Permit <•
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002 -00162
41- DATE ISSUED: 4/22/02
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S103CB -03600
SITE ADDRESS: 13185 SW 124TH AVE
SUBDIVISION: WILLAMETTE NO.2 ZONING: R -4.5
BLOCK: LOT: 015 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: DOMES. INCIN:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Install gas furnace.
Owner: FEES
ERICKSON, NEIL A/PAMELA S Type By Date Amount Receipt
13185 SW 124TH PRMT CTR 4/22/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 4/22/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 284 -2173 Duct Inspection
Reg #: LIC 222 Final Inspection
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 -9189.
Issue By: t -( (k , 1� Permittee Signature: A ,1Q14 e, �1 jti
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
11/14/2001 12:00 FAX 5035981960 CITY OF TIGARD IA 002
• Mechanics Permit Application
D caved: , —
- C iity of Tigard .. `no : v pro - • d�/ .
Cirygart
Address: 13125 SW Hall Blvd, Tiganf, OR 97223 Projcet/appl. no.: Expire date:
Phone: (503) 639 -4171 Date issued: coral Receipt no.:
Fax: (503) 598 - 1960 - Case file no.. rZefirt
Land use approval: Cii Y OF Building pennit no.:
II, V/ tit l'1.ltlilr
1 at 2 family dwelling or accessory ❑ Commercisllindusnial CI Multi- family Cl Tenant improvement
CI New construction U Additionlalterationheplaaement Q Other
.It It SITE 1\I-OR01 i\ (()1M1lz( i �t �l rl).,,, S4 iii rn )
Job address: /4:5 3 5 J W 1. ! Ave . Indicate equipment quantities in boxes below. Indicate the dollar
Bid:. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead.
Tax map/tax lot/account no.: psoft. Value $ __ — -
Lot: 'Block: Subdivision: *See checklist for important application information and
Pro -' name ' 1 C - 0 N L - 0 ��� jurisdiction's fee schedule fir residential . - , it fee.
�+ /County: r , I : s � �j 11111111111111111111111 J s 21 \■II1l 1 /\ 11 _/11".4. PI.I VIII T11 S((t1I,1)1l
Desagiptiou and location k.4ST11-0— of i�L-I(Z/LO�k-G lei i� i f> i 2 E Z i (' i r' I III 5 i i t l i_ L X11 J) .ti 1 f t ti (/ r r U r i _ 1
Est. date of completloa/inspection: r
Tenant improvement - :T :
provement or ch of use:
Ts existing slp;K �or conditioned? Yes Cl No Air handling unit Cpl
Is existing space insulated? n Yes 0 No Aircatrditioning site plan , )
.T taratioa • mustm • VAC stein
1 I1(II \. \f('1I, 4 : O\Iit\1 i uu I niiTTJ com gssoya
Business name: A li A- ltd 1 /J G- CCX3L.. IU Cr- state boiler permit no.:
Address: r , li 11. �' ' ► 14P Tons BTUlH
State: e'1 ZIP: viskai Hea . , „,. (utopian r d)
Phone: ' b `- 1 `J .ilea mail' , s .. ace Tr"1T*si.,, r , - I - •
CC$ no.: Includi • dunce • i yea tax Cl No I i Li' 0 1 q- • a
as • I -.I ._ re ^.r. caters - suspended,
City/metro lie. no.: wall, or Boor mounted
Name (please print): , 111 1, `iip - /S/• eanfar ••• ant an mace
( 11(7 l'El2S4),\ T'
Abstention unite BTU/H
Name: Chillers HP
Address: Cku tweets HP
City: State: 2ZP Errnoarateapil edema vas ii t`aaa:
Phone: Appliance vent
Fax: E -mail: Dryer exhanat I--
( ) 1 t \ l 11 Bloods, - 7'yPe l/ Il/res.ldtcbenthezmat
heed fun suppression system
Name: ere . K Setl∎J - E.1 L. d - P : Exhaust fan with single duct (bath flee)
.' ' addreSS: ML IIIIIM ES r usts .,,. *oat from , ,. : orA
Cl • : I Y > /2 I, ZIP:
min up to 4 • u
I g LPG NG Oil
Phone:
fa B - ma il : Fuel p ' i� — each add.am overd ,
11 \ (; i \ I . II? . Faeces .. (sc • • "c requited)
Name: Number of outlets
Other listed
Address: Decaradve5 a ��
State: ZIP: Insert -type
E-mail: stove
Applicant's signature: (' . ` Yl l-t ' - lam; • •
Name (print): 1 II . - J Efi ni 1 `T”
Q
Nat all o�M
C cards. � + lwtisdm icu ter mac mmmativn. m peaspit application ice: Thin Permit fee .50
cord .,
d:c cord expires if a Wm/mum fee ....._ $
perm (at is not obtained Plan review at _ 95 ) $
Lxpites within 180 days after him: been
ate iterate as Tama an e�edit Cara accepts d as complete. TOTAL stavharge (8%) . • $ ',r 0
ti
Can hol tar danornre Amount ., S F,.•
4464519 (61011 C'olut)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM / PM BUP
Location 1 3183 (per • f Suite
Contact Person Ph ( ) 8 —,21
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: r , Z �
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: . SIT
Post & Beam = d
Shear Anchors , ,
Ext Sheath/Shear �I _ �s[ rd ,i..�1
Int Sheath/Shear /
Framing
Insulation
Drywall Nailing j
Firewall - ,[ < (
Fire Sprinkler �-C.� 7
Fire Alarm ^ �
Susp'd Ceiling T om✓ r ____" I
Roof . . r c 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
PASS PART FAIL
MECHANICAL
Post & Beam
Gas Line �, /�
Gas Line �J�'
S WW' Dampers
• SS 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 FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date 1e1/4V \( Inspector `�' �L
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL