16770 SW QUEEN ANNE AVENUE L
16770 SW Qwieen Anne Avenue
CITY OF TIGARD 24-Dour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
p BLIP -_-
Received — Date Requested 1 a--__ AM -_- _-._.-_PM _ BUP _
Location Suite_ __ MEC
Contact Person —_ _-- Ph( ) �� U PL.aQ
Contractor— -_— Ph( ____ ) SWR
BUILDING Tenant/Owner - _ - ELC
Footing ELC
Foundation Access:
Ftg Drain ELR --
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shoat
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling
Roof
Other:_ f
Final J-—
PASS PART FAIL - - - -- --. - ----- - - -- - - -
PLUMBING -------.—_..- -. _ _--
Post&Beam -
Under Slab ------ ------- - -- - --
Rough-In
Water Service - -- — _— -- -------
Sanitary Sewer
Rain Drains - -- - ---
Catch Basin/Manhole
Storm Diain —
Shower Pan
Other. _ ------ - - - --- — -------____.—..----
Final -
cck_ PAR FAIL AL _ —��—..---------- -- — --- -- --
Rough-In _ ------ -- --- - --..-
Gas Line
Smoke Dampers - ---- ---- -- ------- - ---
ina ..
PART-
FAIL ------ - --- -----------
— ICAL
Service ----- -------.--_.- -.— _-- - ---
Rough-In
UGiSlab
Low Voltage _ ----.--- - _ _-_-- --
Fire Alarm
Final Reinspection fee of$--____--required before raxt inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE -- u Please call for reinspection RE- Unable to inspect--no access
Fire Supply Line
ADA Dats `7 / 1) apaotor l� �� Ext
Approach/Sidewalk ---
Other:
Final DO NOT REMOVE this Inspection reco. J frolrn the job site.
PASS PART FAIL
s
!Tv O F T I G /e R y MECHANICAL PERMIT___
DEVELOPMENT SERVICES T # MEC2002 00395
DATEE ISSUSSUCD: 9/6102
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S115LiC 1700
SITE ADDRESS: 16770 SW QUEEN ANNE AVE
SUBDIVISION: ZONING:
BLOCK: LOT: _ _ JURISDICTION: KIN
CLASS OF WORK: ALI FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORSHOODS:
FUEL TYPES _ _ 0 - 3 HP: DOMES. INCIN:
GAS3 - 15 HP: COMMI_. 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: Furnace replacement.
Owner: __ FEES
DESCHENES, ALBERT P Type By Date Amount Receipt
FRANCES V 5PCT BB 9/6/02 $5.80 KING CITY
16770 SW QUEEN ANN AVE PRMT BB 9/6/02 $72.50 KING CITY
KING CITY, OR 97223
Total S78.30
Phone:
Contractor:
COLUMBIA HEATING + COOLING INC
8900 SW BURNHAM
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:624-2704 Heating Unt Insp
Reg #:LIC 76359 Final Inspection
PLM 34-175
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 requires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain co I of these rules or direct questions to OUNC by calling (50:1)246-9189.
Issue By: r' _ Permittee Signature: - j iL v t;c L
(X'A Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
09/04/2002 12:45 5036393771 CITY OF KING CITY PAGE 02/02
TRI-COUNSERVICE(IN R Mechanical Permit. Application ' '
t City Ol �1111j� City ,,
Date received' 11/� „ '. 1'e:mono.
��� • 13125 SW Hall Blvd. Project/appl.no.: Expire date,
Tigard,OR 97223 Date issued; ey' O� Receipt no.
Clackamas Phone: (503)6394171,FAX (503 •7 9 �
l�tf 1002 Case filen vas mans type:
Multnomah t
Washington Building permit no'.
e O 0 " r t e s Land use approval: tilt k ' '--a•,,,l,,,, ,,
❑ 1 & 2 fanuly dwelling or accessory O Commercial/industrial J Multi-family Tenant imprnvcment
O New construction 'p4ddition/alteration/replacement J Other.
1 1 EDULE
Job address: _�G 7e) �;�,sf ��,�,,,� Indicate equipment quantities:in boxes below. Indicate the dollar !
Bldg no.. _ Suite o.: value of all mechatucal materials, equipment, labor,overhead.
Tax ma /tax lot/account no.:
� pmtlt. Value S
LAt: 114lock. Subdivision; 'See checklist for important application information and
Project name: y _ jurlsdirtion's fee schedule for reskientla/penmif fee.
City/county, _/.e- ZIP; _
Description and location of work on premises: 11pilill '
_ ! Fee(es.� 'rotai
r '
Fst_ date of completion inspection: 10, 14so.-riptsoo Qty.I Res.only,Res,ou1._
tenant improvement or change of use: HVA(': f
Is exisdng space heated or condidoned O Yes O No Air handling unit _ CFM
Alt conditioning(sits len ui ) �—�
Is existing space insttlatexi"J Yes D u ;1lteration o existing A system
CONTRACTORoiler/compressors
Business name: '._ �f- State boiler permit no'
M����t:a+ 114�'�`/N tis __�_ HP Tons bTUM �
Address: R -_ l;ire/smake dam'ers/ uct smoke detextors
City: �' _ State: JUI ZIP: 'J Pa,pum (site plan tequ�3")
Phone:n: i7 0 Fax:�f -mail; nsta rep acs mac urne 1
Includingductwork/vent liner 0 Yes 0 No u
CCi� no.: 7G 3 �_ nsta replac�ocate heaters-suspe-i nate.
-City/metro 11c.no.. —1�_�u� � wall,or floor mounted
Nasne(please print) �� / tv/S�JCd.I.� Vent era lienee of Fr than ace _
Refrigeration:
Absorption units BTU4i
Verne; Chiller, _
�'sQ �b nr
,,kddrCts to��mssors HP
Iia onrnen a us
ot oo vent�doa:
City: __- State: ZIP: AI ence ventPp
I ��
Phone. J.o?qej
_ Fat: -mail tr exhaust
37o , ype nes. ache iv�iazmat
�
y� hood Etre suppression system — -
'me: ///2.,5' ,Qcn.. s ��G.v .. _ Exhaust fin with single dact(bath fans) _
;darling address: /4770 Sll/ ?3`14A,ytJ Exhaust system spirt fr■,m heating or AC
City: C. State; [� ZIP' 7 ue Piping aan. dleri upon tup to 4 sun:ts)
_.__ Type: LPc; KG
f'4one U flax: F'mail: Fuel ting'"Tic itonrt over foill lets
rP ocam pips nr,(schematic required;
Number of outlets
;Name: ---
otherIrsted it piaticr or equipment:
Address _ Decorative tlrtiplace _J'
City: _ State: ZIP: Insert-t� + __
Phone Fax F.lmail: oo stove it stove
h
40pltrttnf's sigrsniter ���� Date - ti Z nterc _ --
Name ipnnt). sfh-_ l --
raeecpi erodl eras.otewte<att jurrsdlcuee ter re fnrornwaen hettrit fee..
Ponce: 77etr permit uppliratiun Minimum foe ................5
J V sa t]MasterCard --
'rrdn card aumeur erpfier "a permit is not obtained pian review(at e!r) b
[spire w(Ai r 180 days after 1t has been �^ 8�
Name or urdho d,r u Shown oa c+edit card accepted as complete. State surcharge(8%).....S
s TOTAL ........................$ ; d
Cardholder silnatare xmau a 44rAA17 iWq CCiM