Permit ;: la
C ITY OF TIGARD MECHANICAL PERMIT
rg1n DEVELOPMENT SERVICES PERMIT #: MEC2005 -00279
...44-711 ! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/26/2005
PARCEL: 1 S125DD -04500
SITE ADDRESS: 09795 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 053 JURISDICTION: TIG
Project Description: Installation of A/C unit.
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KEEVER, MOJDEH B Description Date Amount
9795 SW VENTURA CT
TIGARD, OR 97223 [MECH] Permit Fee 5/26/200E. $72.50
[TAX] 8% State Surcha 5/26/200: $5.80
Total $78.30
Phone:
Contractor:
CARSON OIL COMPANY INC
3125 NW 35TH
PO BOX 10948 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97296 -0948
Phone: 503- 224 -8516
Reg #: LIC 8388
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 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: _5=„
p,
Call 503- 639 -4175 by 7:00 a.m. for inspections that business .
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 24 05 05: 44p CARSON OIL CO 503 2 2 4 2 4 5 6 p . 1
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MechanicalPermit APplication
's • Datereceived: ""--; 6 - 65 - Pennit no.44,203,3 / 4 • ' " 7 q
,
,....14.' LI City of Tigard Projecriappl. no.: 7 ' . ; Expire date:
Address: 13125 SW Hall B 4%, ,, 72
Cit Phone: (503) 639-41741 OR 923
y ofTigard Date issued: ' By: Receipt no.:
0 r 1 .%
Fax: (503) 598-1960 TA Case file no.: Paymenttype:
t C> C1%.S) (P
. _
Land use approval: * •\ \ A \S\ Building permit no.: ..r (r .
. .
TYPE OF PLR NI IT
9 .,,.
1 & 2 family dwelling or accessory 0 COnimercialrmduatrial ' Cl Multi-family • CI Tenant improvement
Cl New construction 0 Addition/alteration/replacement Cl Other
.',.
JOB SITE INFORM \TION COMMERCIAL N' %LI VTION SCHEDULE
.-,
Job address: 9'19,5 5 / /, t u77 7 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: I Block: I Subdivision: *See checklist for important application information and
....z.....: Project name: 4 H A .0 jurisdiction's fee schedule for residential permit fee. -
-7=-• City/county: - 0 - z;.,/, • _ ZIP: " g-,3_3 I & 2 FA)111 ) DI1 MTV.. mow FEE SCHEDULE
Description and lw..adon of work on premises: 4 ft .40 if 0 1ND CO.N1NIERIC1L/INDI STRI VI. COL IPlIENTSCIIEDUI I'
. 11.
.„..! .,:trr& :-.5---.4e.,,e 1(es) Total
H.
Description Qty. Res.only Res.only
. .. 6 ' Est. date of completion/inspection:
Tenant improvement or change of use: . liIVAC:
Air handling unit CFM
Is existing space heated or . , ditionedAiYes 0 No Air conditioning (site . Ian required) .
1 • • insulated? h as 0 No '
s =sting space
.- one existing ' system
..
( ONTR kfl OR Bo' er compressors
. • State boiler permit no.:
. _itifsiness name: 4.5 (9/ e•-• 10 , , HP Tons BTU/II
1 3 .2...3 A/ LAI _..?...-- 08- i • C 1 4
----: . _
- -- r..atr...P. • ...,- icy /-, I State: ell ZEP: q 7, eat paia. sae . an req - -
V.: ffrri IT .. . ace/burner : I •
• .f' ;Phone:, - ,,,, tiFf ax: - mail: -- •,•• - Including ductwork/vent liner Cl Yes 0 No
'-... IfgCB no.: . .. Rg. I Ins •.1ritp rf
!-- ,
City/meno lic. no.: ... 5 -- . • . wall. or Boor mounted
ri.• Winne (please pint): ''''' i -- ; .-- c , 4_=fi . _ i eat or u. Farlee 0 . crib= . .
..--
- , r.rTI
( ()NT 1( I PERSON
Absorpdonunits BTUfli
'•':', I , 3..,e0 ii: 77 77 / • &lee a• Ciiillers HP •
c`o.:.—. • HP
Address •• _
k•.: Orr. - '• State: ZIP:. - ' • ' Appliance
,11111111111111.1 Fax - , - E-mail: • ,'', -.... -- -. , I ) -1,==211111/1111111111.
1
.. . ;. ......: ..., ,. .....
hood fin suppressionsystem
. . . .
' ": ' -:- 1 le/ ' 9 • --•: :- State k
LPG NO • Oil
L 3, c , :fi -... . ..7 :. or • : Fax: - . - . : , E :.• • . • ' • . ; ... - 1 - e .1 .mg - • , .r. . , , over . . eta
• •,:i „L
Milling addreSSI ... d. 1 ;\ G 1:1 1:12. - 'a' '1.A. AIM :41 : _ 4 ., r.: (se . emati a : 7
:::: 11r4. A41 IP • . AI A di '4' : r i . ,....:. ''' '... N E:di umber :usi- o fa' n fo s :ets ' sinl rrIglei...'71duct:ad2uP Wfans). ets)
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t •. - ; , 'T' I il. aInef.....-: ,.. ,... ..... - . - , .- ,
11777. *pp', — or
'Ail:StreS . ' ‘: Decorative -lace . .
•••••-! .,, 1 Wit T.: . - • . -, State: ZIP:
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}2.11/4 E-mail: _ . . . • WiTtrImm. I stove
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....,. dNpOlicant's signature: Wf Ae jl irjpllIllIll - Date:
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Name (FILO '''Araiaerit.4M-li.:W -
- • 7- :.- ' '•
Permit fee ' $ ...,
,. ,ep . A m i s s et i aus occep i ask clads. call ll jerks/Scrim fa r m� m irionasioa.' Notice: This permit application Mi n i mum fee f
J, -;....., li , $
- sst2;_p o gi--. 2 8 .9 7 of , t ,(.., expires if a permit is not obtained Plan review (at i %) $
- .
Jr#, _ xires (.)
within 180 days after it has been State surcharge (8%) .... $ ,g
7iiii Ep
,.... accepted as complete.
TOTAL . $
.1'.: - --- -: -- : . _ -rrITT-INI■ Amotmt
--, 1404617 (61:0/COM)
, ft.! .
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- 7' , ; 4. 5,'.•
May 25 2005 1:50PM Carson Oil 5032278521 p.2
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00279
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' " � . ..
INSPECTION WORKSHEET FOR DATE: 6/8/2005 TIME: 7:12AM PAGE: 61
SITE ADDRESS: 09795 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.: LOT #: 053 TYPE OF USE:
PROJECT NAME: KEEVER _
DESCRIPTION: Installation of NC unit.
OWNER: KEEVER, MOJDEH B, PHONE #:
CONTRACTOR: CARSON OIL COMPANY INC PHONE #: 503.224 -8516
Inspection Request Scheduled For: Date: 6/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
•
699 Mechanical final 008717 -01 503224 -8500 N
Corrections /Comments /Instructions:
4. t <l c i/.%2 / � , "1<0,_ hi,. 164'67
. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,, Date: 6 — i d S Phone #: (503) 718-