Permit M
CITY TIGARD MECHANICAL PERMIT
,,i,,, DEVELOPMENT SERVICES PERMIT #: MEC2002 -00020
- "�fI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/10/02
PARCEL: 2S110CC -11600
SITE ADDRESS: 15905 SW QUEEN VICTORIA PL
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 029 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: 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace existing a /c.
Owner: FEES
SHAY, RONALD E AND MARLYN J Type By Date Amount Receipt
15905 SW QUEEN VICTORA PL PRMT DEB 1/10/02 $72.50 KING CITY
KING CITY, OR 97224 5PCT DEB 1/10/02 $5.80 KING CITY
Total $78.30
Phone:
Contractor:
COLUMBIA HEATING + COOLING INC
PO BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 624 -2704 Final Inspection
Reg #: LIC 76359
PLM 34 -175
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for mor 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utili Notificatio Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
95 -001 -0080. Yo may • • ain spies of these rules or direct questions to OU by calling
(_ '1'24F_Q RQ
Iss a By: `, , r , • 4 1 / Permittee Signature: cam
Call (503) 63. 4175 by 7:00 P.M. for inspections needed the next b, siness day // ��
01/10/2002 09:36 5036393771 CITY OF KING CITY PAGE 02x`02
, P-
10/2a/2001 10: 46 5036393771 CITY ■ LNG CITY PAGE 01/02
SERVICE c TER Mechanical Permit Ap • licatio t N OFFICE 1,1$E ONLY
, s_ :
R417
City of King City 4 ' .. • : ' • .. • ., ` Date receives: Permit no.:
13125 SW Hall Blvd.
P %fecUappl, no,. expire date:
Clackamas Tigard, OR 97223 B `—,
MUltnonlah Phone: (503) 639 -4171, FAX: (503 7 0 2002 Dote a issued; By: Leceipt no.;
Washington Ouse file no.; Payment type,
rr T E k s Land ust approval: BD�T4��II Ruildin
�1 g permit no.;
TYPE OF Minn"'
C) 1 & 2 family dwelling or accessory ❑ Commat'cialAndustriaJ • ❑
0 New constr Oth family O Tenant improvement . Addition /alQest�ttic�n/rp.lticement Q Other:
JOlt3 sift INFORMATION
lob address;
COMMERCIAL VALIJA'FION sun nutj
/ ` L �, C' . i.A, Indicate equipment quantities in boxes below. Indieste the dollar
Bldg. no,:
Suite nu.: _
value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.:
profit. Value $
1 __ c ' t ' Block: Subdivision:
pro'ect name; Sae checklist for important application Information and
*` jurisdiction's fee schedule for residential permit /4,
L /county: 1[ C Zip:
De'. ' tiart and location ■f work I & 2 FAIWIILX DWELLING PERMIT FEE SCHEDULE
P rk Oft premises: AM) Q' OMAXI? .RiCAL./INp[IS1 ")ktllAli. EQUIPMENT sf IIEDULE
1rst. date of ct pletionIj.ns ti0ta: �� Fee (ea.) • Total
Tenant improvement or change of use: Desert .doa • Reg.. oat RA¢. only
II
Is existing space heated or conditioned? C) Xes 0 No Air handli_n _ unit � CFM
Ls 4TdSt:jng space insulated? El Yes 0 No
• u conditionka ; site . An r- . utred)
MECIIANICAi, CONTRACTOR - tera A ' S stem IIIIII
3usutess name: %o! o f ttioa of Ompres so exlstia! ty
C .ar - State boiler permit no,;
kddress: 59 v c�
• r te r - HI' ions STU/H
wily: % r irstsmoke dam . , rs/duct smoke detectors MI MIN
State: pyL ZEE: Q? 'Feat pump Oita p q
12 - Z d y Fax: an requires)
>; -ma instali/rep ace furnace/bgrner STU/ri
CB no " (03 9 - irtaludln_ ductwork/vent liner d Yes U No I
'ity /metro l.ic, no.: (27 '. Install/replace/relocate eater suspends , II
large (pleaso 'tint): wall, or floor mounted
id A
6 J S C. t" exit for a. pliance o r an ace . MINI MINIM
CONTACT P ERS O N ' e• *oration:
rZrrt¢. v � '7\ A}aserntion units EtTU/H
ddress: -L�(� k Chillers _�_„___ p
Compressors UP ity_ ` State: ZIP, Environmcn : exhaust and ventilation: ■
1 "e: �L �
����1 Fax: IRMa Ap•
a et 6x BtrSt
OWNER act. �,' 'ype U icit'ater taunat
•
rate; 2Qtn S hood fire suppression system
ail Exhaust fan with single. duct (bath fans? ns)
ai li ng address: [ n X s S e ; c..'?jtri.A Exhaust system apart. from Heisting or AC
` ZIP: 'ue p p ug sad distr u.• on (up to 4 outlets)
one: 2c' - 3/' Type: LPG NC; Oil
ENGINEER .i. each additional over 4 otittiata Mil
ma ocess pip ag (ac emacic requ ed NM
Number of outlets
, •
dress_ - - e thor sled appliance or equl`prno,tz
y: Decorative fireplace
State: ZIP: Insert t . .—_____ ri
)Ile: r nodstove /pel et stove "
)lieanf I'"
signature Date: � —
i. .. r. .,I r �t$C 4it r d
rte (print): an
t1 iurl.dlet,Jons accept ci edit cargg, Please call iorisAlction for tmre,2ro D
O Ntgster j- Notice: This permit Permit fee $ r )1, Sj
P application mi foe. $ ._
�.dnu mbcr' .....
/ / expires if a permit is not obtained
�^
Expires Within .140 days after it has b Plan review (At %) $ _,
c
t101dAf d9 9Ac wn o0 omit( Bird 1 rr n,.rn.t 4 @d Ctnrr� cttmheren / silt c
Name of 3 • �. gl
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Re nested _ /�° • AM PM ;', s BUP
Location /. -90 S a(..Lr2 (it l.ta -z-Z . Suite rt.- MEC oe. 0 2-00
Contact Person �►'� Ph ( ) ( - f a 7U' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/? 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
Post & Beam
Under Slab
Rough -In
WaterService
Sanitary Sewer
Rain Drains �.
Catch Basin / Manhole
Storm Drain
Shower Pan /� . •
Other:
Final
PA T FAIL
: CHANIC .'t
Post . t= e m
Rough -In
Gas Line
Smoke Dampers
na
•ART FAIL
EL - ICAL
Service
Rough -'1n
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 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA J /
Approach /Sidewalk Date / r Inspector C. Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL