Permit ;
•� CITY OF TIGARD MECHANICAL PERMIT
I � DEVELOPMENT SERVICES PERMIT #: MEC2003 -00060
I I 13125 SW Hall Blvd., Tigard, OR 97223 "(503) 639 -4171 DATE ISSUED: 2/14/03
PARCEL: 2 S 115 B B -02200
SITE ADDRESS: 16435 SW ROYALTY PKWY
SUBDIVISION: ZONING:
BLOCK: LOT: 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: 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 OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: R
Owner: FEES
DOROTHY CHAMBERS Description Date Amount
16435 ROYALTY PKWY
KING CITY, OR 97224 [MECH] Permit Fee 2/14/03 $72.50
[TAX] 8% StateTax 2/14/03 $5.80
Phone: Total $78.30
Contractor:
BELL HEATING
15550 SE PIAZZA AVE
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 - 656 - 1184 Heating Unt Insp
Final Inspection
Reg #: LIC 447
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 start ays of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rums adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -00
Iss e d By: • . / / ;J' Permittee Signature:
Call 503 • • -4175 by 7:00 P.M. for inspections needed the next busine s day
( Y P
02/14/2003 14:23 5036393771 CITY OF KING CITY PAGE 03
MI -COUNTY •
SERVI CENTER Mechanical Permit Application OFFICE USE ONLY
" e , 4 -, City of King City Date rcceived:pl /i�43 Permit no.: fe ii/,
13125 SW Hall Blvd. Prvject/appl. no.: Expire date:
"
Tigard, OR 97223 —
Clackamas Date issued: By: Receipt no.:
Phone: one (503) 639 -4171, FAX: (503) 684 -7297 file no.: Payment type:
Washington
v U N T I E S Land use approval: Building permit no.:
TYPE OF PERMIT
0 I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition /alteration/replacement 0 Other.
JOB SITE INFORMATION CONIMERCIAL ALUATION SCHEDULE
'
Job address:
d 4 O , : 4' ,'T Indicate equipment quantities in boxes below. Indicate the dollar I
Bldg. no.; Suite no.: value of all mechanical materials. equipment., labor. oveihead.
Fax map /tax lot/account no.: - profit. Value $ •
.,ot: I Block. f Subdivision: See checklist for important application information and
} roject name: 1 al ; ^ Ae.,, jurisdiction's fee schedule for residential permit ee.
/count
�it f
Y y t(i''ot ', 7 ZIP: I & 2 FAMILY DWELL : 'G PERMIT FEE SCHEDULE
)escription and location of work on premises: . gr, , e AND COMMERICAL/INDU RIAL EQUIPMENT SCHEDULE
I
Pee (ea.) Total
•st. date of completion/ins • - lion: a - / 9 -eo , Desert . riots Qty. Res. oily Res o my
'enant improvement or change of use: HVAC:
Is existing space heated or conditioned ?i Yes 0 No Air handling unit CFM
Is existing space insulated? IRYes CI No conditioning (site plan requir;x() `
Air con
Alteration of existing 1WAC system
I IECHANICAL CONTRACTOR Boiler /compressors
usiness name: ,8e . 7.',(-1.e. ^ State boiler permit no.:
HP Tons ._ BTU/H
ddress: / S -pj j'' . pd , z mfr./ -ft. e • Fire/smoke dampers/duct smoke detectors
ttY: C C / _ Stater ZIP: ?,p ." 9 Heat pump (site plan required) .
lone: d i ^// 841 Fax:(B . 2,-.1 E -mail: InstaWreplace furnace/burner TU/H
`g np ; 1 In ductwork/vent liner Yes 0 No / -
Install/replace/relocate heaters - suspended,
ty /metro tic. no.: wall, or floor mounted
ame (please print): �' - -4u Vent for appliance other than furniice
CONTACT PERSON Refrigeration:
Absorption units BTU/H
tine: /4Y/ ,e- f i Chillers - HP • .
idress: `mss^ • 4', , v-41( ,6-"e
Compressors _ HP
Environmental exhaust and ventilation:
•
ty: , C i ,c .. State:(j,.- ZIP: 9 O /s^ A.pl lance vent
one: ejV,r. //B Pax:40V ?f// E -mail: i er exhaust
OWNER Hoods, Type If II/res. kitchen/haariat
hood fire suppression system
rue: Po , -v 4 . e 4 )4 AA. 6 0-, ^_s _ Exhaust fan with single duct (bath fans) I
tiling address: ��( mss, , e� e E xhaust system apart rof m heating or AC I
y: S tate: I ZIP: Fuel piping and distribution (up to 4 outlets) •
Typo: LPG NG __ Oil
lne: I Fax: E -mail: Fuel pipin each additional over 4 outlets -
ENGINEER Process piping (schematic required,) _ .
tee; Number of outlets ,
•
Other listed appliance or equipment:
tress: Decorative fireplace
/: State: ZIP: Insert - ty
• •ne: E - Woodstove /pellet stove ,
Other.
licant's signature: �/ Date: — /g/ �3 pthcr• '
�e (print): i� [-t - +► [^
I jurc dicdons accept Crcd it cards. please call jurisdiction ff. ario
mire inrormnl Permit fee .... $ �/X-+�
MasterCard This permit application Minimum fee $
card number, / / expires if a permit is not obtained Plan review (at %) $ '" /Q " >� /14-°.
Expires within /80 days after it has been a
State surcharge (8%) $ .S-
Name col as shown 04 credit card accepted as complete.
S TOTAL $ Pk
Cardholder si: nature Ampun
4404617 (6r00iC:oM)
11/10/2004
Case Activity Listing 12:21:36PM
TIDEMARK Case #: MEC2003 -00060
COMPUTER SYSTEMS, INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MECA007 Application received 2/14/2003 None DONE DEB 2/14/2003 Plumbing app also faxed over but the
BLD contractor said he was going to do
the work under a minor label and that
King City was going to refund his
money. So no plumbing permit
created.
MECA008 Create Permit 2/14/2003 None DONE DEB 2/14/2003
BLD
MECA725 Heating Unt Insp 2/21/2003 None PASS TLP 2/21/2003
TLP
MECA799 Final Inspection 2/21/2003 None PASS TLP 2/21/2003
TLP
MECA060 (F) Issue permit 2/14/2003 None DONE DEB 2/14/2003
BLD
MECA800 Case Finaled 2/21/2003 None PASS TLP 2/21/2003
TLP
Page 1 of 1 CaseActivity..rpt
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location � �o 3 P/ v uJ Suite _ MEC 3- 004 : 3( - 0 6 / ✓ r�
Contact Person Ph ( ) c� / Z1S PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
n
Smoke Dampers
PART FAIL
E
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: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ' 2 / v Inspector � Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL