Permit CITY TIGARD MECHANICAL PERMIT
F �l DEVELOPMENT SERVICES PERMIT #: MEC2001 -00211
`- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/14/2001
PARCEL: 2S115BB -07700
SITE ADDRESS: 16445 SW KING CHARLES AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: 100,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of gas furnace.
Owner: FEES
KRUSE, NAOMI P Type By Date Amount Receipt
16445 SW KING CHARLES PRMT BB 06/14/20C $72.50 KING CITY
KING CITY, OR 97224 5PCT BB 06/14/20C $5.80 KING CITY
Total $78.30
Phone:
Contractor:
ROSE HEATING CO
9945 NE 6TH DR
PORTLAND, OR 97211 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 283 -5183 Final Inspection
Reg #: LIC 00002084
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 , .i s of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: f jam/ j �� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
06113.12001 12:15 5036393771 CITY OF KING CITY PAGE 02
iiiii
Mechanical Permit Application
Date received: `p ..l .61 Permit no.; IN S{' l (�Ol.lI
,, .... Ai City of Tigard _..4...i Project/appl.no.: Expire date: •
City o f T igar d Address: 13125 SW Mall Blvd, Tigard, OR 97223 Date issued: ByI Receipt no.:
Phone: (503) 6394171 .
Fax: (503) 598 -1960 - K1 I Case file no.: Payment:type:
Land use approval: Building permit no.:
•1'11'1( OF PERM 1
X i & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family ❑ Tenant improvement
0 New construction ❑ Addition /alteration/replacement U Other;
JOII SI1'I( INFARIIATION ('ONlJI;ItUlAl. VAI.IIATION S(::I111)1
Job address: _ Lieskimlintm Indicate equipment quantities in boxes below. Indicate the dollar
Bids. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
-- — tot : - ---- • muck - .,- „ �__ - �- subdivision:-- . - . . -. _ ..--- . - . *See. checklist for. imp octancappl .ication-.information...and..'.. ...
Project name: ate_ ‘.../ � jurisdiction's fee schedule for residential permit fee.
City /county: > c_1 I ZIP: l A 2 1 AR'111.1' DWELLING PERMIT h l.Ii SC II I I)IJLIs
Description and locatio ork o remises: ..... . , AND COM 1'II /INDI IS I RIAI.. EO1I1 Pp'J1::N'1'S(Ii1:1)1'1.1;
. ■ • _ - Fee(en.) Total
Est. date of completion/inspection: Description Qty. Rem. only Res. only
Tenant improvement or change of use; IiYAC:
Is existing space heated or conditioned? 0 Yes CI No Air co ndlt ioni n t C 1,
Air cnditioning (site plan required)
Is existing space insulated? a Yes ❑ No Alteration of cxistin: NVAC system
1'IF(:11,.1 (•ONl'ItACTOIt Boiler /compressors
Business name: t, I� k State boiler permit no.:
HP Tons BTU/H
Address: 9 Clit C - , 1 gi Fire/smoke dam . ers /duct smoke detectors
Cit : __ w k UM State :c3 a 1 ' Heat .ump site p an requ red) - iii.
nets replacefurnace/bumer _. _. B � �
Phone; �$�_ �) �t Fax:-..,5”- Including ductwork/vent liner GI Yes D No etsZ
CCl3 no.: • :� nate'rep ac• relocate heaters suspended, III
City /metro lie, no.: . • w wall, or floor mounted
( p) - : L �. i► �`�i
� - - ' '
�ent than-f....... --• --•• • - - - -•� -- •._ .. - -.. -.
Name lease rtnt :7- . . ]tanco•ethec thRn'
('ON'1'1(`I' PERSON Absorption 1eraIon:
Absorption units ' BTU/H
Name; Chillers HP
Address: Cnnttrt . . • • • HP . .
EDVlropnteftal,exhaus( and ventilation: .. .
City: I State: I.2.11): Appliance vent .
Phone: i Fax; E-mail: Dryer exhaust .
OWN 1 :12 Hoods, Type res. kite : =mat
.. hood fire suppression syatetn ' .
Name: . q• a Exhaust fan with single duct (bath fans)
Mailing address; Exhaust a stem a. art from heatin : or AC
City: State: ZIP: ' e p p 11S a, . ,I.. :Ti OD up to • out ets ■�
Ty. :: 1.)0 NO Oil
Phone: _ I 1,....-_:,Fax: E -mail: •ue piping each additional over 4 outlets
1• :N(:INI:I• :R Process piping (schematic required)
�—
Natne Number of outlets
_ —.
Otlrerllsted a Hance or equipment:
-
City: • Sta 7 ZIP: insert ,. type .. -`-
Phone: I ax: I • mall: Woodatovelpelletstove
Applicant's signatu • . Aii I , �' �,� 1' Dare: Other: =�
Name (print): g imm'gfram • _ am -y
Not alt ju tisdicriona accept credit cards, please call Jurladlcion far more Inrormatlon. Permit fee $ _ 1 .
Cl Visa Q MastarCard Notice; This permit application minimum fee $ a .c-ct
dreeu cant number; . _ —,/ f . expires if a permit is not obtained plan review (at %) $
-. - - -- - -r. -: -. Expires within - 180- days - after -ithas- been -, -- - - -,"'• ----
- Name of cardholder as shown on caedir card • • ' accepted as complete,
State SuCChar$e 0396) '$ ` . . :+
TOTAL $ -" Ws.
` Cardholder signature ,• _ Antolini aao 4617 (6/00/COM)
CITY OF TIGARD BUILDING INSPECTION DIVISION •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested Z) AM PM BLD
Location / L 'f 5 S - &i ( ear / c-' Suite MEC e t / —'G Z
Contact. Person Ph 5.6 7 5! % PLM
Contractor Ph SWR
BUILDING. ` ° °; , ° �: Tenant/Owner ELC
Retaining Wall ELR
Footing " Access:
Foundation _ FPS
y /
Ftg Drain " 'Z .1 /
Crawl Drain Inspection N tes.
SGN
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath /Shear
framing
Insulation
Drywall Nailing •
Firewall
Fire. Sprinkler . .
Fire Alarm
Susp'd Ceiling • ._
Roof
Misc: "
Final
PASS PART- FAIL
PLUMBING,w
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
• •� m
Rough In
Gas Line • • -
Smoke ampers
" i
ASS PART FAIL
EL" _CTRICA SL - ; rn
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS " PART . FAIL
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-- - - -- -
Approach /Sidewalk (� �S�d
Other Dat / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from. the job site.