent at on:Cty: State: Z[P: Appliance vent
Phone: F<tx: E-mail:illyol N" ry)7—erexFiausi—
0o s, ype. res. tc e azmat
hood fire suppression system
Name: 1i'�1Q /1/',7;y� Exhaust fin with single duct(bath fans)
Mailing address: C�iJ !.t x ousts stem a a t nom ellen or —
Fuelpiping an st ut on up to 4 outlets)
City: , State. ZIP: 411Type: LPG NO 01
_
Phone: ! '� Fax: E-mail: ue pipi each a tuone over outlets — ----
Process piping(sc ematic require )
Number of outlets
Name: -Other I st appl ance or equipment:
Address: Ldecoretivefireplace
City: State: ZIPInsert-type
- _
Phone: Fax: E-mail: woo love/pellet stove --
Applicant's signature: Date-./r, - Other: --"—
Name (print): � ;�.a Other:
Not UI Jurisdictions accept credit card,,please call)uritdiction for more Information Pen mit fee.....................$ _ �c� �U i
J Visa ❑MasterCard Notice:This permit application Minimum fee $ j
Credit card number, exp!res if a permit is nrt obtained
e.nt71 - wit.In 190 days after It hes been Plan review(at _ %) $
i�unf car
.oof r u shown on credit c _ ar,xpted w compleit- State surcharge(8%) ....$
_ _ s fOTkl. .......................$
Cardholder dµ.uure—' i� Amouai
— 440-4617(001COM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
NIST
INSPECTION DWISION Business Life: (503)639-4171
BUP .—.----------
Received r Z 1 ___�_ rate Requested. __._W_2 AM --PM
— �7 t- . Suite MClocation ___6 3
Contact Person _—_��..1�►%? �• -------�--- ----. Ph -
Contractor _10lu c-1_ at Ph (.—_—__) _— �_--- /SWR
BUILDING Tenant/OwnerCELC —
Footiny — -- ELC
Foundation Access:
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shea, Anchors ------ - -- -- -- -__-..-
Ext Sheath/Shear
Int Sheath/Shear
Framing - ------- .- --------------- -
Insulation
Drywall Nailing - - - ----- -- ----,%-- - -- --
Firewall /• ------__..__
Fire Sprinkler ----- -- ------ - -
Fire Alarm � ----- ---_- __---
Susp'd Ceiling -
Roof
Other -----__-..-- --- - — ---------- - -
' Final -- - -
r PASS PART FAIL -- --- ----- --- � — ----- ----�-PLUMBING -__-_ - - ----- --- --- -- -
Post& Beam --
Under Slab - -- - ------ -
Rough-In
Water Seivice - --- - - -- - --------
Sanitary Sewer
Rain Drains -- -- ----- --- ----
Catch Basin/Manhol<
Storm Drain ---- — ------.-- -
Shower Pan
Other: ---
Final — —
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In -- - - -_ -
Gas Line
93 , ART FAIL - - - --------- -- --- -
EL ICAL
Service
Rough.In
()G/Slab
Low Voltage
Fire Alarm
Final fee of Reinspection $_ required before next ins ectiun. Pa at Cit Hall, 13125 SW Blvd.
PASS PART FAIL l p p y y Fall
SITE - j Please call for reinspection RE' ___- `.____ Unable to inspect-no access
Fire Supply Line
ADA -
Appro Bch/Sidewalk Date_�L?'�_Z_'_d .. Inspector ._�__ __. Ext
Other
Final DO NOT REMOVE this Inspection recoFd ft,-,,n?,he lot) site.
PASS PART FAIL