10030 SW TIGARD STREET ca
10030 SW Tigard Street
CITY' OF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00340
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/27/01
PARCEL: 1 S135CC-03200
SITE ADDRESS: 10030 SW TIGARD ST
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENT' W/O ADPL: VEIJT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES 0 3 HP: DOMES. INCIN:
i_Pc; 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOOD
STOVES:
PRESSURE: y0+ HP: DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHEk CLO DRRYERS:
FURN >=100K BTU: <= 10000 cfm: ASOU1 I_ET S: 1
UNITS: 1
GAS
> 10000 cfm:
Remarks: Installation of gas line to gas insert.
Owner: FEES _
TRUJILL.O, BERNARDINO + EVA C Type By Date Amount Receipt
10030 SW TIGARD ST PRI'AT CTR 9/27/04 $72.50 2720011;000
TIGARD, OR 97223 5PCT CTR 9/27/61 $5.80 272001000C
Phone
Total $78.30 l
--
Contractor:
T + K MECHANICAL
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503-626-4652 Mechanical Insp
Reg #:LIC 121165 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
(cn,i»aF-Q1Ra,
Issue By: � , Permittee Signature: -))
Call (503) 639.4175 by 7:00 P.M. for inspections needed the next business day
mill
Mechanical Permit pplicatinn
--- J Dattreceived:C714 j !P`m"rw..!
City of ! igar yEp PIAIV�ING Proje.dappl.no.: �"`-- Expircde,c:
City ofTigard Address: 13125 SW 11AAK-TlgarJ,OR 97223 Date issued: By'.�f; >' Receipt w.:
Phone: (503) 619-4171 yme
Fax: (503) 599-1960 SEP 2, r, 2001 Case file no.: Pamc,,l type.
Land use approval: .- T"A - , �Builaingper'mirso.:
Jr; f
TUNew2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant Improvement
construction U Acldition/alteration/replacement U Other:
Job address. <-VVV Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no. — Suite no.: _ value of all mechanical materials,equipment,labor,overhead,
Tux map/tax InUaccount no.: profit.Value$
Tax
Boum Subdivision: 'See checklist for important application information ar,d
�_--_ jurisdiction's fee schedule for residential permit tee.
Project name
City/county._z qa
Descrip'on rind location of work on premises:
1 1 s
Q� � l�rc(ea.) Total
Est.date of completion/inspection: & p Ik riplion QIY• Rrt.orily Rex.only
Tenant impr,,vement or change of use: A,r iiandling unit
Is existing space heated or conditioned?U Yes U No ,reo�tuoning(site p an regwrc ) _
Is existing span n,ulaied?U Yrs U No Iteration of existing A systemMECHANICAL CqNTRAC I OR r,
3i er compressors
T4 h Sate boiler permit no.:
Business name: t cc's/ Hca S o P6 4 lip Tons [ITU/11
Addc,:ss: S Si cJitelsma catnpers/ uc�smo aelectors
City: (IQ1 Stair ZIP: �?i) cat pump(site p on re u rc )
IT
Phone: & �((O" Fax:(p�(p [: mail: nclu hep ace urnace t line—T'FO
q/ Including ductwork/vent liner U Yes f]No
CCB no.: nsta rep ace re ocate heaters-suspended,
City/metro lie.no.: q8'a4W wall,or floor mounted
Name(please print): , aril or a lance of er t,tan urnace
1 c l gernon:
Ahtiorprion units BTU/H
Chillers_ HP
Na�It
(V1 t Com ressors HI'
Ad3c Cl V-4 o'`- nv ronmenla ex gust an vent lotion:
City: t^ Stale: ✓ ZIP. QII) Appliancevcnt
Phone: F-mail: )ryerex gust
,foods,Type res. nc c azmat
hood fire suppression system
Name: Iry v f o Exhaust fan with single duct(bath fans) _
. address: �� t 'x aust s stem apart from eatin or
Mailing --�—L � �l t r Fuelpiping nn st on up to 4 out cls)
('ity: qu�.c I — Stair ZIP: TYIx ---hPC) - - NCl Oir
Phone: Ibi(v Pax: E-mail: uc i in cac a dit ona over out cls
roeesspiping(-schematic requirt: _
Number of outlets
Name: -Other 11ii-eappliance or equlpnienl:
Address: Decorative fuepla c y
City: State: ZIP: nserl-type r
0o stov pe et stove _
Ph me: U-bail: Other:
Applicant's sig 276Other-
—7 T— Permit fee......... ...........$
Nat dl judrdidons accept credit cmd%,pleas call jurisdiction frx mon•infonnsuon NUIICC:THIS permit application OVisa u MasterCard p pP Minimum fee................ FW-27,�21,_
expires if a permit is not obtained Plan review(at _ %) _
within 1 gU days offer it has been
l xr11ft y State surcharge(896),.., -�1-�
Name of cardholder a shown on credit car aC
$ �Cpled as Complete.
TOTAL .......................$
Cardhnlder.ISWuro Amount 440.4617 WOWOW
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspectio,y Line: 6.39-4175 Business Line: 639-4171 MST
/
-- —..—Date Requested � z BUP AM_ --PM�� ----3LD
-----
Location UG'?oJit/ / - ,S; - _---- Suite _ -
- - MEC _� ✓ •->!i U.3�U
Contact Person Ph
7�.— PLM
Conh•actor _-- Ph ____---
— _
BUILDING - Tenant/Owner -- SWR
— ELC
Retaining Wall
Fooling ELR
Foundation Access- ---_--_t__--
Ftq Drain FPS
Crawl Drain Inspection Notes. SIGN
Slab
Post& Beam ---- - -- SIT - --
Ext Sheath/Shear --� - -- --- ---
Int Sheath/Shear
Framing - -------- -- -
Insulation - ---
Drywall Nailingty S c'";c-'"
irewall -- . _- -- - —
Fire Sprinkler -
Fire Alarm -- ---------- ----- _
Susp'd Ceiling
Roof --- -- - -- T
Misc:
Final ---------• _ ----- --•---
-- _
PASS PART FAIL - _-
PLUMBING ---
Post& Beam - _ - _ ----
Under Slab - - -
Top Otrt - --
Water Service - -
Sanitary Sewer -----
Rain Drains ---- -
Final
PASS PART FAIL
ANI - -�-f---- - _—
PostB Beam ---..-.-
Rough In — --- __
Gas Line -_
Smoke Dampers -- --- - _
PART FAIL —� -` --'-- ----
TRICA.L
Service - --
Rough In - - - -
Ur/Slab -------•---
Low Voltage --- - - - —_--
Fire Alarm
Final --
PASS PART FAIL --_._-----�---
SITE --— — - -
Backfill/Grading -- ---- --__ ___
Sanitary Sewer -- ---
Storm Drain I )Reinspection fee of$ mquired before next i-;spection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin -
Fire Supply Line ( j Please call for reinspection RE:
Unaale to inspect no access
ADA --•------------
Approauh/Sidewalk J
Other r Date I`o? /`(/ / I11spe ;torFin __- Ext
PASS PART FAIL
-- DO NOT REMOVE this Inspection record from the job site.