Permit CITY TIGARD MECHANICAL PERMIT
`emu r DEVELOPMENT SERVICES PERMIT #: MEC2001 -00086
�n
�-' ° - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/9/01
PARCEL: 2S110DC -90691
SITE ADDRESS: 15510 SW 114TH CT 69
SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO ZONING: R -25
BLOCK: LOT: 069 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: 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: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Fireplace Insert
Owner: FEES
HEINRICH, MAYBELLE P Type By Date Amount Receipt
15510 SW 114TH CT #69 PRMT CTR 3/9/01 $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 3/9/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
LUDEMAN'S FIREPLACE + PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 646 -6409 Mechanical lnsp
Reg #: LIC 51469 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: ��_.. Permittee Signature: ° f' •
Call 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
T& (055 --C 7 &`J L1 iu. (Ts (Ps cA�
r.. Mechanical Permit Application
Date received: Permit no 2t - 0t?I
"tit' City of Tigard �- • :_ ty g Project/appl. no.: Expire date: •
Ci ryojligard F1'Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
MAR 5 2O6f ( 598 -1960 Case file no.: Paymenttype:
•
Land use approval: Building permit no.:
CONIWI It Y t FVFMPMF T
TYPE OF PERMIT
X 1 & 2 family dwelling or accessory 0 Commercial/industrial U Multi - family 0 Tenant improvement
U New construction Ai Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: i 55 Its S(I f f 4 l (OW .'r 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: ISubdivision: *See checklist for important application information and
Project name: �( Fick, e
. t -- J tu`i iit:iiu7l'3 act s aittiiiic lair reit i �,a.i
ideruiii fa.
City/county:71 G Z'D I ZIP: °I`1 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description ant location of work on premises: IS i� _ • :AND COIIAIERIC SL /1NDIJST RIAL EQUIPIIENTSCIIEDULE
/V f/I PL 4- etE.i1 .' Fee(ea.) Total
Est. date of completion/ inspection: Desaipdon Qty. Res.ody Res.only
Tenant improvement or change se: HVAC:
of ri
Is existing space heated or conditioned? 0 Yes 0 No • Air handling unit CFM
8 P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No - . Alteration of existing HVAC system .
MECIIANICAL CONTRACTOR
State boiler permit no.: _ .. .
Business name: 41 ,p /t F e.EPLHCE ANA PATIO * HP Tons
• BTU/H .. _.
Address:
/ oZ 4 . Ski) /j r<'Gt ts.a Read.. - _ Fire/smoke dampers/duct smoke detectors
City: C .e-Qv2r 40 , State:oa ZIP: po Heat pump (site plan required)
Phone:: j364/& (r (csT I Fax:5034,% : - E -mail: — nstal replace r • . umer : 1
Including ductwork /vent liner 0 Yes 0 No
• _ CCB no.: 57 #6, , - X83 a_, Install/ replacehelocateheaters- suspendeC
City/metro lic. no.: — wall, or floor mounted
Name (please print): /a•(e, fC. 4.14_ O&rt A-0. Vent for a liance other than furnace
se . _
Absorption units BTU/H
Name: /t4 r)-(L4 l tt o . M 44(- Chillers HP
Address: Sp ,4S rj VE Compressors HP
nmental exhaust and ventilation:
City: St ate: I.ZIP: • Appliance vent
Phc, ' : I Fs - I E-mail: • • Dryerexhaust
OWNER Hoods Type U II/res. kitchen/hazmat
hood fire suppression system
Name: 144 PN 8 E. LLE 4st u R.,(CJ -4- Exhaust fan with single duct (bath fans)
Mailing address: Ca el (A,2 Exhaust system apart from heating or AC
C1172,4- 2Z! `-i �--� Fad piping and distrlhadon (up to 4 outlets)
"n
City: A � State: Z1P. : `'� LPG NG Oil ! 5 .40 5g0
5 Phone: q Fax: E -mail: Fuel piping each additional over 4 outlets i . Od
Process piping (schematic required)
Number of outlets
ame: Other listed appliance or equipment:
d• - s: . _ Decorativefi fireplace . . 10 .00... .
I State: I ZIP: Insert- type - -fir f 10.0 D 10.06
• on • • ax: E-mail: Woodstovelpellet stove. . . _ • 10. 0
T� Other
APp., •,"T' «a„7�� Date: • . • c rimer. . .
.rrre 1•rint): r, SK- ( A L1 AAa._ l• FOJ - _. _ ... .. - ...
Not all jurirdic6m o accept nadir cards, pleura cell ariwrwrion for
1 ��.... Permit fee ._ .. $ l .CFO.
Vi 0 e: This permit application Minimum fee $ 72.5' 0
O Visa MasterCard IvlastMasterCard Card
CI s tad 0 M / / expires if a permit is not obtained plan review (at _ %) $ -------.
api within 180 days after it has been State surcharge (8%) .... $ i i . gt:) •
N as shown on credit a as wm lete.
card S Other soecdons and Fen: TOTAL $ i p p
. 3 d
t. lnspe cons outside of normal business tours (aiNmum charge-tee hoes) •
Cardholder signature Amount , 1 1 2. per hour. 440 -4617 (6/00/COM)
Inspections la which no lea a specifically Indicated nr � d hour)
tl (
Ii ` s1250 per oar
3. Additional plan review required by changes. additions or revisions to plans (mho moll
charpearedWf hour) $72.50 Per hour
* State contractor Boller Certification required for units 0200k BTU.
CITY GF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / Z AM PM BLD
Location / 5 S) 0 4.--/ /t/ 6 Suite 417 264,0 /--ZU
Contact Person Ph Cry -s Zy V PLM
Contractor Ph SWR
BUILDING Tenant/0 er A it) f /I c$ /irry > h
Retaining Wall �ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: C�-
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing ` 4- CA-S - 0i�i % c
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS • PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
SISEPRZNIC
Post & Beam
Rough In
Gas Line
Smoke Dampers
SS> PART FAIL •
ELECTRICAL_ £x`
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE ,:E _
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 •
Other
Approach/Sidewalk Date — / 2-- 2/ Inspector f Ext
Other p
Final
PASS PART FAIL • .DO NOT REMOVE this inspection record from the job site.