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Permit CITY TIGARD MECHANICAL PERMIT AA Ai' SERVICES PERMIT #: MEC2001 -00253 I' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/11/2001 PARCEL: 2S1 14 B B -18000 SITE ADDRESS: 16285 SW 103RD AVE SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7 BLOCK: LOT: 026 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: 1 DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of exterior NC unit. Cannot be placed within required set backs. Owner: FEES SAMPSON, NORMAN J + ANN M Type By Date Amount Receipt 16285 SW 103RD AVE PRMT CTR 07/11/20C $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 07/11/20C $5.80 2720010000 Total $78.30 Phone: Contractor: SUNSET FUEL CO PO BOX 42287 2944 SE POWELL BLVD REQUIRED INSPECTIONS PORTLAND, OR 97242 Mechanical lnsp Phone: 503 - 234 -0611 Final Inspection Reg #: LIC 00002374 ELE 26 -113C 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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 - 91 Issue By: ,/ / Permittee Signature: A Ct J -e.e Z, Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day /6 4,,, Mechanical Permit Application Date received: 7 Permit no.: / 3 44- 7b 1 City of Tigard 4#0+0g0 Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639 -4171 JUL 1 2001 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: COMMUNITY DEVELOPMENT Building permit no.: L1 PE OF PERSIL 1 & 2 family dwelling or accessory O Commercial/industrial ❑ Multi- family ❑ Tenant improvement O New construction n Addition/alteration/replacement ❑ Other. AIL JOB SUE 1NFORs1AI ION COM11ERCIAL VAR :WON SCIIEDL'LE Job address: M 11-1 11111 Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map/tax lot/account no.: profit. Value $ • Lot: Block: I Subdivision: *See checklist for important application information and Project name: =au • A. •. jurisdiction's fee schedule for residential permit fee. City /county: • i�rIMMII%I►L^.F�`ZI 1 & 2 F:11111,1' D11 FILLING PElill lT FEI: S('III:DCLI: Description .1a l..:. of work o premises: • :. ' % AND COM111ERIC : UJINDI STRLU, FQI'IPIIUN 1 SCIIEDI •• 1 • - Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res.only Tenant improvement or change of use: HVAC: Is existing space heated or c. nditioned l] No Air handling unit CFM space insulated? �` es ❑ No Air conditioning (site plan required) Is existing ,,/ 1 , g P Alteration of existing HVAC system IMF( IIANICAL ('ON7'RA('TOR Boiler /compressors Business name: a _ �.� State boiler permit no.: HP Tons BTU/H Address: d `LtLl��M�� ll Fire/smoke dampers/duct smoke detectors City as , ti�Ci:� aiE reVr!' -sem Heat pump (site plan required) t `.7 Install/re lacefurnace/burner BTU/H v CC �� ' �.,I��rF•� Including ductwork/vent liner O Yes U No CB no.: • Install/replace/relocate heaters - suspended, City/metro lic. no.: _ wall, or floor mounted Name (please print): t - ('' al - - Vent for a . pliance other than furnace ('O\ "1 :'('l 1'1:RSON a ion: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: - I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust 011 NI R Hoods, Type U IUres. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: / 21;i Ta`Ft� r . Ik111,,44' ajo ■ii ititaM11111.11 City: `_t ITJ Z YCRi = T L 1 on p to oua is i ype: Phone: # a s 1 s E-mail: Fuel W i n : each : • ditional over 4 outlets I : N (.I\1 I 12 ' , , , , . sc ematicrequired) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert -type Phone: � Faa ► x: nl ., E -mail: Woodstove/pelletstove � � � . ri aRiirdi J Date: — MAUI Applicant's Other. Name (print a - • I_ _ 1 + I rN Not all jm aMctbm 'wept credit cards, pima can jumiat ction for more information. Permit fee $ -v., • • O Visa O MasterCard Notice: This permit application Minimum fire $ i ?N ! Credit and number / / expires if a permit is not obtained Plan review (at %) $ E within 180 days after it has been State s urcharge (8%) $ Name of cardholder as shown on credit and accepted as complete. $ TOTAL $ . • 3O Cardholder signature Amount 440-4617 oicoroi) • - Z1 P-4):\ .)7-2-2- Lb -2)0 '7?)-1/19,9._ 0? Dr)S 59°)) dos � 1 0 L - CITY OF TIGARD BUILDING INSPECTION DIVISION , MST Y y 24 -Hour Inspection Line: 639 -4175 Business Line 639 -4171 -- BUP Date Requested 7 '"' 6 AM 3, PM BLD Location / L R5 / 03 Ad /1--o--e. Suite ocl Go - 2-s - 3 Contact Person , Ph PLM Contractor Ph S73 ,; 3 9 0 11 SWR BUILDING Tenant/Owner X / 3 / ELC Retaining Wall ELR Footing Access: ,,,�"�� o Foundation c.C.. -u ` G G�" Ic `e-t FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab Z-' SIT Post h Beam n m Ext Sheath/Shear /�- Int Sheath /Shear E(% 9-®0 I _ p�, V 0 3 J lQ (j/c) % I _ Framing Insulation C-7 Drywall Nailing J�Q Firewall Fire Sprinkler.1 5 . Fire Alarm Susp'd Ceiling e 1AA / C Roof Final / • _' C& ) -c-e_ -c-e_ W/ PASS PART FAIL V PLUMBING S f A llik ■ - Post & Beam . 1 ( \-- 1 2-.4A-3 (1L� ` Under Slab Top Out P117 (( `( '_ Water Service Sanitary Sewer Rain Drains Final , \\ PASS FAIL 3 / V me , Posl3ea►ii / ` I - -.L 1 Rough In Ve \ V Gas Line V� Smoke Dampers / PART FAIL riN5, CTRICAL / Service P l 3 0/ 3 U Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE V V Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA n Approach /Sidewalk Date 7/� [.C� 0 I Inspector l Ex' 1 7 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - C Electrical Permit Inspection Description Date Passed By Inspection 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 - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing — MFG Structure set-up MEC - Mechanical Permit Insulation Drywall nailing - 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Engineered soils Gas line Welding Lab Final Mechanical rough -in 7/7 a/6 /2 Concrete Lab Final Fire damper Bolting Lab Final Duct work Structural observation Smoke detector Fireproofing Lab Final Mechanical final 7/14/(1 r Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit 4, Inspection Description Date Passed By Plumbing underslab J Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \forms \InspRecordBUP.doc 04 /17/01 CI TY OF TIGARD MECHANICAL PERMIT wm 'I . DEVELOPMENT SERVICES PERMIT #: MEC2001 -00253 .� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/11 /2001 PARCEL: 2S114BB -18000 SITE ADDRESS: 16285 SW 103RD AVE SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7 BLOCK: LOT: 026 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: 1 DOMES. INCIN: 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: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of exterior A/C unit. Cannot be placed within required set backs. Owner: FEES SAMPSON, NORMAN J + ANN M Type By Date Amount Receipt 16285 SW 103RD AVE PRMT CTR 07/11/20( $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 07/11/20( $5.80 2720010000 Total $78.30 Phone: Contractor: SUNSET FUEL CO PO BOX 42287 2944 SE POWELL BLVD REQUIRED INSPECTIONS PORTLAND, OR 97242 Mechanical Insp Phone: 503 - 234 -0611 Final Inspection Reg #: LIC 00002374 ELE 26 -113C tJ 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 O requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR kih 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-; X89. • a l Issue By: - ,. , , 4 Permittee Signature: a A t � .0 Call (51 ) 639 -4175 by 7:00 P.M. for inspections needed the next business day