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Permit CITY TIGARD MECHANICAL PERMIT .l, DEVELOPMENT SERVICES PERMIT #: MEC2000-00436 �'i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/03/2000 PARCEL: 2S116AD -29900 SITE ADDRESS: 16880 SW 126TH AVE SUBDIVISION: KING CITY NO. 10 ZONING: BLOCK: 13 LOT: OOA JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Alteration of existing HVAC system. Owner: FEES KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt 15245 SW 116TH PRMT DLH 11/03/20C $72.50 KING CITY KING CITY, OR 97223 5PCT DLH 11/03/20C $5.80 KING CITY Total $78.30 Phone: Contractor: MILWAUKIE HEATING + COOLING P.O. BOX 220216 MILWAUKIE, OR 97222 REQUIRED INSPECTIONS Gas Line Insp Phone: 557 -5562 Mechanical Insp Reg #: LIC 104102 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 c.p of these rules or direct questions to OUNC by calling (503)246 -9189. Issue By: ' i - Permittee Signature: . �tj(/ �q��L, n��rnr' — i�} Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day OCT - 31 - 00 TUE 11:03 AM City of King City FAX:503 639 3771 PAGE 2 TRI4cc.juNTY SERVICE CENITEl Mechanical Permit Application OFFICE USE ONLY City of King City Dam received: [p_?��� Permit no.; ' Prv ject/appl, no.: Expire dare: 13125 SW Ball Blvd. 1.4 ., Clackamas Tigard. OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4 171, FAX: (503) 6 -7297 _ - Multnomah Case file no.: Payment type: Washington _- e O .. N r t f s Land use approval: Building permit no.: TYPE OF PERMIT 1 & 2 family dwelling or accessory U Commercial /industrial 0 Multi - family 0 Tenant improvement C] New construction 0 Addition/alteration/replacement 0 Other. JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE lob address: 16,1'%,(:) L3 _ l , _ 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: Subdivision: _ *See checklist for important application information and Project name: rJ. I,„ ,r l , 4 - 6 l0.eJ jurisdiction's fee schedule for residential permit fee. City /county: _ ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: _ , .. .. 7:, AND COMMERICAL/LNDUSTRIAL EQUIPMENT SCHEDULE Fee (ea.) Total Est. date of completion/inspection: T m ^� Description Qty. Res out Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? Cl Yes O No Air handling unit CFM Air conditioning (sue plan required) Is existing space insulated? 0 Yes Q No Alteration of existing HVAC system MI MECHANICAL CONTRACTOR Boiler /compressors Business name: j 1 L . _ l44l �, I t-i '�`"� ty �pG!. State boiler permit no_: II HP Tons BTU/H �■ ' N 6 f. ! 4 _ Fire/smoke dampers/duct smoke detectors _ —_ City: V _ – State: dil t' ZIP: e2 Heat pump (site plan requite) _ Phone: 6 3''7 Fax: 537,42 7f j E -mail: M Install/replace furnace/burner BTU/14 11 CCB no.: / (6.2_ Including ductwork/vent liner Cl Yes Cl No Install/replace/relocate heaters – suspended, ■ City /metro tic- no.: 3 b " wall, or floor mounted Name (please print): 3-0 e.._ R��. vent for ap.liance othee [bran mace _ CONTACT PERSON Absorption uni Absorption units BTU/EI Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: State: ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type D lures. kitchen/hamrat hood fire suppression system I Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart Torn eating or AC City: State: ZIP: Fuel piping and distribution (up to 4 outlets) ri imi Phone: Fax: E-mail: TyE : LPG � NG Oil Fuel piping each additional over 4 outlets Ell ENGINEER Process piping (schematic required) Name: Number of outlets MI Address: - --•- -- Other listed appliance or equipment: III fireplace City: , - I State: j ZIP: Insert – type __ ._ Eli Phone; Fax: _- ..__CI E -mail: W odstoverilet stove _ - Applicant's signature: , j0 r Date: WS/AK) 3 / -L � ._��__- 41 . E _. I / .__ - .- . ___ ...._ __� _, ...._ ___� — Name (print): f '4 J. MII _ - NtN aq juri eictioas aeceo dtdit crds. ukase W11 jurisdiction for owe infprmation Permit fee $ Notice: This permit application Minimum fee $ U Visa U MasterCard expires if a permit is not obtained card rd number.. / / Plan review (at %) S _. . _ within 180 days after it has been __ E.0....., State surcharge (8%).....$ 5-.)312 Name o ? cvdholder as sieve oa credit card accepted as complete. S TOTAL $ 7E5-39 Cara .,.., _ signature qmc rn `y am 44o -dat7 (6I00/coM) CITY.O1 TIGARD BUILDING INSPECTION DIVISION . • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested /,/ - ( - G 0 AM PM BLD Location Z68 .80 Sk) /?4 r ok „ l Suite MEC ,- 1 X36 Contact Person Ph 5b3 7' 7 3 G Z— PLM Contractor ` Ph / SWR BUILDING Tenant/Owner /,/Jc( -�^-r� f c„4/6LC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling L �� �� � Ar Roof Fina F P al PASS PART FAIL (1—/i)-7 laguai Post & B am Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS RT FAIL Post & Beam Rough In ,iva " Gas Line Smoke Dampers Fin PART FAIL CTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE 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 t -X Approach /Sidewalk Date l / I / o Inspector � Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit J Inspection Description Date Passed By 4 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 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 - ‘1 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils _ Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final al./ i6; Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab 4 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 4 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 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS 4 CITY F T I GA R D MECHANICAL PERMIT � y{� DEVELOPMENT SERVICES PERMIT #: MEC2000 -00436 I� DATE ISSUED: 11/03/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S116AD - 29900 SITE ADDRESS: 16880 SW 126TH AVE SUBDIVISION: KING CITY NO. 10 ZONING: BLOCK: 13 LOT: OOA JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 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: 1 > 10000 cfm: Remarks: Alteration of existing HVAC system. Owner: FEES KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt 15245 SW 116TH PRMT DLH 11/03/20C $72.50 KING CITY KING CITY, OR 97223 5PCT DLH 11/03/20C $5.80 KING CITY Total $78.30 Phone: Contractor: MILWAUKIE HEATING + COOLING P.O. BOX 220216 MILWAUKIE, OR 97222 REQUIRED INSPECTIONS Gas Line Insp Phone: 557 -5562 Mechanical Insp / Reg #: LIC 104102 Final Inspection l g i 0 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 0 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 c• • es of these rules or direct questions to OUNC by calling (503)246 -9189. i Issue By: a 1 ' / Permittee Signature: e-A/ ,q/PZ., �:!4- ,r /o-t/ - ,�-k & le Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day iliNi