Permit CITY T I GA R D MECHANICAL PERMIT
D EVELOPMENT SERVICES PERMIT #: MEC2003 -00196
DATE ISSUED: 4/18/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110CC -15900
SITE ADDRESS: 12413 SW KING GEORGE DR
SUBDIVISION: KING CITY NO. 5 ZONING:
BLOCK: LOT: 001 JURISDICTION: KIN
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace furnace
Owner: FEES
OUCH Description Date Amount
2413 SW KING GEORGE DRIVE
KING CITY, OR 97224 [MECH] Permit Fee 4/18/03 $72.50
[TAX] 8% StateTax 4/18/03 $5.80
Phone: Total $78.30
Contractor:
g + S HEATING INC
1123 MEADOWVIEW COURT
EST LINN, OR 97068 REQUIRED INSPECTIONS
Phone: 503 657 - 4137 Mechanical Insp
Reg #: LIC 00070720
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
ssued By: .
Permittee Signature: / I
Call (503) 39 -4175 by 7:00 P.M. for inspections needed the next bu in • ss day
04/11/2003 12:55 5036393771 CITY OF KING CITY PAGE 02/02
ERA O ON" t' Mechanical Perm A pp lication OFF USE ONLY
—�— Date received: P e r mu n o _ pD ,,pa -
°_ J City of King City
g Da je receiv . no.: Expire date:
13125 SW Hall Blvd.
Tigard, OR 97223 Date issued: By: Receipt no.:
ClaCicanlaS Phone: (503) 639-4171, FAX: (503) 684 -7297 Case file no.; Payment type:
Washington Land use approvaa; Building permit no.:
: 9 tJ r`t T t G S
TYPE OF PERMIT I_
iii 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL b ALUATION SCHEDULE
Job address: Q. y 13 . ,, Ic:, �e Ge {. _ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: i te no.: _ value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: -* profit. Value $
* See checklist or important a lication information and •
Lot: Block: Subdivision: �. f P PP
Project name: ‘..) k \55 jurisdiction's fee schedule for residential permit fee -
p�
City/county: ZIP : ' • I & 2 FAMILY DWEL G PERMIT FEE SCHEDULE
Description and location of work on premises: V - \ Ca' 5 \'� %ND COMNtERICAL/iND d� • IAL EQUIPMENT SCHEDULE
, O� �� Fee (ea.) Total
EsL date of completion/inspection: G` ` 0 - Description I Qty. Res. oily ,Res. only
HVAC:
Tenant improvement or change of use: ' ''4 Air handling unit CFM
Is existing space heated or conditioned? it Yes ❑ No - --
Air conditioning (site plan required)
Is existing spare insulated:) Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
• State boiler permit no.:
j3 usiness name: S to • s� ; _ HP Tons BTU/H •
Address: 11 n 6 c/t et,,, Gam- Fire/smoke dampers/duct smoke detectors
City: I State: t ZI:P: • 4. • Heat pump (site plan requue" d) _ :
Phone: 6S') el . L1 Fax: 6c E - mail: Install /replace furnace/burner 1•n 1.1/1-1
[ncludinjductwork/vent liner 0 Yes CI No l
CCB no.: lo') z., .
heaters suspended.
City /metro tic. no.: wall, or floor mounted .
Name (please print): ' Sc.,yt-t , Vent for apps, ice other than frnace . f -
CONTACT PERSON Refrigeration:
Absorption units ,,.,.^ BTUCH
Chillers HP
ti_ame: 5c�'C1 Q _ Compressors HP
Address: 1 ( )-3 Metr< i/irai✓ Cd' Environmental exhaust and vtratilation:
City: G - L( Srate:p(L ZIP:enp6rei Appliance vent
Phone: c c(/ i Fax: I E -mail: Dryer exhaust
OWNER Hoods. Type 11/res. kitche azerriat
. hood fire suppression system - •
Name: , $.t, 25 COtic , Exhaust fan with single duct (bath fans) I
Mailing address: 1 p N v 5l.... t..N., ff.et, � L Exhaust system apart rom eating or AC
1 > Fuel piping and distribution ( (e .ip to 4 outlets)
City: �(,,,r U ty J State:` -bit ZIP: Type: LPG _ NG Oil I .
Phone: i Fax: Email: Fuel ■i•ing each additional over 4 outlets f
ENGINEER Process piping (schematic required) .
Number of outlets
Vame: Other listed appliance or equipment:
''address: Decorative fireplace _
ity: State: ZIP: Insert - type
'hone: Fax: E -mail: Woodstov�e /pellet stove _ _
Other:
t pplicant's signature: Date: Other: _
game (print): - .
- -
j acccpl credit cards. pleain call jurisdiction for more informat No -- - - - Permit fee -- -- - S tice: This permit application Mirdrnum fee $
Visa ❑ MasterCard t rot obtained
Plan ft
:view
c;tn.l number: � .,,., / M1 espires if a permit is Plai view (at %) $ _
gapi within 130 days after it has been state s archargc (8 %) S
Namc of eetdholdcr as shown on crcdit card accepted as complete. TOTAL ,e t
Cardholder signtlturc $ Amount l7 (AM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
�./ �/ BUP
Received [ Date Requested ` -- 1 d AM PM BUP
Location L.D. ` /3 , - � e) Suite f9L MEC 3 —069 i
Contact Person Ph ( ) 31 q-/ rP `j' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain ,
Slab Inspection Note SIT
Post & Beam .' % _ .
Shear Anchors
Ext Sheath/Shear 1 /l/ � %� � - ! '
Int Sheath /Shear
Framing —imm —
Insulation
Drywall Nailing
Firewall zi.V.-----_, J
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /
Roof
Other: r .-- – 0/'''
Final
PASS PART FAIL
PLUMBING:'`'
Post & Beam
Under Slab
Rough -In ),
Water Service 1
Sanitary Sewer
Rain Drains
Catch Basin / Manhole /
Storm Drain
Shower Pan
Other:
Final
PASS PART FAI /
,MECHANICAL'
Post & Beam
Rough -In ► I ,
Gas Line , _�� /
S �
, Dam. -:.
,∎; , 4rifi/1 - T FAIL
S ice
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 0 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA
Approach /Sidewalk Date a Inspector 1. 7 7 2 Ext
Other:
Final ' O N • T REMOVE this inspection record from the job site.
PASS PART FAIL