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Permit C ITY OF TIGARD MECHANICAL PERMIT PERMIT #: MEC2002 -00404 fill DEVELOPMENT H BMEN9 Tigard, ) 639 -4171 DATE ISSUED: 9/11/02 PARCEL: 1 S135DD -03301 SITE ADDRESS: 11945 SW PACIFIC HWY 104 SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: 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: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS FURN > =100K BTU: < =10000 cfm: OTHER UNITS: GAS OUTLETS: 1 > 10000 cfm: Remarks: Gas piping for oven. Owner: FEES TIGARD PROPERTIES INC Type By Date Amount Receipt 2106 SE OCHOCO ST PRMT CTR 9/11/02 $72.50 2720020000 MILWAUKIE, OR 97222 5PCT CTR 9/11/02 $5.80 2720020000 Total $78.30 Phone: Contractor: COMFORT SYSTEMS, INC. 12300 SW 69TH AVE. TIGARD, OR 97223 REQUIRED INSPECTIONS Gas Line Insp Phone: 503 - 598 -4798 Final Inspection Reg #: LIC 137663 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 OA 952 - 001 -0080. You may obtain copies of these rules or direct quesrji o O C by c Zing (1�174R -q1 R. — 1 ! `� ( Issue By: � � 1 / ���(,� Permittee Signature Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bus' s " ay 41.. Mechanical Permit Application OFFICE USE ONLY Date received: mg no.:mkC. /i q / 4 r „f i City of Tigard Project/appl. no.: Expire date: Cr' of Tigard Address 13125 SW Hall Blvd, Tigard OR 97223 , City f 8 Phone: (503) 639 -4171 Date issued: ►� Rece no. Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: JOB SITE INFORNIATION COljli9ERCIAL VALUA'T'ION SCHEDULE Job address: // q L/, 5 („O P4C. H is.) Y /pi/ Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ ,''ADO • Lot: (Block: I Subdivision: *See checklist for important application information and Project name: TO g-T I LI' K/ A S/NN 6AB RJ EL jurisdiction's fee schedule for residential permit fee. City/county: T i A IL9 I ZIP: 97223 I & 2 FANIII.Y DWELLING 1'I R%1I7' FEE SCHEDULE t ription and location fwork on premises: AND COMMERICAL /INDUSTRIAL. EQUIPMEN"I'SCIII Dl1LE q p L 1 An c 6 Fee (ea.) Total Est. date of co/npleti/in ction: Descripdon Qty. Res. only Res. only Tenant improvement or change of use: SAC: Air handling unit CFM Is existing space heated or conditioned? ❑ Yes 0 No Is existing space insulated? ❑ Yes 0 No Air conditioning (site plan required) g p Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: c j,t,�Q(LT S.fs ,r1S ` L�9t_ State boiler permit no.: HP Tons BTU/H Address: 12300 St,ti 6:01 ; kl, Fire/smoke dampers/duct smoke detectors Ci ty: 6krz-D I State: oCZI ZIP:Q'1 ZZ3 _ Heat pump (site plan required) Phone:5t)3 �'T't17g$ Fax:SC36ZOZ564 E -mail: Instal /replace furnace/bumer BTU/H CCB no.: t 3 "7 (o G 3 Including ductwork/vent liner ❑ Yes ❑ No Install/replace /relocate heaters — suspended, City/metro lic. no.: 4 -t7 3 wall, or floor mounted Name (please print): asi) /1.) . 2elA16- Vent for a liance other than furnace Re gera on: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: D er exhaust OWNER Hoods, Type U II/res. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG 1C NG Oil I Phone: Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Name: Number of outlets Address: Other listed appliance or equipment: Decorative fireplace City: I State: I ZIP: Insert — type Phone: � I E -mail: Other: Applicant's signature: ( Woodstove /pellet stove �� I Date: D9- // - O L Other: Name (print): —A2.∎,ts - 4. ? � t .�0 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 7^ —3 Notice: This permit application Minimum fee $ U visa O MasterCard expires if a permit is not obtained o Credit card number: / / Plan review (at _ %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ VO Name of cardholder as shown on credit card accepted as complete. S TOTAL $ 78, 30 Cardholder signature Amount 440 -4617 (6/00 /COM) r CITY OF TIGARO 1 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / BU •41 � - - .l_ Received Date Requ sted / 0 AM PN. B Location 1/ 9 4 1C - Suite /0 r � — 1 . U m C �i_� Contact Person /l, Ph ( ) s 7? O 3 I co (p it _�_— __ ,� Contractor Ph ( ) BUILDING Tenant/Owner ELC Footing ---------_____ ELC Found n Access: as Crawl rain — sl Inspection Notes: SIT Poe & eam Sher nchors Ext heath/Shear Int S 4ath/Shear Frami 4 w in ryw �I Naili D ng Fi wIl Fir prinkler • . / 9 Fir Susp'd Ceiling Roof O : %,: .,�• ,ART FAIL Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final • - - • . - FAIL I i ■ : ■ ' Pos • : eam ii i h wIT .k. l a Dampers PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA 2 Approach/Sidewalk Date ' 0 /1 3 Inspector q69/11 Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL