Permit A
. r
CITY TIGARD MECHANICAL PERMIT
I . DEVELOPMENT SERVICES PERMIT #: MEC2002 -00171
--- 13125 SW Hall Blv Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/26/02
PARCEL: 1S133AD-10400
SITE ADDRESS: 10647 SW 127TH CT
SUBDIVISION: AMART SUMMER LAKE NO. 3 ZONING: R -7
BLOCK: LOT: 160 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: 1
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace furnace, install A/C amd replace water heater vent.
A/C cannot be placed in required setbacks.
Owner: FEES
COWAN, VICKI M Type By Date Amount Receipt
10647 SW 127TH CT PRMT CTR 4/26/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 4/26/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 503 -281 -0752 Cooling Unt Insp
Reg #: LIC 8897 Duct Inspection
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtai ;opies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: ,4 Permittee Signature: ?h C .
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busi „ess day
FROM : ANC$IL Heat ing & Cooling PHONE NO. • 3 2825722 Apr. 24 2002 04:19PM P1
• • •
. • • . • i&
MechanicalPermit App tion
Date received: Lt i . .2.- /
1 Cy , permit no.:/}/ c„).a.:0 -00 47
Tigard ;. ", '� 'l. i , City of igai ai projrctlappl. no.: Expire date:
� r
Cityaf7tgard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued; By: e i Receipt no,:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Ar'R 2 4 2002 Case file no.: Payment-type:
Building permit no.:
Land use approval:
Ta PE OF P..ER1111
121-1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition /alteration/replaccment 0 Other:
JOE SITE INFORMATION CONPlERClAL VALUATION SCHEDULE
Job 2,-) i ., CI- Indicate equipment quantities in boxes below. Indicate the dollar
B ldd g_ no.: 1 Suite no.: address 0 to `�� � value of all mechanical materials, equipment, labor, overhead,
B _ profit. Value $
Tax map/tax lot/account no.: _
Lot 1Bloek: j Subdivision: *See checklist for important application information and
jurisdiction's fee schedule for residential permit fee.
Project name: i ■-( 1 2 FA1i ILl DWELLING PERMIT FE E SCHEDULE
City /county: - (� � tli ZIP: °j 1 ZZ�
Description and location of work on premises: 4.A'u% AND COMMERICAL /1NDUSTRIAL EQITIPM ENT SCIINr)YZE
s : -4 te 1!i a.tr7t. tt9t.Q .. Fee(ea.) Total
Est, dare of completion/inspection: CZ (Jair Deseri_&au Qty. Res. only Rte only
I1VAC::
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned? 0 Yes ❑ No Air conditioning (site plan required) 1 1'&O ,
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
lrlF.C1IANICAL CON'T'RACTOR -.oiler /compressors
State boiler permit no.:
Business name: ; : r ail 1. at .,,•i..) C13&.t HP Tons, BTU/H
Address: 2.6 ' Ili Ai i C FireJsmoke dampers/duct smoke detectors
State: ZIP: '" Z i Heat pump (site plan required)
City: (t, 4r.1 _ Install replace furna burner BTU
Phone: I- Di-S Fax: Z$ Z- Z E -mail Including ductwork/vent liner Cl Yes O No _
CCB no.: : Install/rep ace/reiocateheatcrs- suspended,
City /metro lie, no.: J� wall, or floor mounted
Name (please print): 'f,., , • L . i ,.'j 1.1 G CO301,.4.t G ent for appliance other than furnace a
CONTACT PERSON Refrigeration:
Absorption units BTU /H
Name: ri e .,)+ Chillers HP
Address- FR"
i ex haust and ventilation:
Cit State: 1ZIP: Appliancevent
Prone Fax: E -mail: Dryer exhaust
Hoods, Type 1/1Ures. kitchcn/hazmat
'' ff ` hood fire suppression system
U
Name: i Gk t Cott 4'x3 Exhaust fan with single duct (bath fans)
Mailing address: I 0(04 n c.' l 2,� C-7-• iii Exhaust system apart from heating or AC
d St ate: E ZIP: Fuel piping distribution (up to 4 outlets)
qty: 'ri �ktZ'] eft,' 'Type: LPG NC Oil
Phone: Fax: E-mail' Fuel pipin • each additional over 4 outlets
ENG IN4:i:R asp p ∎g (schcmatrcrcqurrn•
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type .
Phone: Fax: E -mail: Wood+tove/pelletstove
Other:
Applicant's signature: K_ Date: Other: '
Name (print): K • C a TT; ).----
Not all jurisdictions accept crt4it cards, please call jurisdiction for more information. , . - / Permit fee $
Cl kisa MasterCard Notice: Notice: This permit application { mi IUm fee $ i z .5b
expires if a permit is not obtained Plan review (at s
Credit card number: xpl within 180 days after it has been ( ) $
State surcharge (8%) ____ $ S• E�
Name of cardholder as inowu on credit card accepted as complete. TOTAL $ q a . - S6
Cardholder signature Amount , 440.46I7 (6400ICOM)
■
FROM,: ..4.A1C.TIL Heating & Cooling _ PHONE NO. : 503 2825722 Apr. 25 2082 09:32AM P3
N
• E
.'.
•
S
50
20'
60'
Vield Cowan
1 SW 127 Ct.
Tigard, Ore 97223
W/O 216.34
CITY OF TIGARD ilk 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 -�
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location /06 7 /a 7 d6, Suite MEC (" Dn /
Contact Person Ph ( ) PLM
Contractor �) Ph ( ) SWR
BUILDING Tena ca ner ELC
Footing 5 7 - 006 9 ELC
Foundation cceS
Ftg Drain ELR
Crawl Drain
Slab Inspectiolk Notes: 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
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 (r/f
Post & Beam , Ci `
Rough-In
ne 1)1��,y�
Gas Line �"'
S . • ke Dampers
11—
,'}=' PART FAIL
CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ��/- D 7 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD c; 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested l —3 AM PM BUP
Location 1 G Suite MEC --` d' Cc' / 7
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 'P-t2a c 6A-2 e?. I r—
Insulation
Drywall Nailing 0 / ` 7/16C11,4-Ai I CA-
Firewall
Fire Sprinkler
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
ASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: E Unable to inspect — no access
Fire Supply Line
ADA ( a — g40
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL