Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00183
`. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/12/2004
PARCEL: 2S111 CB -01708
SITE ADDRESS: 10260 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R -3.5
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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: Install furnace and a/c
Owner: FEES
JOSEPH SKACH Description Date Amount
10260 SW HOODVIEW DR [MECH] Permit Fee 4/12/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 4/12/200 $5.80
Phone: 503 - 598 - 9685 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 Heating Unt lnsp
Cooling Unt lnsp
Reg #: LIC 62196 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24 9.
Isst.TH Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr- 12 04 09:51a climate control 503 968 72'24 p.1
'4 ,
• ' Mechanical Permit Application OFFICE USE ONLY
Date ate received
- -.. City of 'Tigard AY Permit no.: JrJ �,� .."06/g3
City of Tigard Address: 13125 SW Hall Blvd, Ti ��QC91-2/
� PCO 1ecVappL no.: Expire date:
Phone: (503) 639 -4171 Date issued;
Fax: (503) 598 -1 960
App By: I Receipt no,:
1 2004 Case file no.: Payment type:
Land use approval: Building permit no.:
GI ► Y Gr T !G ^.? p
T 7C ��'E OIF P , IT
•
}3CI & 2 family dwelling or accessory ❑Commercial /industrial
0
New construction 0 Multi family 0 Tenant improvement
O Addition /alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: i 0 �� W 0 S H ut �
' ,
Job Indicate equipment quantities in boxes below. Indicate the dollar
no I Suite no.: va.:ue 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: k(-61 ( _ Sjzca.ch jurisdiction's fee schedule for residential permit fee.
City /county: `T i cJ ZIP: _ aq. & 2FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location ** work on premi e s• A I C0111MERICALIINDUSTRIALEQUI MENTSCHEDULE
��
"ttANv1C`c a / C - ,
Est. date of completion /inspection: - jy (i LI Fee (ea.) Tot
Description Qty. Res. only Res. only
Tenant improvement or change of use:
111 AC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
Is existing space insulated? 0 Yes 0 No Air conditioning (site plan required) ` l
•
Alte:rauon of existing HVAC system ILA •oa t y .�
• MECHANICAL CONTRACTOR Boi:er /compressors
Business name: (j c3 -h o J
State boiler permit no.:
Address: 1 (or3oc 5L).3 7 )_hcv [/e HP Tons BTU /H
City:
Address:
r 1 I /smoke dampers /duct smoke detectors
Kowtc State: O(L ZIP: 9 . ., Li Heai: pump (site plan required)
Phone:�- 4.53- L) 2 ,Fax:
e.,&_7,), E -mail: Install /replace furnace /burner'i� BTU /H
CCB no.: CPaiGCv Including ductwork/vent liner [.Yes 0 No I I -1. ° �
City /metro lie. no.: 1 I Install /replace/relocate heaters — suspended,
Name (please print): i t. _ wall, or floor mounted
• f . ,,� Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Name: Absorption units BTU /H
Chillers HP •
Address: Corn pressors HP
City: Slate: Z[P: Environmental exhaust and ventilation:
Phone: I Fax: E -mail: Dryer vent
Dryer exhaust
OWNER Hoods, Type I/ lures. kitchen /hazmat
Name: �o-� S ��r ` C_ hood fire suppression system
' 1 Exhaust fan with single duct (bath fans)
Mailing address: (p t.p(:) 5ii _ Exhaust system y. apart from heating or AC
outlets)
c ( alck StateO ZIP; Fuel piping and distribution (up to 4 outlets)
City:
Phone: S Fax: y - 7�a�) Type: LPG NG
E - mail: Oil
ENGINIa; Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Address: Ot t�ei listed appliance or equipment:
City: Decorative fireplace
I State: I ZIP: Insert - type
Phone: Fax: I E -mail: Woodstove /pel stove
Applicant's signature: Date: Other:
Name (print): . C yi'f - i% r I �� is �U
Other:
Not all jurisdictions accept credit cards. please call jurisdiction for more information.
Visa O MasterCard
Credit card number:
Perini[ fee $
Notice: This permit application
expires if a permit is not obtained Minimum fee $ 2--'30
E xpir � within 1R0 days aft<:r it has been Plan review (at %) $
Name of cardholder as shown nn credit card State surcharge (8 %) .... $ 5 -$1.) S -
accepted as complete.
$ TOTAL $ - 7
Cardholder signature Amount
440.4617 (6 /00 /COM/
Apr 12 04 09:51a climate control 503 988 7224 p .3
CLIMATE CONTROL
3315 NW 26th Avenue Portland, OR 97210 -1839
A&B HEATING & AIR CONDITIONING 503 - 223 -4393 FAX: 223 -4494
SIB
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
TIGARD • 684 -3355 ST. HELENS • 397 -2501 VERNONIA • 429 -0707 VANCOUVER • 254 -3063
CITY OF TIGARD 24 -Hour
BUILDING - r Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 3 ca Date Request -d BUP
Location 2- d ' 6 MEC -- 1 ".-S
Contact Person Ph (_ 3) 4 4/n22- PLM
Contractor 7 Ph (- ` 3 ( D — B WR
BUILDING Tenant/Owner EL C �JV / c'1
Footing s UNA v - VW (, D~
ELC
Foundation Access:
Ftg Drain CA/V G-4/ 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
Susp'd Ceiling —/
Roof
Other:
c /
Othe
Final
i
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 P - T FAIL
Post& Beam
Rough -In
Gas Line
pampers
•ART FAIL
CTRI A
Rough -In C
UG /Slab
Low Voltage
Fir- • larm
i ey
' S •ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspec ion RE: Unable to inspect – no access
Fire Supply Line
ADA / /
Approach /Sidewalk Date 0 Inspecto / • ( Ext
Other:
Final D NOT REMOVE this inspection record from the Job = ite.
PASS PART FAIL