Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00196
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/06/2001
PARCEL: 25111 DA -11800
SITE ADDRESS: 08901 SW PIPPEN LN
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 111 JURISDICTION: TIG
CLASS OF WORK: ALT 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: 1 DOMES. INCIN:
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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of NC unit. Cannot be placed within required setbacks.
Owner: FEES
NANCY KIMMEL Type By Date Amount Receipt
8901 SW PIPPEN PRMT CTR 06/06/20C $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 06/06/20C $5.80 2720010000
Total $78.30
Phone:
Contractor:
SUN GLOW INC
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 253 -7789 Final Inspection
Reg #: LIC 48131
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 opies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: Permittee Signature: c(
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
04/19/2001 09:23 FAX 5036847297 City of Tigard 0 002
MechanicalPermit Application
C � Datotoccived: 07 it I Permitno.:+ i , . / - pi • 0
alit\ I!, City of Tigard REC Project/appl.no.: Expire date: •
City oj>7agard Address: 13125 SW Hall Blvd, Tigard, 01X_9724-1N1 Datc issued: 'o Receipt no.:
Phone: (503) 639.4171 A,1l 3 �' ��
Fax (503) 598 -1960 p `, J` D�v�`OpMEI'l N Case file no.: Payment typ
Land use approval: l` ����p0 Building penult no.:
TYPE or PE
. 1 & 2 family dwelling or accessory ❑ .mmet+cial/iadusuial ❑ Multi - family O Tenant improvement
p ew construction •• dditton/altcration/replacemcnt Cl Other
.1013 SI I L INFORMATION COMMERCIAL V:'1LLATIO_N SCHEDULE
Job address: his jMII r1TI Indicate equipment quantifies in boxes below- Indicate the dollar
Bldg. no.: Stnte no. value of all mechanical materials, cquipmenl, labor, overhead,
Tax map/tax lot/account no.: profit. Value $
-
Lot: Block: [Subdivision: 'See checklist for important application information and
Pro' name: • jurisdiction's fee schedule for residential permit fee.
City /county: a ��; amm • umenjui. 1 C 2 FAMILY DWELLING PERMIT FEL SCHEDULE
Description and 1 ;on ofwo o, premises: A' DCOMMERICALIINDL :SlRI Al. EQUIPMENTSCIIEDLI,E
lk ...Rae •: 16151Mikiti n ' ■ Fee(es.) . Total
Est. date of completion/inspection: o 6 Description _ Qty. Reir.only Res.. .
Tenant improvement or change of use: HVAC:
Is existing space healed or conditioned? O Yes O No h -'"'„ Cl+lvi
f i - Airco , :_::• top an required) 111. iNIMMINIntaali
Is existing space insulated ?' i Yes CI No :. , otivi exist;, _ HVACsystem IIIII
N1F.CIIANICAL CONTRACTOR Bolledeotiprtsso[s
Business name: ellWalrefflillni State boiler permit no.:
HP Tons BTU/H I
Addr ss: _ =LIE I trelsmokedampers /doctsmckedetectors MN
atr Inalk • j magi! Hcatpump siteplan) • moue: .L �Y ■ •TF.111� ►1'i�.� Install/replace fumace/ BTU /H
Including duetwork /vent liner ❑ Yes O No
C no:: �ii Install/replace/relocatehe heaters -suspended,
City /metro lic. no.: , Q wall, or floor mounted
Name (please print): „A A A Ai • lie y Vent for other than furnace
•
appliance
CONTAC 1 PERSON
Absorption units _ Blv /N
Name: — .11 (A to • Teri.
Chillers HP
Address: ress n_ ati
City: � � Appliance e e exhaust and ventilation:
State: ZIP:
Phone: _ - i ' Fax: E-mail: a erexhaust
O%t'NLR Hoods, , 4 res. fob . ,azmat NI
hood fire suppression system
Name: Q ■ C r i i 1 • Exhaust fan with single duct (bath fans) III
Mailing address: . . aust system a , art , , m , ca • , or AC NE
City: 1 t �� State. a vales Types i'� _ '11 up to o ems) ■
� r � w m • LPG NG Oil
Phone: ' � ; - O►'!� ; Fax: E-mail: l . - ping each additional over outlets
ENGINEER ' ' piping (so mastic required)
Name: Number of outlets
Other lirtedap fiance or egmpment:
Address. Decorativefireplace •
City: Stare: ZJP: Insert-type _
Phone: Fax: E -mail: Woodstove/peiletstovc
Applicant's signatur 1T Z �; �;,:�� �� •'rill c lout
Name (print): 1.�,rntd .n'!•� � A
Nat ■n julusdicdane accept aerie cards, pane call jurisdiction for roam • • • Permit fee $ RAWL
O Pisa O MasterCard This permit application minimum fee $
e xpires if a penult is not oblaiaed
cent spa / / Plan review (at _ %) $
p within 180 days aftrr it has been state BUfC�malg a (8% $ Ufi,
Nam a a.dltpwsr as .mwa ea media card S accepted as complete. TOTAL ) $ • '
a, ---
Cedbe der d�tae Amami 440-46 (6 :4COM)
r5iw \4x0Y\ .
10 \ n
frO
cro
7,1 I 0/
6 , • t.
" CITY OF TIGARD BUILDING INSPECTION DIVISION . 6......1.
MS
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 5'—/O BUP
Date Requested AM PM BLD
Location ' 9 6 ( Lt Suite C'(1pv/ DD / 4,
Contact Person Ph PLM
Contractor _ Ph SWR
BUILDING Tenan - - - _ _ ELC
Retaining Wall — T 6; 6 -: }ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath/Shear '7,, 2 A/
Framing _- ^i�"k_ CD - re _
Drywall on / v ! r/ (- (� �J
Drywall Nailing J�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /
Roof G✓ C .• /, e i / C' y " Misc: ✓ !? ! ?�
Final
PASS PART FAIL
PLUMBING �✓ �y i / ` , O
Post & Beam
Slab �Y,4�, �-C.9-r- c
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PA FAIL OTE
Post & Beam
si. L - t
Rough In C'
Gas Line F'
�
S • • e Dampers /
'^ / �
PASS PART FAIL
CL TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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 l n
Approach /Sidewalk Date Si 1 6 l 5 1 Inspector ` �-?` ` Ext3'
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.