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9690 SW Lewis Lane
/\ MECHANICAL PERMIT
CITY OF T I C A R D
DEVELOPMENT SERVICES PERMIT#: MEC2002-00559
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/11/02
PARCEL: I S 135CD-03 400
SITE ADDRESS: 09690 SW LEWIS LN
SUBDIVISION: RUTH ZONING: R-4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS_ HOODS:
FUEL TYPES _ 0 - 3 HP: — T DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: B rU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OD
GAS PRESSURE: 50 + HP: DRYERS.
DRR
FURN < 10,.K BTU: AIR HANDLING UNITS C
FURN >=100K BTU: <= 10000 cfm: OTHER UNNITS:ITS:
1
GAS OUTLETS: 1
> '0000 cfm:
Remarks: Install gas line and gas insert.
Owner: -- — -.---_-- ---- --------------FEES --- - --
KNEELAND, JAMES H + DEBORAH L Description Date Amount
9690 SW LEWIS LN — — -----
TIGARD, OR 97223 �%IFCFI I I'e111111 I ec 12111102 $72.50
1 IA 8%,state l a\ 12.111102 $5 80
Phone: -- _— Total _— $78.30
Contractor:
SHAMBURG HEATING LLC
23975 SW BOONES FERRY RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone: 503-692-5563 Gas Line Insp
Mechanical Insp
Reg #: LIC 126881 Final Inspection
This permit is issuoct subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of i°;suancC, or if work is suspended
for more than 180 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR
952-001--0100. You may obtain copies of these rates or direct questions to OUNC. by calling
(503)246-6699.
Issued By: t�� i IJr�L :�-.etc j` ; .__ Permittee Signature: _7 , �-
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
flips CI9 02 10: ?.7a St.nt.t. 503-631 -6855 p. 1
Mechanical Perinit Application
�
Date received: . ,I I - 'y Permit
iln City of Tigar �ECEIVED ProJecUappl.no: Expire date:f:j,)�"•' �
--�
Cio-of')'igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Ry ' Ileceiptno
Phone: (503) 639-4171 �) n 2002 ---- - -
Fax: (503) 598-1960 J LU Case file n.: Payment type:
Land use approvA: CITY OF TIGAgn 13ualdingpen,liI ntt. --
1
Qd fit
fl-fi 2 family dwelling or accessory O Commerc:ial/industrinl U Multi family U Tenant iinprovernem
U New construction Ul Addition/allrriltinn/regi icement O Other:
3011 SITE 1 1
Job nddress: i D 5�..i „l _ Indicate equipment quantitics in bcwes below. Indicate the dollar
IG ,(.• 1�. /i a,._t ---
Bldg.no.: __ I Suite ser value or all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/accottnt no.: profit Value$ _
Lot. Block: Subdivision: - _ 'See checklist for important application information and
Project name: u jurisdiction'; fee schedule for residential permit fee.
City/county: ,z- ZIP: -/-,9,,q �J
Description and location of work�(in_Ipremises .kiza-/- UWA1
1'r•.I rl.) t ulna
_Est.date of completion/insprction: /Z; '%, 40 IDewsiption t)tr. Hew.only Iles.unh
Tenant improvement or change of use: - Alai`
Is existingace healed of conditioned?U Yes 1]No Air handling unit Cf ___ -
space mon ilioninR(sitep on required)
is existing space insulated?U Yes U No 'Mhera ion ofexisting-FIVAC.syT stem
Hoiledcompressors
Slate boiler permit no.:
Business name: , � IIP Tons IiTU/H
Address: ga`�— �'- tre/smo a damps uct smo a etectors
City' u-��+�7./'L Slate: � 7IP: �7� ! est pum (a tc an r• tore ) _
Phone: 9 5�3 Fax: _ E-nutiL nstn rcp nce urnoc umer - BTU7FI-
_� Including ductwork/vent liner U Yes U No
CCII no-:/Z(/� / R►sta vrrepincr re ocateheaters-suapen r�,cT
Ci(y/metro tic.no.: wall,or floor mounted
, ., raatlancaanuN;unr (pleaseprint): rnace
Refrigeration:
AbsentetionugiL% �._._ BT11/H
Name: 6u�r Chillers_.._- - Hp
