Permit Tr
. •. . .
CITY TIGARD . MECHANICAL PERMIT
vd �Iik I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00183
�- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/11/03
PARCEL: 2S 103BB -05000
SITE ADDRESS: 12360 SW KATHERINE ST
SUBDIVISION: BROOKWAY ZONING: R - 4.5
BLOCK: LOT: 050 JURISDICTION: TIG
CLASS OF WORK: ALT 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: DOMES. INCIN:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install gas furnace.
Owner: FEES
ASHENFELTER, CHARLES G Description Date Amount
BEVERLY A
12360 SW KATHERINE ST [MECH] Permit Fee 4/11/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 4/11/03 $5.80
Total $78.30
Phone:
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 72623
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- O- UNC -by- calling - - --
(503)246 -669,7
Issued By: /i
Ve f / )�, L, ,(.) Permittee Signature: fl) _d& e 0 9y`
i
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
It . _
' City of Tigard
Date Projec r eceived:
Uappl. no.: - 7 Permit no.: m_091 3
Expire date:
City of Tigard esigard Addrs: 13125 SW Hall Blvd, Trgard, OR I7V223ED
Phone: (503) 639-4171 Date issued: Ir Receipt no.:
Fax: (503) 598 -1960 APR 0 9 2003 Case file no.: Payment type:
Land use approval: MY OF TIGARn Building permit no.:
0 1 & 2 family dwelling or accessory ❑ mmercial/industrial 0 Multi - family 0 Tenant improvement
0 New constructi /alteration/replacement ❑"Other:
Job address: ' Indicate e
' � � 0 ) I�Gt,I�`)r /.1//7i)J / Q.� equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: ' value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: 170 I ZIP: / _ I & 2 Ft1111.Y F WFl.l.tw(; PERNII F rui: SC11E1111'1.1'
Description and locati n of work on premises :(,' . , -d( . 1 ND 001111FRIC %I./1\I)1 STR1 U. EQl`IP11F.NT.SCIIFE)
Est. date ofcompletion %inspection: Fee (ea.) Total
D escr i ption Qty. Res. only Res, only
Tenant improvement or change of use: / HVAC:
Is existing space heated or conditioned? 1D yes ❑ No Air handling unit CFM
Is existing space insulated? `U/Yes 0 No Air conditioning (site plan required)
Alteration of existing HVAC system
1IFF:(I1A \1(:1I. CON l RACTOR Boiler /compressors
Business name: Tri Count V' Temp Control State boiler permit no.:
HP Tons BTU/H
Address:
13150 S . Clackamas River Dr. Fire/smoke dampers /duct smoke dete4tors '
City: Oregon City I State: OR I ZIP: 970 45 Heat pump (site plan required) a
Phone: 5572220 (Fax: 5 5 7 0 9 1 4E -mail: Install/replace furnace /burner j/ / t BTU /1{
CCB no.: 7 2 6 2 3 Including ductwork/vent liner Yes 0 No 1
Install/replace /relocate heaters - suspended, r '
City/metro lic. no.: 1 1 2 6 wall, or floor mounted
Name (please print): Gi esele Saha. on Vent for appliance other than furnace
(.O 1 A( I PERSON Refrigeration:
Absorption units BTU /H
Name: Giesele Sahagon Chillers HP
Address: Same As Above Compressors HP
City: I State: IZIP: Environmental exhaust and ventilation:
Phone: 5 5 7 — 2 2 2 0 FaxS 570 91 9 E -mail: Dry er exh aust D exh uausst t
Hoods, Type U II /res. kitchen/hazmat
/ e ,^ hood fire suppression system
Name: �/ Yf��I Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
ZIP: Fuel piping and distribution (up to 4 outlets)
City: I State:
Phone: Type: LPG NG Oil
Fax: E -mail: Fuel g
pipin each additional over 4 outlets
Process piping (schematic required) '
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: I State: I ZIP: Insert - type
r Phone: Fax: -- I E -mail: Woodstove /pellet stove
Applicant's signature: (4. ,. ' hea Date: L/ / Other:
�� } Other:
Name (print): / /7 /L�: eil,fl t 7i.11%al ff rn J /
"Not all jucisdic«oos accept credit cants, please cal jurisdiction tot - rn information. Permit fee S a
0 Visa ❑ MasterCard Notice: This permit application Minimum fee S NAM
Credit card number: / / expires if a permit is not obtained Plan review (at %) S
Expires within 180 days after it has been n ��
Nam. of cardholder an shown on credit card accepted as complete. State surcharge (8 /o) .... $ .3
Cardholder signature
Amount
a'd GT6O -LSS (EDS) J uo2eyeS aTasaiD 1: ED 60 add
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
f L ,! q BUP
!
Received • O N '` Date Requ sted / r AM PM BUP
Location ) a` 3(e 1 Suite MEC 3 _ ax 3
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 5 — ELC
Footing — ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection:Notes: ,,��� P / SIT
Post &Beam r-r
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
Final
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 PART FAIL
MECHANICAL"::
Post & Beam
Rough -In
Gas Line -
Smo. Dampers
P -S PART FAIL
ECTRICAL Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE = ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line —
ADA
Approach /Sidewalk Dat Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL