16060 SW QUEEN VICTORIA PLACE 16060 5W Queen Victoria Place
MECHANICAL PERMIT
CITY OF T I G e R®
/ \ DEVELOPMENT SERVICES PERMIT#: MEC2002-00501
DATE ISSUED: 11/12/2002
13125 SW Hall Blvd., 'Tigard, OR 97223 (503) 6394171 PARCEL: 2S110CC-06700
SITE ADDRESS: 16060 SW 0UEEN VIC10RIN PI_
SUBDIVISION: KING CITY NO 3 ZONING:
FLOCK: LOT: 041 JURISDICTION: KIN
CLASS OF WORK: ALT���T 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 TYPF_S -- ---- DOMES. INCIN:
F7r,- — - - -- -" 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: _ `=�a00� cifm GAS OUTLETS:
10000 cfm:
Remarks: Replace furnace
Owner: FEES
5'NELL GLADYS H TRUST D
5Description Date Amount M
6060 §W QUEEN VICTORIA PL MECI-I Permit F'ee 11/12/20 $72.50
ING CITY, OR 97224 1
[MECHj Permit Fee 11/12120 $0.00
1 TAX]8%StateTax 11/12/20 $5.80
Phone: IT'AX18%StateTax 11112120 $0.00
Contractor: Total $78.30
O.OLUMBIA HEATING +COOLING INC
P.O. BOX 230397
IGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 624-2704 Final Inspection
Reg 0: 76359
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 Ngrmit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 130 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
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by ca ling
(503)246-6699. LL
ssued By: ' � 9._- Permittee Signature:
Call(503 839-4175 by 7:00 P.M. for inspections needed the next business day
11/07/2002 10:58 503639'y771 CITY OF KING CITY PAGE 02/02
J,RKOUNTY
,EkviG aNrU Mechanical Permit R►.pplic..ataon '
�
City Of King City nate received: Permit no.• qp -opSul
Projecdappl.no.: Expire date:
- 13125 SW Hall Blvd.
Tigard,OR 97223 Date issued: By: Receipt no.:
Clackamas phone: (503)639-4171,FAX,(503)684-7297 Case Fie Payment type:
Multnomah - - __.
Washington Building permit no.:
c o „ N . t 1! s Land use approval: —
Vol• �
CI 1 & 2 family dwelling or accessory U Corttmercial/utdustrral > ;Multi-family U Tenant improvement
* New constructionAddition/alteratioti/replacement 'J Other.
JOB Sft INFORMATION1
Job address: 'co ; b tr G� .[1ir.Z a L°G lndti atc cyuipincnt quantitic in boxes below.Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials,equipment.labor,overhead,
Tax ma rex lot/account no.: profit. Value T
Lot: Block: Subdivision: "See checklist for important rtpplication information and
Project name: - ir.r>.rdicrion's ee schedule of nesidendal permitfee.
City/count : Zlp_'cs 7�?���_ 1Al loll I
Description and location of work on premises:
Fee IrxJ Totio
Est,date of completiott/in tion: Uest.Tipdou Qty. Res.only Res.onlyl
T nant improvement or change of use: AC.
Is existing space heated or conditioned?-D Yes U No Air handling unit (.FM
Is existingspace insulated?O Yrs O W) con don g(site plan requu )
P� Alteration of existing ', :Sys em
1 of er compressors -
Business name: r State boiler permit no..r Iei K .t;t -r._ G ��N 6 HF 'tons Ills
8'fL1M
Address: P,6 �l�X �� _J�of ire/smoke dam rs/duct smoke etectorl
City; 'riGiir/tD State Zjp: '"jy� est um (site rut ce u t) �'�
Phone: �.71�i7 a Fax E=mail: nstr rep ace mace umer� i
Phone:
: Including ductwork/vent liner Yes U No
7G 3 s'9 nstr rep ace/te ocate heaters-�iuspende
City/metro lie,rto. wall,or floor mounted
gigVarve(please print):
• ent or app.iance other than ace
r eratiae:
Absorroon units _BTU/H
Varve: Chillers _ _HP
address: QA�u �14LLr♦! —'— — C,rrt ressors ---HP -
---- o anmwt-tarxhauat aad venlitntlon:
;Ity: State, ZIP: A plitrtce vent
'hone: F Rtall: e.�hausl
1 Hods,Type V jUrea.kttctt� ery axh mat
hood fire suppression system
Jame: l / Exhaust fan with single duct(bail, fans)
trailing address: p , - W�
Exhaust system apart heai�n;or AC
G 5t�te: 7Ip: y'?��� 1Huel piping an ttri on(up to 4 outlets)
_ _ _ Type: LPG NO Oil
'hone Fax: — Email' are i in each additional over out�—
ocees piping(sc ematic req to T—
Number of outlets
15ther listia appliance or equipment:
Adress: _ Decorative fireplace
ity: — Stnte: ZIP: insert-type
hone: Fax: E-mail: o c�tove et stove
pplicant's sij,natur i Date: //'-7 O Z t7t err —
Ame(print). _ 1
t all jurWicrioro accept credit ends,pleue call jvnadleunn rot mora lafornratlea. Permit fr'e......................5 ('1
Notice!Ms permit application Minimum fee ................S —_--
visa Cl MasterCard expires if a permit is not obtalned
. __—__—.__ —614
�14 wllhir 180 days after it has been Plan review(at _ �) S
dll cud eumbcr —._.
888xp ra State sut,:harge(896).....$ .S•gD--
-- Name at cud older as shown ae credii card accepted as ron plete.
cardholder slanarure �mouaij At 10, 4404617 4TOR_oM.
CITY QF TIGARD 24-Hour
BI IILnING Inspection Line: (503) 639-4175 j
MST -
INSPE. I DIVISION Business Line: (503)639-4171
BLIP _
Received _ __ __-_Date Bequested AM PM BLIP
Location -... ____120 C)___ Q"_A:e' 'tV��! --�;� Suite_ I-"L— MEC 2 G
Contact Person f�»'1 Ph( ) L/2-70 PLM
Contractor — Ph(_ ) --- SWR
BUILDING Tenant/Owner _____-- __ __ ELC
Footing -- ELC _-
Foundation Access:
Fig Drain ELR
Crawl Drain —
Slab Inspection Notes: SIT _
Post&Beam .t- --
Shear Anchors
Ext Sheath/Shear ---
Int Sheath/Shear
Framing - -�---- - - l--`
Insulation --�� r- 'T`,"'!ii _-
Drywall Nailing
Firewall
Fire Sprinkler _-"- —
Fire Alarm
Susp'd Ceiling -----
Root _
Other: ---------- _ -- -- _ -
Final — --_
PASS_ PART FAIL
Post&Beam
Under Slab - -- - -- ----- --
Rough-In
Water Service — - i---^
Sanitary Sewer
Rain Drains
Catch Basin/Manhole _
Storm Drain
Shower Pan _
Other:
Final _
PASS PART FAIL
-MECHANICAL --
Post& Beam
Rough-In ✓
rias Line`,Smoke
Smoke Damp � --`-
P_ S PART FAIL --- - - -- -
_ TRICAL
Service
Rough-In —
UG/Slab
Low Voltage - -------------
Fire Alarm
Final I j Reinspection tee of$---__--_required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL _
SITE _ ] Please call for reinspection RE:._ n Unable It, inspect-no access
Fire Supply Line
ADA
1 1
Approach/Sidewalk Data `1 - ��a Inspector --- -- -- ut _
Other: ----
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL