Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00421
��' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/03
PARCEL: 2S111 CC -13900
SITE ADDRESS:--terSSW HIGHLAND DR
SUBDIVISION: SUMMERFIELD NO.4 ZONING: R -7
BLOCK: / � OT: 190 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: 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:
Remarks: Install exterior A/C unit. Do not place within the required setbacks
Owner: FEES
SHIRLEY CRAMER Description Date Amount
10225 SW HIGHLAND DR
TIGARD, OR 97223 [MECH] Permit Fee 7/23/03 $72.50
[TAX] 8% StateTax 7/23/03 $5.80
Phone: 503 620 - 6469 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 453 - 4822 Final Inspection
Reg #: LIC 62196
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 -00
Issued By: Permittee Signature: i /
Call (5 ) 639 -4175 by 7:00 P.M. for inspections needed the next burin- s day
u�K 22 03 03: 29p climate control 503 968 7224 p. 1
Alt Mechanical Permit ` .. on
Date received: Permit no d/ � ��
1 �� CAU of Ti Prolect/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,d r
Phone: (503) 639 -4171 Date issued: By: l Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval:
BUILDING DIVISION Building permit no.:
TYPE OF PE III
il 1 & 2 family dwelling or accessory ❑ Commercial/industrial O Multi-family 0 Tenant improvement
D New construction
❑ Addition/alteration/replacement 0 Other:
. JOB SITE INFORMATION . COMMERCIAL VALUATION SCHEDULE
Job address: 1025s 510 iAhltLin QR... Indicate equipment quantities in boxes below. Indicate the dollar
` 1
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: C2re - • ' 1111 jurisdiction's fee schedule for residential permit tee,
City /county: j ; of 1-m .� ... _
ZIP: � 1 & 2 FAMILY DV1 ELLIIVG I'I;It11ZIT _., " . SCHEDULE
Description and &anon of on premises: COMMERICAL/INDUSTRIAL EQIIIPMENTSCHED t
:N.1)+tt. l �
1 A
Est, date of completion /inspection: Fee (ea.) Total
Description Qty. Res. only Res. onl■
Tenant improvement or change of use: H[VAC:
Is existing space heated or conditioned? 0 Yes D No Air handling unit CFM
Is existing space insulated? 0 Yes CI No
Airconditio existing plan required) te
4 ....:-...t, Alteration of existing HVAC system
MECHANICAL CONTRACTOR : oiler /compressors
Business name: C Ifm t C 3 I State boiler p no.:
iM Address: A00 ,SLt) ?2ld otvt _ HP Tons BTU /H
Fire /smoke dampers /duct smoke detectors
,_ Ci ty: T i K I State: I ZIP: C(1 Heat pump (site plan required)
C Phone: :966- 712,4 E -mail: InstalUteplacefurnace/burner BTU /H
N CCB no.: e ci L Including ductwork/vent liner ❑ Yes D No
In stall/replace/relocate heaters - suspended,
City /metro lie. no.: 1 141-fi wall, or floor mounted
Name (please print): tom"; g%141 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU /H
Name: Chillers HP
Address: Compressors HP
City: I State: I ZIP: Environmental exhaust and ventilation:
Appliance vent
Phone: Fax: E -mail: Dryer exhaust
o vi ui Hoods, Type l/ 1I/res. kitchewhazntat
S�� hood fire suppression system
Name: '�'X Exhaust fan with single duct (bath fans)
Mailing address: L Q'5; 5w ti't Lt44nef !�� Exhaust system apart from heating or AC
City: ` t - I Stat ZIP: Fuel piping and distribution (up to 4 outlets)
47° � �' ` � Type: LPG NG Oil
Phone: (, f • .. 414 • Fax: E -mail: Ft:.el io i each additional over 4 outlets
ENGINEER p p g
t•oetss piping (schematic required) _
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: - _. I State: I ZIP: Inaert - type
Phone: I Fax: I E -mail: - Woodstove/pclletstove
Applicant's signature: I D , tether.
. �. - • Other: .
Name (print): 1 6 1 •' _ __ —
' Not all jurisdictions accept credit cards, please call jurisdiction for more information' Permit fee $
t7 Visa ❑ MasterCard Notice: This permit applicatio Minimum fee $ 7,a.5O
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ S. Va
Name of cardholder as shown on credit card accepted as complete.
TOTAL $ 1IS*
Cardholder signature Amount
440 -4617 (6/00 /C0I
JuT 22 03 03:30p climate control 503 968 7224 p.3
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CITY OF TIGARD • 24 -Hour .' •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 • MST
BUP
Received Date Requested - 7 AM PM BUP
Location / 3 '3 Suite MEC 3 -JO qal
Contact Person 0 -1/ (/ Ph ( ) `'5 3 — 4- 4- PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC N °
Footing
ELC
Foundation
Ftg Drain • Access: ri�w_ ,; ELR
-
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam •
Shear Anchors
Ext Sheath/Shear .
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler •
Fire Alarm J A
Susp'd Ceiling
Roof
Other: (tI r •
Final
PASS PART FAIL
PLUMBING -
Post & Beam
- Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole 3 ^ \/ Q\
Storm Drain \
Shower Pan
Other:
Final •
FAIL
ECHANI
Post - &beam
Rough -In i f �I
Gas Line �V(V \ , G
Smoke Dampers
&
FAIL �J
ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fir Alarm
a ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call fo reinspec on RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /
Approach /Sidewalk Date V 6 Inspe r % /��' ' i" Ext
Other:
Final DO NOT REMOVE this inspection record rom the 1 ' site.
PASS PART FAIL
•