Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00143
DATE ISSUED: 05/03/2001
`,f � l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110CC -16300
SITE ADDRESS: 12433 SW KING GEORGE DR
SUBDIVISION: KING CITY NO. 5 ZONING:
BLOCK: LOT: 037 JURISDICTION: KIN
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: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: 60 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 0
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replacing 60btu furnace,no ductwork/vent liner.
Owner: FEES
SUMMERS, ALLEN W + ROXANN P Type By Date Amount Receipt
425 FRENWOOD WAY PRMT BFB 05/03/20C $72.50 KING CITY
BEAVERTON, OR 97005 5PCT BFB 05/03/20C $5.80 KING CITY
Total $78.30
Phone:
Contractor:
ALLIED MECHANICAL CONT
14275 NW SCIENCE PARK DR
PORTLAND, OR 97229 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 350 -1963 Final Inspection
Reg #: LIC 005807
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 copes of these ules or direct questions to OUNC by calling
Issue By: Permittee Signature: API
• Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business da
05/03/2001 14:09 5036393771 CITY OF KING CITY PAGE 02/02
Mechanical Permit ti on
Date received: . : - �'j I Permit no. I "OP
-4,,,, City of Tigard Pin
• Jecdappl, no Patpire date:
City ofT (g asd Address: 13125 SW Hall Blvd, Tigard, OR 97 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 555 -1960 • Case file no.: Payment type:
Land use approval: Building permit no.: ,
TYPE OF I>Fki%'iI'I'
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
.1011 SITE IN1 (ommEIU IAI.. %ALIIATIoN S('iIFDlll.l•:
. Job address: - - s �. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: uite no.: value of all mechanical materials, equipment, labor, overhead,
Tax nmap /tax lot/account no.: profit. Value $ -
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: l & 2 FA1 111.Y DWI ?I.l_INC: PERMIT FIT SCHEDULE
Description and location o work on premises: _ roriec i n _ AND CON 1MIlilt'UI.11NDUISTRIA.I.,1.;Qt II I'Nih :NTS(11E1)1!I,I
• •_ • Fee Total
llescrl ! . oil I Res. on' Res. only
Est, date of completion/ins. em r change ge of; S
Tenant improvement or change of use: liVA ` MIN
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit r
Aircon. on n. (site .Lanrequae. S ��
Is existing space insulated? 0 Yes 0 No Alteration o existing • AC s stem 11111 —iii.. .
MICCIIANI('AL ('(►NIltA( °1 OR :o et /compressors
M ,till . . State boiler permit no.:
Business name : F HP Tons BTU/H
Address: I, t3,'Ia7fi ; .1. ; . t, .rZIVVMIINMMIIIUIMOM
� �� q • eatpum. (site . an requ red) r�
�L7 /1' _
Phone' k.- t^ s ..,. E. mail: Instal rep ace urnace/burner .. : • 1I1ES
Including ductwork /vent liner 0 Ye: %,' o
CCB no.: , ti•-_ . lnstaWrep ac re ovate eaters - suspen•e., ill
City /metro lit. Co.: wall, or flo or mounted
Name (•lease print): Vent or a y. once other than umaee : =MOM
CONTACT PIEHSON e i gera • our
Absorption units _ BTU/H
Chillers HP 11.1
Com. ssors HP M -1.111.
Address: 1 ,.
a • ronmenta e , ust and yen at ore Ell
- .-r/ Sate f ZIP 4§),,, 4 A..liancevent .-
Phone:7 -. < =MIN E-mail: s oust . =MEE
OW,NFR Hoods, Type I Tres. 1 1 tchen/hazmat ■1111111
hood fire suppression system
rrll`
I MIIIIIMIIIIIII
,� - Exhaust fan with single duct (bath fans) - -MI
Mailing address: = haust s stem a.art om heatin : or •
e p p ng an . .. • ■ on up to 4 out e
Ty.e: I. PG • NG _._ oil .■�-
Phone: Fax . .riel . i. in: eac a.. itional over 4 outlets =MIEN
UN(.INEFll ' ocess ,, . ng se ernaticrequire.) IIIMMIIIIIIMMIIIMII
Name: • Number of outlets -�
(her I etc . app I • ace or eq pmenti 1111
Address: Decorativefirapeplace
City: State: ZIP: 111212MEMIMOM OM
Phone: Mffinalliffil E -mail: "oo. stove/.elletstove ii/iiMil
Other:
Applicant's slgnatu _ •. 1'f r there- -
f' M
Not all judsdictlons pampa credit cards, please can jurisdiction for matt information. Permit fee $ 7 Std
4 Visa 0 MasterCard Notice: Phis perm appl Minimum fee $
expires if a permit is not obtained Pl review evew %) $
Credit card_numDar: f / (a[ - �°
a„ p i ng , within 180 days a(ter ithas been •
Name of caniholder as shown on credit card C accepted as complete. $[ate SU (8%) ... • $
, $ TOTAL $
Cardholder signalorr! Amoutl. 440 - 4617 (r/oo/COM)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
•
BUP
Date Requested , Z 9 AM PM BLD
Location / L Y3 3' sw ILi hf C9 e & r5 Suite MEC 0. b / —1 l q3
Contact Person ea4 Ph 6 4' 5 PLM
Contractor Ph SWR
BUIL'DING', Tenant/Owner -(4 5-c C ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
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.
e b-
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final -
•
PASS PART FAIL
MECHa
Post & Beam
Rough In
Gas Line
Smoke Dampers
F'
PAS PART FAIL
ELECTRICAL 4 r `. t
•
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
•
Other Date 5 2 Inspector Ext
Final
PASS. PART FAIL DO NOT REMOVE this inspection record from the job site.