---------- -
------ -- - --
Co ressors.. FII'
Address: r ✓ _ __ __ r suneota elUton"and rent 1bn:
City: — State: __ I zIP: _-�� Appliancevent
Phone: Fnx:6,Jl �J'S mail -��ir-yl- c7rcxfioust
notn�i, ype r65. lIC Ief 112R1a[
hood fire suppression system
Name: /_),/6�/ Exhaust fan with single duct(bath tans)
Mailing address: y _a :xhaust syslcm a tart fromTieatln or AC
ue p p ng an d strlb'at o up to 4 nu ells)
City: i Sante:dk 7_iP:f+ �3 Ty _� LPU NG Oil
Phone• p p� Fa,(: E-mail: ue to enc n ttot.o over outlets
�+P P n(sc emnt crequ red)
_N_a_me: Number or outlets
_ )1 trr ieif appliance ore pTmem
Addtess: Decomtivcflr lace
City: State: Zip: Inscri-t e — u 12Woodil
Pbone: Is-mailtov pe etstovc
U ler:
Applicant's signature: Dale: rz-f-4'z 1 _
Nainc (print): Cv2,41,S%7Qsfl _ —
V � permit IS •moi
No ell juNfdktiont tuxnpt rmbt ends.pleme call Juridictina rut enols W mtnlm- inifee fee
................$
U M¢stcK'aal Notice:"Itis pctmll application Minimum fu:................$ �Z• �_
(, �_ expires i(a permit is sent obtained plan review(at %) $
Ctedlt read number"_".___. —^ -- Pxpirel within!80 Boys atter it has been
complete.as accepted lete. State surcharge(89i,)....$
---tune of ce r aa"3wwn an a cmd s P p TOTAL .......................$ •�+D
C ho -r sllounce -�7:ttwuel Mn-1617 WOUPCOM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP _
Received Date Requested -2 -14- AM__ PM __- BUP _
Location ��SID _ _-- zlJ -tet. ' —Suite--.
MEC
Contact Person - ' - Ph( ) ' Ss le 3 PLM Contractor-__-_____ - Ph( — --) - - SWR —
BUILDING — TenanV� ELC
Footing _ 7 Y O a --
Foundation Access: ELC _.
Ftg Drain ELR
Crawl Dain _ ----
Slab Inspection Notes: — SIT
Post& r,u,•r -
Shear "rci -.rs
Ext She-AP ahear
Int Sheath/Shear -
Frarring �) �u�5 grin. 1'•T TczT = � fS•� /c,� /�L.Gf�.��✓�Z��
Insulation
Drywall Nailing S Z_.
Firewall
Fire Sprinkler
Fire Alarm —
Susp'd Ceiling -
Roof
Other:_
Final ---_ _
PASS PART FAIL ---
PLUMBING —
'oat& 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 ---�- -----
Rou h-In
2Gas Li - —
Smoke Dampers
AS PART FAIL
ELECTRICAL —
Service — — --------
Rough-In
UG/Slab - - -- -
-ow Voltage _
Fire Alarm ---- - --- -
Final F] Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS_ PART FAIL
SITE [] Please call for reinspection RE:_ _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk pate -1 �G -D z Inspector
- --' _ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hous
BUILDING Inspection Line: �..3) b 4.117
MST
INSPECTION DIVISION Eusiness Line: (503)639-4171 _
BUI,
Received _ Date Requested- _ _�.p __ - P,PA— PM_ BUN
Location Suito — _ -_ MEC er_sS
C.-tact Person _.__ _.. Ph(-.. —) � �� PLM _
Con,•actor — ----__ —_. — Ph( ) o�-S ( SWR - - -
BUILDING Tenant/Owner _ ___._ _ ELC
Footing ELC
Foundation
Access:
Ftg Drain EL FI
Crawl Drain _
Slab Inspection Nous: SIT
Post& Beam _
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: - -- —
Final _—
PASS PART FAIL
-
Post&Beam
Under Slab
Rough-In
Water Service -- —
Sanitary Sewer
Rain Drains --- -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final v
PASS PART FAIL -
MECHANICAL
Post& Beam
Rough-In -- - - -
Gas Line
Smoke Dampers — -- -
ina
PASS _PART FAI
_ELECTRICAL
Service -_-
Rough-in
UG/Slab
Low Voltage ------.__� --
Fire Alarm
Final [� Reinspection fee of$_ __required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIT_
SITE Please call for reinspection RE:— Unable to inspect-no eccess
Fire Supply Line
ADA Date _ / Inspector Ext
Approach/Sidewalk ` �-
Other
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL