Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00284
S jy; DEVELOPMENT SERVICES DATE ISSUED: 5/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 105DD -04100
SITE ADDRESS: 13480 SW SANDRIDGE DR
SUBDIVISION: PACIFIC CREST ZONING: R -7
BLOCK: LOT: 017 JURISDICTION: TIG
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: Install exterior AC unit. AC cannot be placed in the required setbacks.
Owner: FEES
MICHELLE HARROLD Description Date Amount
13480 SW SANDRIDGE DR. [MECH] Permit Fee 5/30/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 5/30/03 $5.80
Phone: 503 - 524 - 9291 Total $78.30
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED INSPECTIONS
Phone: 503 - 848 - 3838 Cooling Unt Insp
Final Inspection
Reg #: LIC 43124
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 -669e!' �
Issued By: qr • L ��, _ Permittee Signature: (Th
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
05/29/2003 14:31 5033569002 GAROKEN PAGE 02
03 21.01 WED 1 FAX 503 598 1960 CITY OF TIGARD 0004
I
Mechanical Permit. Application
M � , Date received :aD -05 Permit no ��p03 — '
,4., -ti .-11 City of T�gardC2 �E�VED Projecl/appl.no.: Expire date:
City ofT1gord Address: 13125 SW Hall l igarl OR 97223 Date � = i Receipt no
Phone: (503) 639 -4171 13 2n03
Fax: (503) 598 -1960 MAY 2 9 Case file no.: 2: meet type:
„mpg Land use approval: CITY OF TIGARD Building permit no.:
• , i 1V1510N =l>.
TYPE OF PERMIT .
•
is I & 2 family dwelling or accessory D Comm.:rcial/industrial ❑ Multi- family 0 Tenant improvement
O New construction - Additic•dalteration / replacement 0 Other: _
JOB SITE INFORMA'T'ION COMMERCIAL VALUATION SCIIIi1ULE
•
lob address: 134 Sew S <r Jrii2 Indicate equipment quantities in boxes below. Indicate the dollar
' Bldg. no.: Suite no value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot; Block: !Subdivision: •See checklist for important application information and •
•
Project name: id • a parimmgy , jurisdiction's fee schedule for residential permit fee. '
City /county:? '• 7a � ,..4 ZIP: q _ I S 2FAMILY DWELLING PERMIT ELI: SCHEDULE
llcscrip:ion and I'd of wprk on premise : AND COMMERICALMDUSIRIM. L•'QUIrM EN7:SCI1EUULE
/�v�r ,Cl� gIL Fee(ea.) Total
Est. date of completion/inspection. t - 0 - 3 Description Qty. Res.only Res. out)
Tenant improvement or change of use: Ii'VAC:
Air handling unit CFM -- ,,
•
Is existing space heated or conditioned? 0 Yet p'No i
Aircooditioning (siteplantequired) i /
Is existing space insulated? 0 Yes o Alteration of existing >'IVAC system.
IIIIMIIIIII Boiler/compressors
State boiler permit no.:
Business name: ( aro en �nPt-g3 HP Tons __BTU/H .
Address: (off S1N ($ oZ rle Ave Fire/smoke dampers/duct smoke detectors _
City: ves+Dr) I State: t (L 12.IP : ' 0D . • cat pump (site ' an require
Phon 6b3 4LI 3 j fax :�e�la - 00R J E -mail: nue i/rep ace urnac •umer BTU /H
_. Including ductworktvent liner 0 Yes 0 No
CCB no.: 1 431 ik InstalVreplace/relocateheaters- suspended,
City /metro lie. no.: ni555 wall, or floor mounted
Name (please print): p Z Vent for appliance other than furnace
Refrlgeradon:
Absorption units BTU/H
Name: ") p art aaY...c.---._ Chillers _ HP _
Address:
Compressors HP �,,,!
�___. Environmental exhaust and ventilation:
I City: State: S :IP: Ap v ent
Phone: Fax: E-mail: ryerexhau
Hoods, Type I/ litres, lotche-Ohazmat
A A hood fire suppression system ---,-- ---,-- ,
Name: iv ` k C� O.h p oY rn Exhaust fan with single duct (bath fans)
Mailing address: aust system apart om eating or
City: Fuel piping and dIstribullon (up to 4 outlets)
y: State: l'IP: _, Type: ,LPG NG Oil ■
Phone: • Fax: E -mail: Fuel ping each additional over 4 outlets - i
Process piping (schematic required)
Name. Number of outlets •
_ Other listed appliance or equipment:
Address: Decorativeftreptace
City: I State: 1 :f.IP: Insert - type . i
� Phonc: _. Fax: I E Woodstovefpellet stove mail; Other:
1 Applicant's signature: I Date; _ _ _ Othert •
Name (print): 1
t Ncs alt it.ristcuona accept credit car please call jurisdiction (m more Inf rmtation Permit fee $
0 visa 0 MasterCard Notice: This permit application minimum fee S .
L_ expires i a permit is not o Plan review (at pia) $ _
Credit card number w ith in ISO days after it has been
e.FIr y State surcharge (8 %) .... $
Nano: of cardholder as shown dU card S accepted as complete. TOTAL S
.■
Cardholder signature -. Atru•anr , 4434417 (6'D0,CQ'.l:
05/30/2003 09:15 5033569002 GAROKEN PAGE 01
ale GAROKEN ENERGY CO. INC.
SlNce 1979
3565 SW 182ND AvE • BCAVERTON. DR 97007 • TEL 15031 848 -383a • FAx (5031 356-9002 • cc's* a3 1 24
5/30
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CITY OF TIGARD 24 -Hour • •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIV)SION• Business Line: (503) 639 -4171 MST
BUP
Received Received / < 3 S Date Date Requested AM PM BUP
Location 7 3 «F() <S d gam Suite _ -OD 2- cr5'
Contact Person Ph (5 J 2 e/- 92_9 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 e L G 6 4 ? / )-z- s O Z.7 47 L /1 e.2,,
Insulation /%' �� sT
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
Rough -In
Gas Line
Smoke Dampers
final —
S ART FAIL
E ICAL
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