Permit ~ CITY OF TIGARD MECHANICAL PERMIT
4 rAc' DEVELOPMENT SERVICES PERMIT #: MEC2002 -00576
� ` j 11 � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: PAARR CELL : 2 2S S110C 110CC -09100
SITE ADDRESS: 15615 SW QUEEN VICTORIA PL
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 004 JURISDICTION: KIN
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: 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: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS: 2
> 10000 cfm:
Remarks: Install gas furnace and water heater, 2 outlets.
Owner: FEES
ZANE MULHAUSEN Description Date Amount
15615 SW QUEEN VICTORIA PL
KING CITY, OR 97224 [MECH] Permit Fee 12/16/02 $72.50
[TAX] 8% StateTax 12/16/02 $5.80
Phone: 503 626 - 2939 Total $78.30
Contractor:
HEAT RELIEF CO
1704 NE HIGHLAND
PORTLAND, OR 97211 REQUIRED INSPECTIONS
Phone: 503 - 260 - 0077 Gas Line Insp
Heating Unt Insp
Reg #: LIC 0122424 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
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
. 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -669•,
Issued By: -_ - LGc - - _ Permittee Signature: 77 /� ��
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busi es ay
12/11/2002 11:28 5036393771 CITY OF KING CITY PAGE 02/02
. '4111$1k Date received a - It 4-oZ lv
;;r Cityof Tigard RECEIVED <
Rwite dear: .
alY cinEard Address: 13125 SW Halt Blvd, Tigard, OR 97223 Date i BSr : Receipt no:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 DEC 11 2002 tar fin: type
Land use approval: rITV PE TIOARD . Building permit no.:
- -
1 \ 1'1 (II 1'1 . I011 1
18t 2 fannly dwelling or accceamy p Commucialfindustrial 0 Multi- family O Tenant improvement
New construction 0 Ad alt lion f epiacemont 0 Other:
I U ) l ) ' , I I I (NI () 1 2 • ■1 1 1 1 ()\ ( O M I \ 1 1 I 2 ( I U. \I.1 \ 11O\ Y 111 1)1 I.I
Job t> / s / S Spo G1Kafo4 i. i C,ritiff?]. P I • Indicate equipment lea inboxes below. Itbcate the dollar
Bldg. no.: 1 Sultan.: value of all mecbrnical mate riab, egtdpmaaat, labor, overhead,
Tax =Sax lota000nnt no profit. Value $ ' -
Lot: IBIS I Snbdivi�lon: *Son checklist for important s licatien information and
Project tome: jurisdiction's floe schedule for residential permit fe.
Q7 .1A. 1 .,,. .'.I 1 \III.1 1) \1I I (, 1'110111 I1 i:.ti( III MI 1.i
Description and , I r s q g f • . • an p r e m i s e s : 1 ol .,54 5 c f i \ . \ 1 ) ( ( ) 1 I \ l i I : 1 ( \ i ! i \ l ) l I I I ( I \ I 1 () I f i' \ I I : \ I ( 111 I i .
' . EBt: date of .. ;le1io - 7 7 on: Drai do _, Qty. Res. tidy ,Res.
Ten ant improvement or change of use Air handling unit aid
is existing space heated or conditioned? 0 Yes 0 No s;ba r
Is existing space inealated7 0 Yes Q No 4 , :,,, , . r,,.,. I system
1 1 1 , ( I I \ \ I ( . 1 1 . ( ()\Il2 S( I Oi' Hocompremars
State boiler
i r permit no::
Business fl - name: � x - } e ;e-k-- HP Tons ____ BTU/11
Address: IA /I N e 11145 .Au.e • i;ikis duet smoke dsteetots
City. Pat4tr, (4 I State: OKI ZfP: cr 7 1caa ,, . 77,, ,
Photo .)4o -od7 Fax: - • E -mail: C."71 1 -^ I' MUM
CCB,na.: 012 MIIIIIIIIMIEMMIIIIIMIIM " - • drhaat tin" 411(Y°813 N° 1 • i di]
17711 , ., . ,- :, - . -. suspended,
City /metro lie. no.: S G walker Boor maotmtad
Naive (please •, • t) vent ibr :.; 01.: , , - ether than Anna= .
( 1► : I \( I' 11 l t O Absorption units _ i31V/H
Name: a ) • Frt.. Gat o mere — HP
Address: i3 / 1 No 6 ' • " ' ' ` " III
Cr i - , =MI zu►: g77.-zo . vet
Phone:503r:2140 -GM Fax -a401- 2/ &mall:
t)11 \.1 It Hoods, , I i7,::, . .. ..
bond fire sappsystem am system
Name: - 2.c4, � i h444Se _ P fan with �e duet ( atb ads
Mailing addr+esa:1 / s ,p"
_ , ` G . - g e r - r & 9/ - Reboot : • • ' ° ° r
a : • _ f 0 ' ZIP: - ov to 4 enacts)
Phone: ' • /AI Fax: B•tnail: , 1^7-, �4 stet
1. \(.I - •,I 1 I (•.....,,.•., PRO Ted) -
Name Number ofoofiats
Mier WtamelIomaaraIPIl1U
Address: Doty fireplace
City: _ I state: I ZIP: Insect -
1E-mail: •, pact ]'lama: Paul: •. -
OtbGr
Applicant's signature: i <, , . . ' Date: /� - 7" . -
Name (print): I'hAfk _ , grgxnrl5c a ,
"Mot ao WOVE and ants. phase ads iormga Permit fee -_ -- $
ov►fo DMortacma Notlot) Ibis p app an Minimum fee...............- S 7 . -5v
csdh card a J / X lh if ■ pt:mtit is not obaednod non i>:,vtefv (at .S5) S
• ,ph;,a widdn 180 tips of er it Bea been
`tom olau er es Mown ® edit ®d accepted as oomple�. State slut aqe (89b) .... $ K - R
s TOi'P/i,L .............. -...- S 7A -30
!--V -- t dmhmo na++na (6610/COM)V
•
CITY OF TIGARD • 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received / Date Requested r / /� AM PM BUP
Location /DDS 9.1) �tc a&r+ ��� e �- Suite MEC cq
Contact Person AA' Ph (93 ) �rrPd 0477 PLM
Contractor 1 j �R / ^# Ph ( ) SWR
BUILDING Tenant/Owner _ � [.r -at- cce-A. ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear OAS ',�i L i ri 4 F 'i 7 S� = Z7.5" r ' 5 F d / $ �
Framing _
Insulation
Drywall Nailing ' r--7-71-0 47 ,S_s_
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS 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 FAIL
A L
Post & Beam
Rough -In
.Y
Smo e Dampers
Final
PASS PART FAIL
ELECTRICAL
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 El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA /� D �_ Ext
Approach/Sidewalk Date f Inspector
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested t2 — 0 AM PM BUP
Location ls6 /s" QuP�M MEC S 7 (P
Contact Person rn (A 4_- Ph ( ) 0/6 4 -O D 7 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: �J� SIT
Post & Beam �D
Sr Anchors
Ext
Ext Sheath/Shear �� � Y�ti .edi 14
Int Sheath/Shear /"��
Framing �*� ��1�[�L. / .rc� D,� l/i46E4.- 376) 7V
Drywall ywal A _
Dywall Nailing �'T�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS 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 FAIL
Post & seam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
ELECTRICAL
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 reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA _ _�
Approach/Sidewalk Date y �_ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business tine: (503) 639 -4171 MST
/ BUP
Received Date Requested / a J 23 AM PM BUP
Location /54 (5 a --YL L'--v+ -1,c- Suite pi-- MEC a - 0,0S 703.
Contact Person lJ Ph ( ) 62&C) ' 00 7 - 7 PLM 42 d 4 195"
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: /,
Ftg Drain 6V m O O ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ffia PAA /'r // /• /p �l
Int Sheath/Shear
Framing
Insulation
Drywall Nailing / ii , /Pi �_
Firewall . 411I Fire Sprinkler
Fire Alarm 1, / If , ■
Susp'd Ceiling r -
Roof
Other:
Final ./% ■4010 I_
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PASS FAIL
MECH • CAL
Post & Beam Gas Line e110-
Gas Line
Smoke Dampers
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE D Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA l
Approach/Sidewalk Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL