11960 SW GREENBURG ROAD-1 T
rJ;
I
rD
C
't
7G
a
11 ►00 SNN' (;rrcnhurg Itd
CITYOF T I G A R _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERIVIIT#: MEC2002-00221
13125 SW Hall Blvd., Tigard, CR 97223 (503) 639-4171 DATE ISSUED: 5/28/02
PARCEL: 1 S135DD-04404
` ITE ADDRESS: 11960 SW /,ItFENBURG RD
3UBDI!/ISION: ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF IrVORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B `DENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUE_LTYPEC _ 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: CLO DRYERS:
FURN < 100K BTU: _ _ AIR HANOLiNG UNITS OTHER UNITS:
FURN -100K BTU. <= 10000 cfm GAS JUT'-ETS: i
> 10000 cfm:
Remarks: Replace gas piping for(1) rooftop unit
Ov,rner:
KL USMAN, WANDA Type By - Dam Amount Receipt
BY AGE NCY CONTRACTOR'S INC PRMT CTIR 5/28/02 $72.50 2720020000
11960 SW GREENBURG RD 5PCT (,TF' 5/28/02 $5 80 27200200')(7
TIGARD, OR 97223 ---- --- -- -- _
Total $78.30
Phone: -- --._
Contract3r:
ROSE HEATING CO
9945 NE 6TH DR
PORTLAND, OR 97211 REQUIRED INSPECTIONS
Gas Line Insp
Phone:503-283-5183 Final Inspection
Reg#:LIC 00002084
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law rewires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtal copies of thesF rules or direct questions to OUNC by calling (503)246-1)189.
Issue By Permittee Signature: L' H
Cali (503) 639-417.5 by 7:00 P.M. for Inspections needed the next business day
May 23 02 02: 01p p. l
Mechanical Permit Application POEM MW
bate received:j-,)�6-U Permit
jr City of Tigard %F1 V E 1 Project/appi.no.: Expire date:
Ci Addr-+ss: 13125 SW Hall Blv 2 �/
ryo Ti and Phu ie: (503) 639-4171 bate issued: By( ; Receipt no.:
Fax. (503) 598-1960 •n„, u, Case file no_---- -- Payment type: -Land use use approval: r t v Iluildingpertnil no.:
U I &2 family dwelling or accessory XCommercial/industrial U Multi-family U'Tcnant improvement
U New construction U Addition/ttlteration/replacement U Other.
/ 1 w 1
Job address: Q Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Sdi4c no.: value o1 all mccliaOical mat rials,equipment,labor,overhead,
Tax map/tax lot/account—no.: --_ - profit. Value$ C 0
Lot: Block: Subdivision: "See checklist for important application information and
Project name. jurisdiction's fee schedule for re;tdential permit fi-e.
City/count: _ ZIP: • 1
Description and c tion of work on premises: `[eS 1 '
ly
1 (V M RO Fee(em) Total
Est date of completion/inspection: DewAptlon - "y. Ht s only Res.only
Tenant improvcmenl.or change of use: rZ�., it - CFM
Is existing srace heated or conditione9?O Yes U Nn AtrCori ditioning(sitean require ) _
Is existing,;Iv( mrsulatcd'?U Ycs U No Alteration of existing VACsystem
oiler compressors
`V State boiler perrait no.:
Business name: Hp Tons B,rU/HAddress: l_ �E t smo a dr riper tier smoke detectors
eat um site Ian required)
City: Stale: ZI P P( P
Phone: �� Fax:56 - -mail: nstal replace. urnace/burner
- Including ductwerkivent liner U Yes O No
CCB no.: O�.� -- - Insta rep nccTrcZcxute eaters-suspen e .
metlnjic.no.; -, wall,or floor mounto!
Name( leaseprint): r A" Ventfora ianceotfierthat,furnace
gen on:
Absorption unit s—.— _, HTV/H
:Narar.."
1 Chillers-- Coal ressors _ HP
ess:^ ( otuey � Appliancevent
State,: 7dp:e r "= a Faxv - (53SO E-mail: )rycreac taust -- --� -
0o-�,7ypciTs.kitchc azmnt
hood flre sup,,.-tssion system
Name: Ext.aust fan win,Jingle duct(hath fans)
-
M
oust system a art from heating or-AC
ailing ar.dress: x
- -- — -- -- - -
Fuel pagan r tityn(up to outlets)
City -�-- - Slate: Z1P: _ i'ypr: _ JIG -Z NG Oil
Phone: Fax: E-mail: -Ful t-'in cac'h a itional ova
in roce"piping(schemnocrr equirorl)
Number tit uutictz
Name: _ Wlfwiltaea ap txe or e4Tmens:— - —
Address. -J _�Wi Decotstivcf-ireplacc -,-
City: - — State: ZIP: Insert-type
Phone: --i Fax: 111-mail: ood tov I't etstuve--
O Mr:
Applicant's signature• tDate:
Name(print': nt� _
Not all jurivlleNarn rccet+t credit c>snL,plrax cn h+rirectlan for mom Iafontuakm. Permit fee.....................$
N Visa le MaaterCtcr Notice:This permit nuplication Minimum fee................$
eyptres if n permit is not obtained Plan review(at ._ %) S
Credit corcl number---- ,._---- ---
,q acc,
ept 180 days lets it hes been State surcharge(R96)....S
.ho o0 o t s accepted as complete. 411 —
!I
-
,_.tdbolau we- 4404617(&MCOM)
sssi
CITY OF TIGARD 24-H-)ur
BUILDING; Inspection line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 BUP
Received `�`2 - Date Re uested S 2 AM__ - PM __— _ BUP
— — I►,�Ec 002 -QO:22
Location _ o-e e �—Suite
Contact Person
LZ.GK t -G _ Ph( !5;0 2�3 S� PLM
Contractor D 4r' r! Geigy '�"�y^s7 —_ Ph(— ) _ SWR _ --
BUILDING Tenant/Owner _ ELC -
Footing ELC
Foundation Ak'cess:
Ftg Drain ELR —_
Crawl Drain -- 31T
Slab Inspection Notes:
Post& Beam -- --- - ------
Shear Anchors
I Ext Sheath/Shear --
Int Sheath/Shear
Framing -
Insulation (-�-`�1 _1 2
Drywall Nailing -
Firewall
Fire Sprinkler '
Fire Alarm ---
Susp'd Ceiling - -�
Roof ✓ V t N
Other:
Final / te - - -
PASS PART FAIL 7-1
PLUMBING ----- _
Post&Beam
Under Slab �-
Rough-In 0 _ l �Q vl I9-i_ZLSL�WaterServiceService --
Sanitary Sewer -y V
Rain Drains
Catch Basin/Manhole - - -
Storm Drain -- -
Shower Pan
Other:----- --
Final --- r-- —.
_ AL
PAT FAIL
MEC"'U -- - ------� —=-��-----1-N ''
x --
ost&Beam
as
3S a,rpers
ri
PAS$ PART FAIL --- -
ELECTRICAL _ —
Service
Rough-In -- --
UG/Slab
Low Voltage ---
Firta Alarm
Final Reinspection fee of$ _- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAIL
SITE—_^ _-_ Please call for reinspection RE: Unable to inspect no access
Fire Supply Line
ADA 9 Ex3-
Approach/Sidewalk Data GG-
Inspector
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL