Permit CITY TIGAR1b MECHANICAL PERMIT
asetwo DEVELOPMENT SERVICES PERMIT #: MEC2004 -00122
..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/17/04
PARCEL: 1S136AA-07200
SITE ADDRESS: 07063 SW LOCUST ST
SUBDIVISION: AUM DOWNS ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 2
Remarks: Installation of (2) gas inserts and gas piping.
Owner: FEES
STEPHANIE BUTTICE Description Date Amount
7063 SW LOCUST ST
TIGARD, OR 97223 [MECH] Permit Fee 3/17/04 $72.50
[TAX] 8% State Surchar€ 3/17/04 $5.80
Phone: 503 892 - 5713 Total $78.30
•
Contractor:
T & K MECHANICAL
11525 SW CANYON ROAD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone: 503 - 626 - 4652 Gas Line Insp
Mechanical Insp
Reg #: LIC 121165 Final Inspection
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
Utili _ : • Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
• . - 001 -0100. • u m. obtain copies of these rules or direct questio - • UNC b calling
503)246 - .699.
sued By: / . Permittee Signature: jQ ,� %j
Call ( 03) 639 -4175 by 7:00 P.M. for inspections needed the nex business day
FROM : HOTSPOT FIREPLACE PHONE NO. : 15036269138 Mar. 17 2004 11:55AM P2
1•-
r
• AN, Mechanical Permit Application
O Date received: : Ad Permit n4. j + p — Qp / ;.A
..>�`
`a_i; City of Tigard 1 rojcct/appl. no.: c date:
• �
Cif n Tigard Add 13125 SW Hall Blvd
N I � 23 0� Date issued: By , Receipt no.:
• Phone: (503 639-4171
Fax: (503) 598 -1960 P� , PL Case file no.: _ Payment type:
Land use approval: M OF � o, 0 \ c, \O Building permit no.:
1 & 2 family dwelling or acccssory 0 Commercial/industrial 0 Multi - family • O Tenant improvement
• ' U New construction Addition/alteration/replacement 0 Other: _
JOB SI l L INI-OIIMIATION C'OMIMlER('l: \l. VALUATION SCHEDULE
Job address:, C(03 Sew...) •• 1 • Q •- Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: • 1 Suite no.: value of all mechanical materials, equipment, labor, overhead.
Tax map/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: % 1 4kr•I far: 4'i. -3 r 1 5: 2 FANIILY riNvi • , ER llT 111 SCHEDULE
• Description and 1 6 ocation o work on premises: ND CONEV111tl(:: NIA NDUS IR1AL EMI P\71: :NTS(:IIEDULE
g as [/ N Q (114 el 4--c.4)0 qo C t /.. Fee(es.) Total
• Est date, of completion inspection Description Qty. Res.only Res.only
Tenant improvement or change of use: HVAC
. Is existing space heated or conditioned? 0 Yes 0 No Air handling unit , CFMI
Avcoaditloniog (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
•
llLCIIANICAL CONTRACIOIt Boiler /compressors
Business namer1 -K Mo , •te.0 State boiler HpPrmitno,:Tons BTU/IT
Address: (Lg •54) (&2t4 01.4 CZ1 Fire /smokcdampers/duet smoke detectors
. at :gaa Q^4o Stat e. I ZIP: g7p �1eat pump (sal required)
. Phone: „4,S Fax: JE -mail: lnstalL/replacefumaM umer BTU /H
Including ductwork /vent liner 0 Yes C3 No .
. CCB no.: / 1 / /AS . Instatwrep a r ocateheaters— suspended,
City /metro lic. no.: t1SID.t. wall, or floor mounted
Name (please print): — Vint for appliance other than furnace
• e Refrigeration:
('ON1'ACl' PERSON Absorption units BTU/H
Name: _ e ! K Chillers HP
Compressors HP xhaus
Address. ) [ S, S'LJ !� O %n Environmental et and ventilation:
CitY: c 4Iczo2vkov\ I State0/ ZIP: 'WOOS Appliance vent
Phone: (o- &S) Fax' - E-mail: Dryerexbaust
H s, ype 1/res. kitche azmat
14,214e hood fire suppression system
Name: e_s c4i; t e _ - Exhaust fan with single duct (bath fans)
Mailing address: 10/ S(.,,.) /emu • , Exhaust system • • from heating or AC
p • and . 1 • • e up to 4 ou ets
:
City. a,' ( �i ZIP: ' .,�_ T : LPG y NG Oil 9 5:5/0
Phone: ,y; �� Fax: E Fuc pl' tag each additi • nal over 4 outlets
ENCINEFR • . p . 1. (schematicrequired)
• Number of outlets
. •
Name: a .. 1st -, app i , or equipment:
• Address: Decorativefi -'1 •
may: State: ZIP nsert — ripe • • rflT!tLr __ 7 ,.
• Phone: Applicant's si ; , " . tove/pelict stove —
8n �-' 5/7 %/ tom. • 4.--__— sl / Datc:
. Name (print): / eI ll ivt t .
— •
•
Na all judo:U vitas adapt co die C. please call jurisdiction for mote ioforteIIIon. Permit $
pYtsa O MasterCard Notice: This permit application Minimum fee $ 7a t sa
/ / expires if a permit is not obtained plan review (at _ %) $
cardnumber: within 180 days after it has been
— Expires a ccepted a s c omplete. • State surcharge (8%) .... $ 0
films of eardaolder as shorn on creme card TOTAL $
S
Cardholder signature Amount 4404617 (6100/COM) •
•
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: - (503) 639 -4171 MST
BUP
Received��7 �� d� ate Requested D l — 0 ( 4 AM PM BUP
Location r ? O 6 3 Suite at, V
1 z-
Contact Person Ph ( ) PLM
Contractor Tv ` VI/xi( Ph ( SO 3) 3.5 1'V6,9' 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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING /CV,
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer e1 6 G` 4 S �
Rain Drains ll >>
Catch Basin / Manhole GA L-�
Storm Drain /
Shower Pan
Other:
Final
P T FAIL
HANICAL
Post & Beam
Rough -In
..e Dampers
PART FAIL
TRIC .'-
Sere"
- ough -In
UG/Slab S�
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: • Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Da Inspector .���. Ext
Other:
Final DO NOT REMOVE this inspection record fr the job = Its.
PASS PART FAIL