Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00171
- �� 414, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/6/04
PARCEL: 2S112BC -05800
SITE ADDRESS: 08420 SW LA MANCHA CT
SUBDIVISION: LA MANCHA ESTATES ZONING: R -4.5
BLOCK: LOT: 011 JURISDICTION: TIG
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: REPLACE GAS FURNACE
Owner: FEES
DARREN SHELSTAD Description Date Amount
8420 SW LA MANCHA CT [MECH] Permit Fee 4/6/04 $72.50
TIGARD, OR 97224
[TAX] 8% State Surcharf 4/6/04 $5.80
Phone: Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503- 266 -1249 Final Inspection
Reg #: LIC 14008
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 - 01.00. You may obtain copies of these rules -or direct questions_to_O_UN-C- by calling —
(503)246 -6699. --
Issued By: Permittee Signature: 441/ . -
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b si ess day
Sent by: ROTH HEATING 503 266 3478; 04/02/04 11:46AM; #438;Page 2/2
Nee :e vnc.1: 13/25/02 10 :02AM; 5035081Oao -^ RUTH 1'1t=ATINO & A /C; P 2
06/25/2 2 09:30 FAX 3035981960 ®CITY OF TIGARD EI002
�
{ ti�� t M echaid Pen i tj pl
\.» ° � \' -, Pace rccctved: Permit no. . i I
,44-AY City 0
ty of Tigard r , N (k ( Prajectlappl. no -: >?.ttpire date: .
�'iry of Tied r4 Address: 13125 SW Hall E iv 5 OR 97223
Phone: (S03) 639 -4171 pate issue4: 1 Recclpt no.:
Fax: (5 J3) 598 -I960 ` 0 Case file no.: PaYmcnttypa:
Land use approval: building permit no.:
T><'PF OF PERMIT
Si ✓a & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family • Q Tenant improvement
£ New construction ' 0 Addition/alteration/replacement 0 Other .
JOE SITE INFOR ('OMNIERCIAl. VAll.l. ATION SrlIri)III.F
Job address: 8 '21-, 5 I • • A It Indicate equipment quantities in boxes below. Indicate the dollar
BM:. no.: TSuite no.: value of all mechanical materials, equipment;, labor. overhead,
Tax ma tax latlaccaunt no.: profit. Value $ .
Lou Block: Subdivision: "See checklist for important application information and
Project nbxne: jurisdiction's fee schedule for residential • rmit fee
City /coun E ! .. ZIP: ��►�� I S 2 FA.ali1.Y IMEI, PERMIT FEE SC11Eilli a:
D an io o f w or k on promises: A.M.) (COitiMO IC'.A1,11N:IAiS t R 1 Al 1(:,Q111 PA1E::N't S C11'EM71_E
i • ' sl.. a a-1 i Fae(ea.) Total
+. Dcse i Bon I Res. only Res only
Est. dat!• f comp on/ins. � coon: /
Tenant improvement or change of use: HvA 11 11111111111 Is existing space heated or conditioned? D Yes 0 No ' Air handling unit aired) $ p A�Y COndiupnin_ (site plan - •aire INIMMONN
Is existing space insulated? 0 Yes Cl No Alteration o existing 1WAC system L
R.1i 61ANl('A1. CONTRACTOR Dotter /compressors
/' Stateboiler permit no.:
� r ► /
1•1P Tons _ BTU/1 -1
Address: . 457,11 1 smo ice darn, r. -uct smo o • erectors ��
•� A ZIP: / eat • um • s tc • an •Lad M
Phone : j� : /� , r/r. L E -mail: Instal eplaeefurnace/burner BTU/
Including ductwork/vent liner O Yes 0 No
GCB no,: / fat - us , - I eplae relocate heaters- suspend • •, ■ UM
City /metro lie. no.: / ,, wall, o r poor mounted
lent or a 9• lance other an furnace � -
Name (please oriel): Li S - 19 /g
CON Cr PI'RSONI a Absorption unite BT ua:
Abaorpdon LT /I-I
Name: Chillers HP 111 11111
Com -ssors HP
Address: --. a Hance ttstgp v • , rtaR: ■
City:
State: 74P; A
Phone: E-mail: D er 1
:- �
\�'
n NFR ' nods, Type e V lures. latchstt/tlaztnat
hood Fire suppression system .
IrMilitijakir# Exhaust fan with sln :le duct (bath fans) III
Exhaust system a , art , ore heating or AC NM
Mailing cadre. ri ping and , r7 p . 11 , ■ (up to 4 outl )
City: �� /r State:':
Type:
LPG NG Oil
Phone: • Fax: E Fuel • i. inn each additional over 4 outlets
t.N(:INF.FIl - rum:is rptng(schematicrcquIre• i■_
Number of outlets 11 MO MN
II Name.; ct I n , awe or eq • pinCllt:
Addres &: _ Decorativet -lace
State: . ZIP: •lt1t:>si?: 111•111
Phone: ♦ E-mail: t oo • : rnve/pahat stove
• then. M
Appliennrs signature :, /Efer �� sn� Dam: Other: - i
Name •rine): :' fe' di
Pcrmit fee $ _ ' 2. a
Notice: This permit application minimum fee S _
expires if a permit is not obtained play review (at _ 4 7) $
— — wirma Igo days it has-been state eurchargo (8%a) ,... $ — 7 - ,., 1
accepted as complete. TOTAL $
����ff
eaa46i1 t%AWcotso
•
CITY OF TIGARD 24 -Hou
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
i
Received - q Date Reque -d �- 2 AM PM BUP
Location �1
�q (Z �/ r t � -�— Suite MEC Uv !
`
Contact Perso . Ph (_7' / ' 3l9 PLM
Contractor t _ -'F' p Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing �►
Insulation \ lb 7 v `
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P ASS 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 FA
MECHANICAL
Post & Beam
Rough -In
Gas Line •
dampers
11104 PART FAIL
EL ICAL
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 reinspectio RE: / ❑ Unable to inspect — no access
Fire Supply Line � /
ADA
Approach /Sidewalk Date Inspector _ _ L. . Exit
Other:
Final DO NOT REMOVE this inspection record from the Jo . site.
PASS PART FAIL