Permit .
CITY TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC2000 -00481
''` r. � II 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/8/00
PARCEL: 2 S 110 D B -91092
SITE ADDRESS: 15371 SW 114TH CT 109
SUBDIVISION: FOUNTAINS AT SUMMERFIELD ZONING: R -25
BLOCK: LOT: 109 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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Remarks: Remove Existing Heat Pump & Install New Unit
Owner: FEES
WILLOUGHBY, GEORGE F AND Type By Date Amount Receipt
SYLVIA R PRMT CTR 12/8/00 $72.50 2720000000
15371 SW 114TH CT #109 5PCT CTR 12/8/00 $5.80 2720000000
TIGARD, OR 97224
Total $78.30
Phone:
Contractor:
SUNSET FUEL CO
PO BOX 42287
2944 SE POWELL BLVD REQUIRED INSPECTIONS
PORTLAND, OR 97242 Final Inspection
Phone: 503 - 234 -0611
Reg #: LIC 00002374
ELE 26 -113C
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:
Call (5 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
1.2:07:00 THU 11:06 FAX 503 598 1960 CITY OF TIGARD V1002
Ath
. Mechanical Permit ARRlication ' ` . .. s ; , ° ' ' ,'.
G , � ll "
r °°" " Date received: Permit no.
at . N . 2eDb 4 ,ay,', J
• , City of Tigard
Project/app).no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Ti COR' Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 COMMUNITY DEVELOPMENT Case file no.: Payment type:
Land use approval: Building permit no.: •
:'' . `; ' TYPI OI? :PERMIT . `. .. .; -
0 1 & 2 family dwelling or accessory U Comm ;rcial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction X Addition/alteration/replacement 0 Other.
l
it SI'I1;11FOR111AT1U V` ' ; CU1119rR �':1LU:4TION x
�� ,
. Job address: ) , ,3 c51....o III 10 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
i 1cct az e: �� I IQ! „• ( jurisdiction's fee schedule for residential permit fee.
. ..
City /county: Zr'P: � _ fioj ,. - 1• & 117 1ILl ' I) 1 1'F 111\G P1 I %1I I FEE SCH
Description and location of work on p eir s: _ AND COM1'IERICAIJI\DUSTRI 1I TQIIPNIENTSILDL
CILT
f en1CM -e ex1s`i-t HI V b.nl‘ w Fee(ea.) Total
Est. date of completion/inspection::: Description Qty. Res. only Res.only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned ? Air conditioning O No Air handling
red) unit ning (site plan required)
Is existing space insulated?-Yes Cl No Alteration of existing HVAC system
s ., ,,' "11' F ii :61IC1LCO1 1`RAC1'O c• ;"" _ ' '. Boiler compressors
iness name: t - ■ it ` State boiler permit no.:
Bus
mess s 00 . HP Tons BTU /H
Addre '4 1 i I sIS !C( _ Fire /smokedampers/duct smoke detectors
Ci ...4C2 a it . Stat.. IP: ��, 1 Heat pump (site plan required) I 95.0
Pho , its = a I J P :: , ail: Instal replacefurnace/burner BTU/11 it .r� 1 i. fir Including ductwork/vent liner U Yes D No
CCB no.: ti■X Instal lireplace/relocateheaters- suspended,
C /metro lic. no.: . L wall, or floor mounted
Name (please print): l ti , al - - le-) Vent for appliance other than furnace
'I. CONT�1Cf l'l;R1\ r t r Refration:
-y'; : ? -a r. .:_ .. t S0 t �: . Absorptio units BTU/H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: State: L:IP: Appliance vent .
Phone: Fax E-mail: Dryer exhaust
•r r x t _ , ° . t t, Hoods, Type U II/res. l dtchen/hazntat
.�,- .? «-.. x +. _ •,r. _ •. z ^. ;:t ' , _' -' hood fire suppression system
N ame `i/Ike ' 1 0 m a Exhaust fan with single duct (bath fans)
Mailing address: Ili w cum cu Exhaust system apart from heating or A
�� nn � - U piping an , button (up to 4 outlets)
City: \ , lob ��1 1 `ZP • � • Type: LPG NG Oil
Phone: NI7LI / • ` j a E-mail: Fue piping each additional over 4 outlets
7 ' , '.' '; :ENGLNLL.R f ?; „r. ,`z a n, Process piping (schematic required)
° Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: State: ';1P: - Insert - type
Phone: ax: x E -mail: Woodstove/pelletstove
� Other:
Applicant's signature. .. V/ / tit • _ frizii D 71(71:77-Z5—
Other:
Name (print): ;0 L �� I--' Not all jurisdictions accept credit cards, please call jurisdiction for more info nnation� Min m $
❑Visa ❑ MasterCard Notice: This permit application Minimum fee
expires if a permit is not obtained Plan review (at %) $ J
:
Credit card numbe E re s within 180 days after it has b een
p State surcharge (8%) I... S '
Name of cardholder as shown on credit card accepted as complete. TOTAL $
S
Cardholder signature Amcant ” 440 (6/00/C0M)
`