Permit C ITY O TIGARD MECHANICAL PERMIT
4214 VeI� DEVELOPMENT SERVICES PERMIT #: MEC2003 -00299
�' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/6/03
PARCEL: 2S110CC -01700
SITE ADDRESS: 16170 SW ROYALTY PKWY
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 026 JURISDICTION: KIN
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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:
ELE 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:
FURN > =100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of exterior AC.
'Owner: FEES
JEANE CHASE Description Date Amount
16170 SW ROYALTY PKWY [MECH] Permit Fee 6/6/03 $72.50
KING CITY, OR 97224 [TAX] 8% StateTax 6/6/03 $5.80
Phone: 503 670 - 8212 Total $78.30
Contractor:
OREGON HEATING +A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Phone: Cooling Unt Insp
hone: 538 - 2953
Final Inspection
Reg #: LIC 125815
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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 -00
Issued By: �� Permittee Signature:, 1/:_Ei
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
06/05/2003 13:31 5036393771 CITY OF KING CITY PAGE 02
TRI.COUNTY A?FC a ?cro 3 - .,� •
SERVICI Mechanical Permit Application OhFICE USE ONLY
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Data received: Permit no.:
�; ;. C of King City
�J� 13125 SW Hall Blvd. Projectlappl. no.: Expire date
Clackamas Tigard QR 97223 Date issued. V By: I Rewipt no.:
Multnomah Phone: (503) 639 -4171, FAX: (503) 684 -729 Case file no.: Payment
Washington
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Y type:
nr • r ( s Land use approval: Building permit no.:
TYPE OF PERMIT I
'A 1 & 2 family dwelling or accessory 0 Commercial/ industrial • O Multi - family 0 Tenant improvement
• New construction 0 Addition/alteration/replacement O Other. _
JOB SITE I TORMATION COMMERCIAL, VALUATION SCI{EDL'LE
lob address: 16110 S . 0i fq l p Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: l Suite no. : value of all mechanical materials,
egt»prttenC labor, overhead,
Tax map/tax lot/account no.: profit. Value $ _ •
Lot: 'Block: [ Subdivision: *See checklist for important application information and
Project name: 4 'urfsdicrion fee schedule for residential permit fee.
City /county: kiAq Criu ZIP: ft izr 1 & 2 FAMILY UWELRU [NG PERMIT FEE SCHEDULE
Description and l ocado of work on premises: AND COMIMERICAL/L\DL NTRlAL EQUIPMENT SCHEDULE
t i rtt t..0 Q.t. Fee (en.) Total
Est. date of completion/ nspecnon: D st ipton ' Qty. Res. oaly Res. only,
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Au handling watt CFM
Is existin Air conditioning (site plan re2u)red) J
g space insulated insulated? Q Yes O No Alteration of existing HVAC system
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MECHANICAL CONTRACTOR Borleslcompressots
Business name: . State boiler permit no,:
Adduces: l � S AG (I I�i HP Tons T 8111/H
City: State it smoke dampers/duct smoke detectors
OL rK ZIP: 4'1 115 Heat pump (site plan required)
Phone: 538. F a x: ..2� E -mail: Ins ta p ace furnace/burner BTU/1i
CCB no Z,s a�s Including ductwodr/veut liner CI Yes 0 No
Ittstall/replace/telocate heaters - suspended.
City /metro lie. no.: 4'?ZI wall. or floor mounted
Name (please print): , . L0 - Vertu or appliance other than furnace
CONTACT PERSON Refrigeration:
Absorptioo .units RTWH
Name: Chillers
HP
Address: Compressors Hp
Envtronegeatal exhaust and ve_at'tladoa:
City: State: ZIP: A u. Diane vent
Phone: Fax: E - mail: Dryer exhaust
OWNER Hoods. Type fTiutes. kitchen/haanat •
J �IL�, 4S�i hood fire suppression system T ._ _
Name: Exhaust fan with single duct (bath fans)
Mailing address: 164/0 Sit✓ j - Exhaust system apart from heating or AC
City: r S te ZIP: _fi r___A-; Fuel piping and distribution (gai 4 outlets)
. T i . e • LPO NG Oil
Phone: A r • it Lr Fax: E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
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4ddres5: Other listed appliance or equipment:
Decorative corative fueplace
icy State: [ZIP: Insert — type
'hone: ' woodstove
.tea.:. : E-mail: /pellet stove _
plieant's signatrrr WA r � ��� Date: C. 0 • Other:
Jame (print): A . 1.", - , il. O 0 ■
of all jufirdiclloo• accept credis cards, Please call juritdielloa Par more infornmian Permit fee $ i e a 00
visa 0 MasterCard N o n ce: 7 7rit permit gppticadon Minimum fee $ 7R. SO
will lard number; / / expires ifa permit Is not obtained
Plant review (at _ %) $
t?npira roithtte 180 days after i! hat been
State Name of cardholder as ahe.•q on credit card s accepted at compile. TOT charge (896) $ S i AL $ 87.30
Cardholder signalurc 0.0000111 . .
4404617 r6AOICOM)
SITE -POI-N1 , RA -G ��� r
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 - 3 AM PM BUP
Location /60/70 P104d Suite MEC 3 .� �� L
Contact Person a44.1 Ph ( ) sJ 8 - ,?-933 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4. ' ' - ELC
Footing ELC
Foundation
Access:
Ftg Drain ELR
Crawl D rain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof /Alt
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 FAI
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Damp rs
S S T FAIL
ELECT AL
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 Inspector . Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL