Permit CITY OF TIGARD
MECHANICAL PERMIT
f DEVELOPMENT SERVICES PERMIT #: MEC2001 -00317
.,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/10/01
PARCEL: 2S 103DA -00800
SITE ADDRESS: 13175 SW WATKINS AVE
SUBDIVISION: DERRY DELL ZONING: R -3.5
BLOCK: LOT: 008 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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Furnace installation.
Owner: FEES
BRADEN, ROBERT W + KATHLEEN J Type By Date Amount Receipt
13175 SW WATKINS PRMT CTR 9/10/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 9/10/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 234 -7331 Heating Unt Insp
Reg #: LIC 1441 Final Inspection
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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling
(11117[1.R- Q1R
Issue By: Permittee Signature: ern 042 1 g
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Sep -06 -01 03:43P P -01
i s r-..-
....., .. M echanical Permit Ap 0 d 1 • : tion
Datereceived:9 /Q O) Permit no.: a g_a' iv- 663../
„, °'4�l!, City of Tigard Prnjcct/appl.no.* Expire
City Address: 1312 SW I loll Blvd, Tigard, - 7 223
Phone: (503) 639 -4171 Date issued: By .66 j ! Receipt no
Fax: (503) 598 -1900 Case file no. Payment lypt'
Land use approval: Building permit no.;
•
TYPE OF PERMIT • -
& 2 family dwelling or accessory ❑ Commercial /industrial V N
0 Multi-family ❑'Tenant improvement
New construction 0 Addition /altertdlion /replaeenlent ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address. , .. a e
�� 0-15 Indicrte equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suits nu.: 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 information and
Project name: rCA - 1/1 -jurisdiction's fee schedule for residential permit fee.
City/county: 1 gp, ` A ZIP: - iaa3 I& 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Des - tion and lo tion of work on premises: AND ['OAIRiI ?lit(', \L11NUl1S'I'Itl; \[. l :Qllll'�iL'NTSCIIE[)U .F
f /1 Q C Fee (ea.) Total
act_ date of complction/inspeclion: Description _ Qty. lles.only Res. only
Tenant improvement or change. of use: IIVAC:
Is existing space heated or conditioned? O Yes U No A c o n di t io unit CUM
is existing space insulated? U Ycs U No
Air nitioning(siteplanrequired)
Alteration of czivtiny H V AC system
MECHANICAL CONTRA(-I.OR Boiler /compressors
State holler permit no.:
Business name: I g � 2 ‘ m.. __ I IP Tons _ BTU/11
Address: �L �� v� �,t►6 lire) sm tike dampers/ducl smoke detectors
E^ ��L7 ZIP: _ To . Heat pump (site plan required)
Phone 1§11:71M Fax: �� �z�.Z; Install/replace furnace/burner ____BTU /I l 1
Including ductwork /vent liner ❑ Yes ❑ No 1
CCB no.: I t. InstalUreplace/relocatchcatcrs - suspended.
City /metro lie. no.: - 1 r wal 1 or floor mounted
Name (please print)' A , • , ti ' c C% r WI. Vent for a. pliance other than furnace
CONTACT PERSON ' e :etallun:
Absorption units W1'UIH
Name: S .0" IM C Q r La . C Chillers LIP .
Address: Conyressors __ _ _. ., _ , _____ LIP
State: ZIP: nvlronmental exhaust and ventilation:
City: I Appliance vent
—
Phone: Fax: E -mail: Urycrcxhaust J ^
OWN 1,11/ Floods, Type 1/ lures. kitchcn/hazniat
1 • , hood fire suppression system
__ I_' L� s Exhaust fan with single duet (bath fans) -
Mailing address: ir1�l giIe..nalate Milli Exhaust system apart from heating or AC
• T' � — ' ire piping an • rstr . at on up to uu etv)
.� t���JC��.i7 ZIP: �' Type' LPG NCi _ Oil
�a F'ax E � '
� _ , � r� Niel piping each additional over 4 outlets
• ENGINEER Process piping (schematic required)
Name:
Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: , State: ZIP: Insert - type
Woodstovc/peltet Ylnve
_ -. _....
Phone l - Fax: I^ril ®)
AppIics� `" `� IItfiI-�L,‘1 Other
t cr
. 1 1 •. •ma ` x1.. I f,��J� .7 II .�.,..,,-.,. - � • �J `�,
/Not an f arl6dictieps accept credit cards, please Lail junsdteuun fox muse uduinlAUgl Permit lee $w • v
4 vsa ❑ M,istzrCal l Notice: This permit application Minimum fee $
c■u nu
lit card mber: 3 �' 5 2 - 19'• 7 1D 0 3 expires if a permit is n 1 ot obtained , Ian review (at c,
_ / %) $
t l7' mhro Sle� Exp,,e, withi 180 days atter it has bee State !l
surcharge %
. Nal of alder as shown Ott credit card accepted as complete. 8 ( )
x11111..11 {;?�' $ 7 830 TOTAL ._ $
•
Cunlhnls er signature AnlOWtl , - 17 tN00/C0
o
„ c.6, CITY OF TIGARD BUll DING INSPECTION DIVISION
MST - -
24 -Hour Inspection Line: 63. i75 Business Line: 639-4
BUP
Date Requested 9 AM )( PM BLD
Location / C 61 1.th41;4 S Suite MEC ab
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Crawl Drain Cr
Slab I Drain Inspection Notes: ,J,4ce
Post & Beam SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:. _
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab •
Top Out' -
Water Service
Sanitary
Rain Drains
Final
PASS PART FAIL
ts= C_Att
m
Rough In
Gas Line
Smoke Dampers
a r _ r kU ) PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab ,
Low Voltage
Fire Alarm _..
Final
PASS _ PART FAIL,
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Dat � �
Other Inspector Ext
Final
PASS PART FAIL - DO NOT REMOVE this inspection record from the job-site.