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CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SE PERMIT#: MEC2002-00010
DATE ISSUED: 1/8/0:!
13125 SW Hall Blvd., Tigard, OR 9722,1 (503) 639-4171 PARCEL: 1S133AD-07900
SITE ADDRESS: 12820 SW CHICORY C'I
SUBDIVISION: AMART SUMMERLAKL ZONING: R 7
BLOCK: LOT: 123 JUKISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EV/'.P COOLERS:
TYPE OF USE: :�F UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS--- HOODS:
_ FUEL TYPES 0 3 HP: DOM,S. IWC IN:
LI-L -- -- — 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UN'.S:
FIRE DAMPEQS?: 30 - 50 HP: WOJDSTOVES:
GAS I,-,:E:jSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTLI: 1 _ AIR HANDLING UNITS —
� OTHER UNITS:
FURN >=100K BTU: 7<-:—,0-000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace heat pu nr`
Owner: _ _ _ FEES
N/ICCLUHAN, MICHAEL L + SARAH J Type By Date Amount Receipt
12820 SW CHICORY CT NRMT CTR 1/8/02 $72.50 272002000C
TIG^.RD, OR 97223 5PCT CTR 1/8102 $5.80 2720020000
Total _ $78.30 _
Phone:
Contractor: ,
THE HEATING SPECIALIST
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Mechanical ' !sp
Phone:257-7000 Heating Unt Insp
Reg # LIC 56628 Final Inspection
PLM 26-494PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be cone in accordance with approved
plans. This permit vvill expire if work is not started within 180 days of issuance, or if work is susperded
fur more than 180 days. ATTENTION: Oregon law requires yogi to follow rules adopted in the Oregon
Utildy Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain espies of these rules or direct questions to OUNC by calling (503)246-9189.
Permittee Signature: i <� ' l<-` '' f •'
Issue By: _ _�) -. , - .• f.�.�_ _ --
Call (503) 639-4175 by 7:00 P.M. for inspections needed the nex!busilless day
Mechanical Pernihfttrur 'FFICE,USE 111N,
— — Date received: - `t;-C. i Femur no.:M _1�,[ d
- -' City of `Tigard 2�^ Project/appl.no.: Expire date:
Address: 13125 SW Hall Blvd,Tigard,t 97t1ii -�
Date issued: By: Receipt no.:
Phone: (503) 639-4171 CITY of
Fax: (503) 598-1960 RftDIND D ase file no.: Payment type:
Land use approval: _ _ Building Permit no.:
t
i 4t 2 family dwelling or -xessory O Commercial/industrial O Multi-family U Tenant improvement
O New construction J �,I,lition'alteration/replacement U Other _—
iOB siTE INFORMAt
Jub
address:/ /i r c Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: __ value of all mechanical materials,equipment,labor,ove-head,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: 'See checklist for impotiant application information and
Project name: ,clictiun'ti fec jw(lulc fur residential Permit fee
J /) /u ,,,
City/county: �i t*L{d ZIP: )y 2 2 3 t t
Description and location of work on premises: ___ t t
Intl
d 4- t r v — —_ Fee(ea.) t,.la1
Lm.date of completion/inspection: Description _ Qt .I Re'..onl Res.only
Tenant impn.,vemcnt or change of use: i Ai, h.tr,!ing unit C:-M
Is existing space heated or conditioned?U 1 (:I No Air(nnduioning(site plan requi.ed)
is existing space insulated?U Yes U No A-IFc•duon or existing sysim
r' t t BoiieNcompressors
Stole boiler permit no.:
Business name:`,.-,— N=eetc.,_ �_�����-�� HP--_—Tuns BTU/H
Address /it.' '-f) t� -1C/a .��- _ Firelsmoke dampers/duct smoke electors
City: 7<4.r.71 v,11X -- State:e 1 ZIP`S y.) eat pump(sue p an require ) / �-t+oz,
stu717rep1i+ce umace urner.— /
Phare: -1-5 7 JFay: j.z r s E-mail: including duct,vork/vent liner U Yes U No
CCB no.. :i�.r. d _ t c^a lista rep ace re ocate heaters- sust+rn e .
City/metro lic.no.: 6-lo wall,or floor mounted
Name(please print) vent for an lienee of er than furnace
—
Vent
r gerat on:
t Absorption units _- _ BTU'H
Name: i Chillers lip _
Campressors HP
Address: ___Y nv ronntenta ex east an vent at on:
City: State: ZIP: Appliance vent
I'lxme; Fax: I E-mail: Dryer exhaust _
Hoods,Type 1/lures,kitchen/hazmat
hood fire suppression system ——
e
Exhaust
upst pfan withsle duct fas)n
Name: from
Mailing ado,ass: Exhaust amspan aaq oL.—
h
: - ZIP:9 3 ng andistribution(up to 4 outlets—)
City: / Oil-
-11,
_
Type: LPG NO Oil # .
Phone: ., ; 4f G ti 7 Fax: E-mail: ue t m sac s ht 'ta over 4 outlets
Process piping(r .amide required)
''� Number of outlets _
Name: _ _ ter ste app ince or equ pmenft
Address: Decorative fire lace
----- --(;tate: ZIP. Insert-type _
City: — tov pe ct stove
Phone: Fax:
Applicant's signature: Date:/ .3 Ua ten _ —
Name(pti ,t`; •_'r.:r >".y� FR-.s�u s -- i�d��
Permit fee.....................S
Not ati jurisdictions accept credit cards.please au jurisdiction rot more information. Notice: This permit application Minimum fee................$ ��
0 visa O MasterCard expires if a permit is not obtained plan review(at_ %) S _
Credit card number:.�_ — cap ref within ISO days after it has been State sureho,gc(8%)....S 'T fee)
Name of cardhmldar es shown on credit card f accepted as complete: TOTAL. S 79-416
Amount paCU1�
Grdholdcr aignnuro
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o S
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k
CITY OF TIGARD 24-Hour
3UILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BUP
Received Date Requested__ AM. PM_ BUP
Location 11 1 k Z U (y I ..a� __�- Suite MEC�CT�. 'JO�d
Gntact efs0n J -� a176ph c 8 PLM
@aaeler_ `�Y�(�(' ( r,,.,, . ph ) 7(1 {9 7 SWR _ —
BUILDING— Tenant/Owner _ ELC
Footing - -
Foundation ELC
Fig Drain e8t3' V Y•ti�•.�►_r `-��c�. ELR _—
Crawl Drain -—
Slab Insp ,tion Notes: c� , SIT
Pont&Beam _1.-, ��I _� • •� 0 - —_ -
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
_P_ASSPART FALL -- -
MECHA_NICAL
Post& Beam - - --
Rough-In
Gas Line —
Smoke Dampers
ZC`TkICAL
PART FAIL
Service
Rough-In
UG/Slab — - --
Low Voltage -
Fire Alarm -
Final LJ Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for rpi,ispection HE: -_ _ _ Unable to inspect-no access
Fire Supply Line
A-)A
Approach/Side Dote--� 1-V-- -- . -- Inspector _ — _ t -
Other•.
Final — DO NOT REMOVE this Inspection record from the fob site.
PASS PART FAIL