Permit C ITY OF TIGARD MECHANICAL PERMIT
0 DEVELOPMENT SERVICES PERMIT #: MEC2003 -00493
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/13/03
PARCEL: 2S1 11 DD -01000
SITE ADDRESS: 15800 SW 88TH AVE
SUBDIVISION: STRATFORD ZONING: R -4.5
BLOCK: LOT: 048 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install extrior A/C unit. Do not place within the required setbacks
Owner: FEES
KNUTZEN, DAVID W + CINDY B Description Date Amount
15800 SW 88TH AVE [MECH] Permit Fee 8/13/03 $72.50
TIGARD, OR 97224 [TAX] 8% StateTax 8/13/03 $5.80
Phone: 503 620 - 4811 Total $78.30
Contractor:
SUNSET FUEL CO
PO BOX 42287
2944 SE POWELL BLVD REQUIRED INSPECTIONS
PORTLAND, OR 97242
Phone: 503 234 - 0611 Final Inspection
Reg #: LIC 2374
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 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 Center. Those rules are set forth in OAR 952 - 001 -00
•
Issued By: Permittee Signature: ,- .{1Y1
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next • usiness day
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Mechanical Per t, , liy n
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Al
Datereceive Permit no a D7�'f93
i,IL'''�� City ' Cit of Tigard
dd —�--
�1 �{ Projectiappl- no.: Expire date:
•
City of Tigard Address: 13125 SW Nall Blvd, Ti t]S X9 7 3 Date issued: $y; Receipt no.:
Phone: (503) 639 -4171 •
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment typo:
Land use approval: BUILDING DIVISION Building permitno.:
T1' P1 OF PLRMIT
I. I & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement
Q New construction kAddition /alteration/replacement Cl Other:
JOB WI% INFORMAT ION (.'0M1111•.R('IAL VALUATION 1(.'IILDULE
Job address: i5$OD GO cato • Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: S uite no -: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit Value $ .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: ov jurisdiction's fee schedule for residential permit fee.
City /county: "TI yrk 'ZIP: ('n. s1/ 1 .i 2 F;1MI1:1 1)11 F:LLIN( PERMIT hF:E SCHEDULE
Description and Vication of work onpremises: tiAesittalit i(. % NI)(' O\ 1MFlt1(' :1LlINDiIs1 toALLQUIPMENI'stir! flFLE
Fee(ea.) Total
Est, date of completion/inspection: %in, 0 Desert , .. , Qty. Res. oal Res, onl
Tenant improvement or change of use: e- ' AC:
I
Is existing space heated or conditioned? Cl Yes 0 No Air handling unit ., CFM PD-00 ■
Air conditioning (site plan required)
Is existing space insulated? LI Yes 0 No Alteration of existing HVAC system
11E01 kNICAL ('ONl'It,1(''I 114 : o er compressors
Business name: 5uk1,s.e+ 'IrUi, Start boiler permit no.:
HP TOna BTU /H
Address: .2444. S e () I B V&I Fre/smo •amper: • uct smoke detectors I ____
City: ' ) CZ d' ZIP: et a'1„ ' eat punip site plan requ 14 14-60
Phone: 2,54. o p 1 I Fax: E -mail: Instal rep ace urna3 • urncr : T /H
CC$ na.� Including ductwork/vent liner 0 Yes 0 No
City/metro lie. no.: InstalUreplace/relocate heaters — suspended,
tY 5'2.+ • wall, or floor mounted
Name (please print): e _ �� ��,, ' ' ent or a , , lance other than urnace IME MOM
('ONT:1('l' PERSON ' e' :era on:
Absorption units BTU /H
Name: Chillers HP
Address: Corn •reasons HP
n =mental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: D er exhaust
O \\ N LR ' oo • s, ypc f fres. tc e azmat
hood fire suppression system
Name: 'pay l kt'1•U, Z.;P.in Exhaust fan with sin Ile duet (bath fans) II
Mailing address: I$ ' lm ., .', Exhausts stem a. , rout eaten • or C
City: 1 T v90,10_, State :fib ZIP• 4122.4.4
Type: Pa a p alien up p to out 1 �
Phone: •. • Fax: E -mail: Fuel p 1
Fuel •i• tt: ea a• • t on over � outlets = Mil
1:N(,INLER ' roceasp , g (schematic require • MN
Number of outlets
Name:
- Other listed appliance or equipment:
Address' Decorative fireplace
City: Man ZIP: - Insert -t .e
Phone: Fax: E -mail: "o• • :toy pc ctatove ■
R't
Applicant's signature: ,' e
) ,,,', �.: Date: • 13 173
Other:
Name (print): - hoLL- -etA.- Ddb rc.:61< .
`'Na all jurisdictions accept credit cards, Abase call iuriscfiction for
more totormation permit fee $ n? too
Notice: Th permit application 'y
Ig Visa U MasterCard � � expires if a permit is not obtained M inimum fee $ a?
it card poml cr: e ' — within 180 days after it has been Plan review (at , %) $ xpires
'der as shown on ere& card accepted as complete. State surcharge (8%) $ 5 $a
C o
TOTAL $ "7 $.3U
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Lines (5os 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
G BUP
Received Date Requested % - . AM PM BUP
Location 1 D 0 8'$ A-y Suite ME 3 - 00 4 4 9j
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ 3 DD s3(
Footing o s 47"_. 47"_. Ab 6x O —4"g// ELC
Foundation Access:
Ftg Drain 66 ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam , A �C�C /�
Shear Anchors (-
Ext Sheath/Shear
int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm X . N1 1 �'l�� , `���� S usp'd Ceiling = �! �� �Ly iretkAW '
Roof \ r
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
- Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS T FAIL
CH NIC L
Post am
Rough -In jp< _
Gas Line r
Smoke Dampers
Fin._ ��`
��
1 • RT t , ` . r '�
- RI
Rough -In
UG /Slab (/
Low Voltag
Fi - Alarm J
F .; Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
71 PART FAIL
SITE ❑ Please call f• rein - section RE: Unable to inspect — no access
Fire Supply Line
ADA Z
Approach/Sidewalk Date °� Inspe
Other:
Final DO NOT REMOVE this inspection record fro the Job = e.
PASS PART FAIL