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12355 SW ALBERT A AVENUE
CITY OF TIGARD
IGARd —_ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00374
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/3/03
PARCEL: 2S 103BC-02500
SITE ADDRESS: 12355 SW ALBERTA AVE
SUBDIVISION: CANOGA PARK ZONING: R-4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: OTR F1 OOR 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: I 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: CLO DRYERS:
FURN < 100K BTU: _AIR HANDLING UNITS
FURN >=100K BTU: — <= 10000 c`m: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Remarks: 1 ,i."II \" iw
Owner: _-- _ _ FEES---- -- .._-.
FFNNELL, DELBERT S Description Date -- Amount
12355 SW ALBERTA ST
TIGARD, OR 972;_'3 INIL('II1 11crmit Fee 7/3/03 $72.50
8 ;;tate'Fax 7/3/03 $5.80
Phone: _ Total $78.30
Contractor:
COLUMBIA HEATING 4- COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503-624-2704 Cooling Un( "nsp
Final Inspection
Reg#: LIC 76359
This permit is issued subject to the regulations cy)ntained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All worts will be done in accordpnce with approved plans. This permit will expire if work is
not started within 180 days of issuance or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-6'-
Issued By: Permittee Signature:��"% �-
Call (503) 639-4175 by 7:00 P.M. fer inspection., needed the next business day
Mechanic,A Permit Application
t T-�� -- --- Datero:eived Permit no.:/)tE '
City of i I �--IM,
�,�rPruJecVoppl.no.: Expirt date:
City of Tigard AddreSS: 13125 ST%11Q TiZ'Jlt 97223 —�_
Phone: (503) 639-4171 n hate issued: Bye: l� Receipt no
Fax: (503) 598-1960 JILI�_ 11, 20,0: Case file no Payment type.
Lana use approval;, U KU Building perrnu no
❑ 1 & 2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement
O New amstru;tk,rM Addition/al!eratiort/replacement U OUur: ____
ZEi 1101MI110RUL
Job address: r �A) Indicate equipment quantities in boxes below. Indicate the dollar
BIS. no.: Suite no,: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax IoVaccount no.: profit. Value$
Lor Block: Subdivision: •See checklist for important upplication information and
Project name jurisdiction's fee sched lie for residential permit fee.
City/county: _ ZIP: j
Description and local on of v ork on premises:_
LO-tZ. Eee(ea.) Twa.
Est.date of completion/inspeztirn: Desert on
_ _ "y. Res.only Res.only
Tenant improvement or change of use:
_
Is existing space heated or conditioned?❑Yes ❑1JAir handling unit CFM
o cloning(site plan required)
—T
Is existing space insulated?U Yes Ll No it conteras on of existing HVAC system -
of er compressors ---
Business name:(f&/ /_ State boiler permit no.:
''"`��'� �lsN--F �J��1d�-� G HP _Tons_ 9TU/H
Address: p-�d-PX_AL>Z 0 J 1'- it smo a amper uctsmokeaelectors
City: " _ Stale ZIP:97/a�1 eat camp(site p an re ogre 1 — -
Phone: q- _7t4 I hx _ Email. nsta rep ace urnac urner T T V
CCB no.: Including ductwork/vent liner LJ Yes U No
—',7(►--3�-4 st
na rep as.c ocatateheates-suspenc d, --
City/metro tic. no , 4-0-0404o
wall,or flour mounted
Name(please pro n''fr' Lens or a���anee of ler t ian urnace
e gerat�on:Absorption units BTUiH
Name. /� Chillers----- HP
� 0- -��0tw— CA - Com ressors HP
Address:
- n ronmenta exhaust an rent at on:
City: State: Z[P: Appliance vent
Phone:
Fax: i; n ail, --_-- . r, rex aus-ei t -
Hoods,Type U 111res. tc a azmat
hood fire suppression system
fJwnr: Exhaust fan with single duct(bath fans)
Mailing address: J c � x aui u5t s atom a anrom cane or A
City: L Sta!e:0/i ZIP: G` Fuelp p ng andistributiononup to out rets-)
Phone;' 1'a I YPe LI'(l NG —_ Oil
E-mail: u�`e"]pipingea aaWliona over 4 outlets
races p p ng(schematic require i — _Number of outlets _
Name -_-
----- ----- - --- ---- ---
Other �e app aoce or equ pment:
Address: Decorative fireplace
Sta
City_ T _-- rr ZIP: Tscrt-t a _
Phone: Fax: E, magi: Nk"oo tovelpe let stove
Other, — --
Applicant's signature.: Gi�(� Date: t er, -
Name (print): s�—�-— -
NM III Juridirunru accept credit cards,pleur call Jurladletw fa niam mfamati , Permit fee.....................$
Cl Yua U MasterCard Notice:This permit application Minimum fee...... .........$
Cmdit cars r.mnraexpires if a permit is not obtained -- —�"a
--_----� ---" �,p;' within 180 days after it has been Plan review(at — %) $ r
can�iTder u own oa c i c — accepted as complete .state surcharge(g%) $ _� 7d
0
—— $ TOTAL ...................... $
—CS' older rlsoarure — Amount 4404617(6MIMM,
HEATING & COOLING, INC.
8900 S.W. BURNH.AM ROAD, SUITE P, !()
TIGARD, OR 97223
(503) 624-2704
FAX (503) 598-0270
7 .
I
� r
..)013 ADDRESS:
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
. / SUP --
Received _-._---_—__Date Request d 3 - AM PM----- BUP
Location AA.L—!Suite__ —_ ME Q o
Contaf t Person _ — C4 Ph c1( ____ _) _�2 'a d PLM _Contractor___- - —_____--._ __ Ph (`___) ___v______--.__ SWR
BUILDING Tenant/Owner _ _ ELC
Footing ELC
Foundation Access:
Ftg Drain V/ ELR ----
Crawl Drain
Slab Inspection Notes: U SIT ---- - -_-
Post& Beam
Shear Anchors -_-
Ext Sheath/Shear
Int Sheath/Shear
Framing ------ ....---__ -
Insulation
Drywall Nailing -- — -- -- ---
Firewall
Fire Sprinkler - ------ - -
Fire Alarm
Susp'dCeiling - --------- - - - -- -
Roof
Other:
Final -
PASS PART FAIL -
PLUMBING__ ------
Post&13oam - --- --- --
Under Slab -- --- - - -- -- - -- -
Rough-In
Water Service -- --
Sanitary Sewer
Rain Drains - - -- -
Catch Basin/Manhoie
Storm Drain -
Shower Pan
Other. --- -
Final
PASS PART FAIL_ - - --------- - - ---- -.._
MECHANICAL -
Post& Beam
Rough-In �/ ---- --- - - --
ras Line
Smoke Dampers - 7. -- ----_�_.-_---
��ASS PARTFAIL- - -- -<� -- ---
ELECTRICAL—
Service
Rough-In
UG/Slab � - --- -----�_�
\r-
Low Voltage
Fire Alarm \ --------�--.---- --- -----�_�-.-T.--__ --- -
Final Heinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW!-tall Blvd.
PASS PART FAII. _
SITE_ - J Please call for reinspection RE:_ _- Unable to inspect-no access
Fire Supply Line
ADA - �"r-',Approach/Sidewalk Dab - - --�- Inspector ---[1 �-`- 1
Other:
Final DO NOT REMOVE OVE this Inspection record frr.►rA the job site.
PASS PART FAIL
■