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Permit CITY TIGARD MECHANICAL PERMIT l DEVELOPMENT SERVICES PERMIT #: MEC2001 -00451 Al A DATE ISSUED: 12/12/01 I - ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110CA -01600 SITE ADDRESS: 15245 SW 116TH AVE SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM 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 > GAS OUTLETS: 10000 cfm: Remarks: Remove and replace pool heater with like kind. Owner: FEES KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt 15245 SW 116TH PRMT DEB 12/12/01 $72.50 KING CITY KING CITY, OR 97223 5PCT DEB 12/12/01 $5.80 KING CITY Total $78.30 Phone: Contractor: MILWAUKIE HEATING + COOLING 9961 HWY 212 CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Heating Unt Insp Phone: 557 -5562 Final Inspection Reg #: LIC 104102 EXPIRED 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 Utili i i ation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 95 - 001 -0080. You ma, •btain copies of these rules or direct questions to OUNC by calling , !"417dR -Q1 RQ • Iss By: , :.;.�rfj� /� Permittee Signature: / I /, ,;1 , ., Cal •3) 639 -4175 by 7:00 P.M. for inspections needed the next usiness day 12/11/2001 09:29 5036393771 CITY OF KING CITY PAGE 02/02 Y a CENTER • Mechanical Permit Application OFFICE USE ONLY 'RI-COUNTY o Date received: 11 01 Permit no.:/6e.. <0o / - 60S/S/ - City of King Cit Q his 3� zi Projectiappl. no.: Expire date: 1 ± . 13125 SW Hall Blvd. 7 7 Tigard. OR 97223 IOOZ T T 330 Date issued: By: Receipt no.: Clackamas Phone: (503) 6394171, FAX: (503) 684 -7297 Multnomah Q Case file no.: Payment type: ,____._._________ Washington Building permit no,: A U N T I E S Land use approval: -___ .-- TYPE OF PERMIT © 1 BE 2 family dwelling or accessory C] Commercial/industnal GI Multi - family D Tenant improvement ❑ New construction O Addition /alteration/replacement 0 Other: , JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: . ` - 6t 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: rBlocic; Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: _ , 40011M ZIP: 4 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Descri.tion and iota • if o on premises: / = ,C ,1'...k..; AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE Am.,'" . `'.• , _ Total Est date of completion/inspection: Description _ Q . Res. oil Res. only HVAC: Tenant improvement or change of use: Air handling unit ,_ CAM Is existing space heated or conditioned? ❑Yes 0 No Air conditioning (site plan required) II Is existing space insulated? D Yes D No Alteration of existing 1 system MECHANICAL CONTRACTOR t oiler/compressors State boiler permit no.: Business name: u �.0 _ . i «' � mot_.. HP Tons BTU/11 Address: „Q.-/ Fire/smoke dampers/duct smoke detectors;.. ... IMEIIIM City: u , Statei ZIP: 1 f�.2, Heat .uutp (site 'Ian require) III Phone: ,57.5'2,5 Fax: 23 E-mail: Instal /replace mace/burner B I/H 1111 Including ductwork/vent liner 0 Yes CI No CCB no.: /Q _ Install/replace/relocate heaters - suspended. City /metro tic. no.: fi` wall, or floor mounted . Name (please print): �, = /. i. Vent for appliance other than furnace CONTACT PERSON Refrigeration, Absorption units BTU/H Name: Chillers - _ HP .- Com.ressars HP Address: Environmental exhaust and ventilation: III City: State: ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust =MEI OWNER Hoods. ' ype I/ ll/res. kitchen/haxmat ■EI hood fire suppression system Name: Exhaust fan with single duct (bath fans) E Mailing address: Exhaust system apart from heating or AC Fuel piping and, distribution (up to 4 outlets) City: State: _ ZIP: T ye: L.PG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets ■ Mill ENGINEER Process piping (schematic required) Number of outlets • Name: _ Other listed appliance or equipment: Address: ____�� Decorative fireplace City; State: ZIP: Insert -- type _ Phone: F./ : E- mail: woodstove/n filet stove • then.. VAI IMSFZE t II■� — Applicant's signature: '_.'� >. D = - C d Other: Name (print): ,0• - 1_6 _ —. Permit fee S r ii. `tom `lot all jurisdletlam a •• it cards. please call jurisdiction for more in tor7ttation. Notice: This permit application Minimum. fee $ D Visa CI Mas i - • espires ija permit is not obtained :rodit card number. / 1 _... Plan review (at %) $ expires within .180 days after it has been State surcharge (8%) 5 5» F Name af cardholdcr as shown on credit card S deteple X TOTAL $ J t KED CardholdercignaIure Amount - 440441 (6r00/COM) CITY OF TIGARD 24- Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Received / 7 Date Reque / J 23 AM PM BUP a' Location I s s (� ` Suite MEC ,, DO / 4.51 Contact Person Ph ( ) , S7 5.5 -GO - P LM Contractor Ph ( ) _ SWR BUILDING Tenant/Owner ( ELC Footing g LL ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing Insulation 'F f / S % gj l " S ie � U � 0 v �' wv� C Drywall Nailing l ��� S Firewall >✓ {�7 J %7 J2V;,/ �' f �' / //All Fire Sprinkler / v y Fire Alarm Susp'd Ceiling'. Roof 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 PART FAIL %,MECHA L POT & Beam e a Rough -In Gas Line I 4 Smoke Dampers Final AS S PART FAIL TRICAL 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 FAIL SITE El Please cal for re' spection RE: Unable to inspect - no access Fire Supply Line 0 ADA Approach/Sidewalk Date 2 _. - Inspector - 1?) -1) Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL