Permit CITY TIGARD MECHANICAL PERMIT
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I � DEVELOPMENT SERVICES PERMIT #: MEC2003-00208
r�I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/23/03
PARCEL: 2S102BC -01100
SITE ADDRESS: 10140 SW WALNUT ST
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R -4.5
BLOCK: LOT: 028 JURISDICTION: TIG
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace.
Owner: FEES
MUMM, RICHARD C Description Date Amount
PO BOX J
ENTERPRISE, OR 97828 [MECH] Permit Fee 4/23/03 $72.50
[TAX] 8% StateTax 4/23/03 $5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 66578
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.
Issued By: k a44 Permittee Signature: pi ( r (-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr 23 03 07:19a Specialty Heating 503 598 0718 p.2
•
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4
A l it, Mechanical Permit V E Application
. ED b 0 3 . ived aob3 -oa2DB .
' I. '!! City of Tigar H C E G Pelmitn �'
Pcoject/appl.no.: Expire date;
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
n Date issued Bye I Receipt no.:
Phone: (503) 639 -4171 Apg 23 2z23
; 23
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
IgU9 DING ° /S1l0 O QsITY OF TIGP+F " g permit no.:
_
_
TYPE OF PERMIT j
A 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant impro' einenc
0 Now construction 'Additiou/alteration/replacement 0 Others
3011 SITE INFORMATION COMMERCIAL VALUATION SCHE I ULE
Job address: id 1 Su) , GJr- Indicate equipment quantities in boxes below. Indic; to the dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: • profit. Value $ .
Lot: Block: I Subdivision: 'See checklist for important application infnrmatinn and
Project name: • ale m jurisdiction's fee schedule for residential permit fee.
- - -- City /coun • ---r• . 3 • 1 S: 2 FAMILY 'DWELLING PERMIT TI] S . I1EDULE ----
•ption and location of work on premises: .../ C AND COiMMERIC. EQVI1'h1EN SCHEDULE mn
/ Q //[� Zt Fee (..) Total
date of�eo lfu�lt inspection: �l fa5�p3 Description Qty. Res only Res.only
Tenant improvement or change of use: H'VAC:
Is existing space heated or conditioned ?Yes 0 No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 11Ycs 0 o Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler/compressors
Business name: ei nt.ir ,ormy 462 , # G State boiler permit no.:
HP Tons BTU/H
Address: Q/ SE ?Ifs' Reg.', '
Fire/smoke dampers/duct smoke detectors
City:/ i. • Stater ZIP: 9 1.34 .,9 Heat •ump (site plan required)
Phone: - 0 - . _ 4 o 7 Fax: � p $7 /57Q3 B-mail: • lace • a • • utner . e• : f
CCB no.; 57� Including ductwork/vent liner XI Yes 1] No 1 • �astsil rcplaccholocateheatere - cuspesded,
City/metro lic. no.:/69G wall, or floor mounted
Name (please print): Of#97 , A fifi{ is Vent appliance than furnace
CONTACT PERSON Re BTU/H -
Name: K KQ. !y . ,& " //Y/y -P/ Cbillers HP
Address: •- $E Jo ped< • {. e vMD • Compressors HP
City : /l5�/it I State j ZIP 07/3-3 Ap� vent l exhaust and reot:htino:
Phone: 4/Q- 3607 Fax:($7 =0'7q. E -mail: ... Appliance
Hoods, Type U Wres. kitchen/harinat
Name hued fuse suppressiun system
e g g� • Exhaust fan with single duct (bath fans)
• Mailing address: r c f X Sr-• • Exhaust system • • art from heath: or AC -
Q 7y �3 - pi` , : , ; ,1 , . ,, on up to 4 outlets= •
Ci
tY• l• y el stat - ZIP: T ype: • LPG NG Oil
Phone: (; $ov Fax: E-mail: 1lrel PIP n8 r cacti additional over 4 outlets
piping ematicrequired) —.
Names : ' , ' Nuniber of outlets
Other listed appliance or equipment: •
Address: Decorative fireplace •
City= • • - • I State: • I ZIP: • J _t .. - .
Phone: • • •• •:• , •• • F : .. • . .. _ • wooasmve/pelletstove • .
Applicant's signature: ,radio,/ Date: 5/��-�44 oche,:
Name (print): , ,9 .
'Nor ell Ant:tiadoos roxpt credit card& please cd &
► puts don for more lnfanma
ie Permit fee $ _ 7.,2 , stJ
CI Visa O MasterCard Notice: This permit application Minimum fee $ _
1.1. / expires if a permit is not obtained Plan review fa _ %) $
Expires within 180 days after it has been State surcharge (8%) .... $ _ _$.
Name of cardholder us Amen on credit cord accepted as complete.
$ TOTAL $ '1K .30
■
Cardholder signature war a v 4617 (aaoncora)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
� BUP
Received 193/4 Z (
S Date Requested tie- AM PM BUP
Location /t) / 7 t , f/ "laded' Suite MEC 3 — 002
Contact Person ' Ph ( ) %eve 3667 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
•
ELR
Crawl Drain
Slab Inspection Notes: 11 SIT
Post & Beam \ c e c/". L C
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
( LMEMNICl.
Post & Beam
Rough -In
Gas Line
S is e Dampers
• PART FAIL
CTRICAL
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line � /� /b' cl
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL