12920 SW GLACIER LILY CIRCLE 1
N
ID
N
r1
G7
LL
n
m
lmd�l'I��II� 1I7I:'I N�7�'d7;? t9S OZ57L
M m M m M rn m M y
fpJD lil (-4 D -4 --1C) Dp
O O tD O O O U w K N CO
vO V i O
9T
QOr. .v y
0 y 0 ''
�O
Cr. <
a
J
Ln Ln
� A
0
r«
N
� � O
N
CDD D
0 0
CD
O
cl
is o m
-� co cn rn r
uo
Ut
0 � m m �
Z vii o 0 4 O
00
o x
Q N a
a
C
O
T) b m T
N n
o4h A A f4h SpA_ f�A A y
G CT t�J1 to Ch (h CJS Vii iA
Q
Z
O
A
N
m
c) �»
C) p N
N N (NU
4
M Z7
z � �
cu
v
0
0
o;
a
D
p �
d rr
N
K
O
tp D
m � �
0(a
o �
a
r� h
p m
0
00
to
i p �T.
� N V►`f
Y
Aa
C
Z �
CL
p C
N
z
0
m
N
Community Development RESTRICTED ENERGY ELECTRICAL. APPLICATIOhI J
13125 SW Hall Blvd. C S_U/
Tigard,OR 97223 PERMIT#
_ � - ---
Phone(503)639-4171FAX(503)684-7297 DATE ISSUED. -- - —
A4M TDD No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY _A'/jgr/��:�d�/
PLEASE COMPLETE ALL SECTIONS
1./LOCATION OF INSTALLATION ///[JJ,(_`�0 4. TYPE OF WORK
Address n RESIDENTIAL—Restricted Energy Fee. . . . . . . . . 1,40,00
7 (FOR ALL SYSTEMS)
City Stale Zip .Check Type of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems*
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
1R0 DAYS. EL Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPaLI��TION ❑ Heating,Ventilation and Air Conditioning System*
ConlractoTypes ❑ Vacuum Systems*
Q� , ❑ Othcr�_.�
Address
Date lO,S _ COMMERCIAL—Fee for each system . . . . . , . . . 140.09
-- '— �7C { ]�/y� (SEE OAR 918-260-260)
Property Owner i_ _—L „1iI'~' of Work Involved:
Contractor's Boar Reg. No.?—_A/ ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone# ' _- --- - ❑ Clock Systems
❑ Data telecommunication Installations
3. O YNEER APPLICATION / ❑ Fire Alarm Installation
(�-t/,8tt2 , �'���5.r�3 ❑ HVAC
P in Owner's Name Phone No 0 Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State lip _ ❑ Medical
This permil is issued under(lAR 918-320.170.This applicant agrees to mak,- rely ❑ Norse.Calls
restricted energy installations(100 volt amps or less)under this Iwontt anti to d t the ❑ Outdoor Landscape Lighting*
following:
❑ Protective Signaling
1. Only use electrical litt•nsed perv,ns to do installations where required.(certain
residential and other tratimctions are exempt from licensing.Those have ❑ Other
asteriskst*).All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 103-639-4175. ❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector r,not In inspect under this permit, •No licenses are required. Licenses are required for all other installations.
4 Assume responsibility for assuring that all corrections required by the inspector
are rinne,and
5. Assume responsibility Rtt calling fora final inspection when all of the corrections S. FEES
are completed.
The person signing for this permit must he the applicant or a person a. Enter Fees
authorized to hind the applicant. _Y
h. 5% Surcharge(.pS x total above) $___
Signature .—.��._
TOTAL $_
Authority if other than applicant
ENERGAP.CHP
CITYOF TIGARD __ MECHANICAL. PERMIT
3
DEVELOPMENT' SERVICES PERMIT#: M21/0 -00515
13125 SW Hall Blvd., Tigard, OR 97223 ( IS13 3
503) 639-4171 GATE ISSUED:
BARGEE: 1 S133DA-05700
SITE ADDRESS: 12920 SW GLACIER LILY CIR
SUBDIVICION: AMART SUMMERLAKE ZONING: R-7
BLOCK: LOT:079 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 _ AIR HANDLING_UNITS _ OTHER UNITS:
FURN >=100K BTU: — 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace ps furnace
Owner: _— FEES +
'1CLEOD, KAREN L AND Description Date Amount
HERRALL, JAMES C 1111 c'll� I'crmit I UL 8/21/03 $72.50
12920 SW GLACIER LILY CIRCLE 1 1� tit ite'lax 8/21/03 $5.80
TIGARD, OR 97223 I "
Total x78.30
Phone: 503-524-6303
Contractor:
A-1 AIR CONDITIONING CO INC
2038 NW ALOCLEK
HILI-SBORO, OR 97124 R'--QUIRED INSPECTIONS
Gas Line Insp
Phon4: 503-645-5900 Final Inspection
Reg#: LIC 62102
This permit is issued subject to the iogulations contained in the Tigard Munn:pal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in actx.rdance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 1 PO days. ATTENTION: Oregon law
requires you to follow rules .adopted in the Oregon Utility Notification Center. Th _e rules are set forth in OAR 952-001-00
issued By: _ Permittee Sigrature: ,
Call (Z) 639-4175 by 7:00 P,M. for inspections needed the next b si ss day
FO!OtL jo {+v FAX N0. : 6907435 Aug. 20 2003 01:58PM P1
Mechanical Permit Application
ID�leived; c � C1( qF , �Clty -
of Tigard ProjecVappl.no.; Expiredttte:
CiryofTigard Address: 13125 SW Hall Blvd,Tigard,OR 977.7' � -
Phone.: (503) 639-4171 Date issues By: Receipt no,:
Fax: (503) 596-1960 1 Case file no.; Payment type:
Land use approval: _.. __ Building permit no.:
i
IXI 1 Al.7 family dwelling or accessory U Commercial/industrial O Multi-family U'icnartt improvement
❑New construction U Adodionlaltetation/rcplacement 0 Other:
s
Job address; 12920 SW G lacier 1.i 1 y Cir Indicate equipment quantities in boxes below.Indicate the dollar
gid ,no,; Suite no.: value of all mechanical materials,equipment.,labor,overhead,
Tax ma ax lot/account no.: profit.Value$ _
t.el: pluck: Subdivision: *See checklist for important application information and
F'rojeetname: - _- jurisdiction's fee schedule for residential permit fec.
City/county:_ ZIP: t t
Description and location of work on premises:
R lace gas furnace M'rrtr�•) �'nt�1
list date of coin letion/inspectitm: Description Qty, Its.only Ties.only
Q
Tenant improvement or change of use: Airhandlln unit _ CPM
Is existing s act,heated or conditioned?❑'Yes O No
A•P r conditioning(site play requl _
Is CRistutg spam insulated?❑Yes U No ttrauon ofexist ng HVAU_system
Boll cr compressors _
t bill, State boiler permit no.:
gu$iness name: A-1 _Air Nedti lin Hp fans BTU/H
'
Address: 2038 NW Alo Dr. #� it emo c amper uctsmoke-detectors
Y pR ZIP: 97124 eat pump s to tan re utr )
UIH
City: i 11 sboro State:Phone:' - ' 1)titi
690-743511,rnail: 1 ai @ stat rep ace furnace/burner HT
including ductwotk/vent liner O Yes d4 No 1 14JO
U
CCB no.: 6' __ nsta rep I, aroheatcrs-suspen e ,
City/ttletto tic.uo.: wall,or floor mounter!
Name( lease t) rnl or ap ancc of her an furnace
xe erat on:
Absorption units--_.— _ BTUM
Utlllers_ - -- � NP
Name: OWner _. Compressors Hp
Add:cvs: _ �w—unmestta "u and rent 1 on:
city: State: ZIP' Ap liancevcnt
_�
. I'Irone: ' Fax: E-mail: crex usi __._
jq7��
lire suppression system
Name: Karen MC(.POd _ uatfanwithsingleduct(bathfensaddre:ts: 20 SW 1 ac i er L i l L.1 r st systema oritecta eadn orAMailinga_ State:OR ZiP: 9 223` C'S a°d to oa top to out etaity: 9 ar . LI'G NCI offPhone: `i[ -G 3 6' H F-mail: ipinR each�dltlona over out ems
y pmess virtngkicneInAticrequiredi
Number of outlets
ie' er whir or eqITJ�a t
Decorativefireplace
S. `Addmis: nsert-rypc ---�
e, ✓ City: - State: Z1P: — t--el .
E-mail.
i' Phone: x: r:
A plicatirs st natur Date: 8/20/03 _ er: _
My�,r.t Name(print): e n i s e Mc r i e _ 5 1 .00
Permit fee...............
Na as twt.aeuoas aQipt etattt sect pkw out kAl"selim tc.O1"'"t"t` 0` Notice:This pcnnit application Minimum fee.,..............$ .22.33 0
Umsa O Mutescard expires if a persalt is not obtained Plan review(at _961 $ -
G1sda cad numbs. ---. /p�p}� within 18o days aver it has been Stam surcharge(9%) ....$ _ •80
e accepted as complete. TOTAL, ..S 7 8J3
-'—`FTame�o`card►wtder's�tea+ _ ..........••.....•. _
--- dsaala!• �mosa 44D A17l6iWOM)
is•; —
CITY" OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BUP
Received _�� �_ Date Requested -..____ _ AM- U PM BLI _ _
Location J ite e-
Contact Person Ph
Contractor _ Ph( ) SWR r
BUILDING _ Tenant/Owner (.p3 - ELC LY �-
Footing E LC
Foundation Access:
Ftg Drain V/`/A �i1,1-:e,/'Z ��,��,�, ELF!
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
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
FAIL
M --
Post&Bea,n
Rough-In
Gas Line
Smoke Dampers ---fln-aj;�
OA-0 PART FAIL
LITURICAL
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 _ Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the )oh site,
PASS PART FAIL