13040 SW 107TH COURT a
13040 SW 107"' Court
CITY OF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SE.R\,1ICES PERMIT#: MEC2002-00419
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DAI E ISSUED: 9/23/02
PARCEL: 2 S 103AD-04000
SITE ADDRESS: 13040 SW 107TH CT
SUBDIVISION: PATHFINDER ZONING: R-4.5
BLOCK: LOT: 030 JURISDICTION: TIG
CLASS OF WORK: GTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATEFS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORSHOODS:
FUEL TYPES _ 0 - 3 HP: DOMES. INCIN:
3 - '15 HP: COMML. INCIN:
MX: 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 furnace with like kind.
Owner: _ FEES
DELBERT MCCONNELL Type By Date Amount Receipt
13040 SW 107TH CT PRMT CTR 9/23/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 9/23/02 $5.80 2720020000
Phone:503-444811 L Total $78.30
Contractor:
COLUMBIA HEATING + COOLIE',-3 INC
8900 SW BURNKAM
TIGARD, OR 97223 _ REQUIRED INSPECTIONS
Ideating Unt Insp
Phone:624-2704 Final Inspection
Reg#:LIC 76359
PLM 34-175
This ')er nit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This perm,t will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. 'Niose rules are set forth in OAR 952.001-0010 through OAR
952 01-0080. You may obtain copies of these rules or direct questions to OUNC by calling
lrin l9[.R_Q11tQ
Permittee Signature: .
Call (503) 639-4175 by 7:00 P.M.for inspections needed the next business day l
Mech-inical Permit Application
T
�Datereceived: Y AS 09- Permit no.: ►-'e1,2
City Of Tigard ProjecUappl.no.: xpi date:
City of Tigard Addre& 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: B&La I Receipt no,:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type: _
Land use approval: _ Building permn nam
s
O 1 &2 family dwelling or accessory 0 CommerciaUindustrial 0 Multi-family O Tenant improvement
O New construction 16 Addition/alteration/replacement 0 Other
Job address: /0 7 Indicate equipment quantities in boxe,below. Indicate the dollar
Bldg.no.. Suite no.: value of all mechanical materials,equipment, labor,overhead.
Tax map/tax lot/account no.: profit.Value$ _
Lot: Block: Subdivision: *See checklist for important application informatiun Lind
Project name: jurisdiction's fee schedule for residential permit fee
City/county; ZIP: . P �_ M x l
Descriptiun and location of work o premises: Fil s N t
Est date of completion/inspects n;
Description t . Rees.onl Res.ouly
C:
Tenant improvement or change of use: Air handlin unit ---CFM—
Is
-CFMIs existing space heated or conditioned'?O Yep. J Nei rcon itionmg(site plan required)
Is existing space insulated?0 Yes Cl No A teration o existing A systen-
r t at er compressors
MECIIANICAL State boiler permit no
Business nantc /-Hb_k_ X1/4 0 HP funs IiTU;H
Address: 0 p &GO s o Ftrelsmo cdampers/duct smoke detectors
City: _ State: ZIP: eat pump(site plan reyuirerlj
rata repluce urnac urner TU/
Phone: Fax _ Z? C-mail: Including ductwork vent liner Yes Ll No
CCB tto.: 2` 3 "� rata rep ace re ocute eater -suspen ed,
City/metro lie.no.: 1,22.47- _ wall,or floor mounted
Nnme(please print): M'e-A Ientor ap Tlance other than furnace
ON cf gerot on:
t Absorption units BTU/11
Nome: _ 00A�.__S1_ooL�;7� `A!� ��y Chillers.____ HP
/ c'um ressurs�_____. HP
Address: Envirommental Environmentalexhaust aul vent at an:
City:+ State: ZIP: Appliance vent
PI. nc: l: ryerexhaust
0o s, ype re8-F t-5ert/ atmat
hood fire suppression system t— --
Name: (�D ti'�✓ �� Exhaust frin with single duct(bath fans)
Mallin address: �x Rust s stem a tart rom cutin or A
8 .� �. `��� Q � —-- 'ue p p ng and st ut on up to out cis
City: { / _ Slate ZIP: hype. LPG NG Coil
Phone: 11k1,11 Fax E-mail: ue i rin eat It add itiunaoverout etc
rocasppng(schernaticrequire )
Number of outlets _
Name: 1 er sit app. once or eyu pment:
AddressDecorative frep:ace
City: Stater ZIP_. nse_r_t.-type
uo std uveJpcllet clove _
Phone: Fax: I E-mail: a t♦er
Applicant's signature: O11e �7 ✓� t rx:
Name (print): �—
Permit fee..... ....... ......
of all Jurischctiotts accept crani cads,please call junkhcu 3n rut mute inrornutim notice:'nlis permit application
Visa pP Minunum fee............ ...$
❑ sa ❑MasterCard I ._.—
expires if a permit is not obtained plan review(at — %) $
credit
card number --- --L— within 180 da s after it has been
Expires n y State surcharge(8%) .,..$
—done of carto der u s wwn un c t tail $ accepted as complete,
TOTAL .......................$
CadhWider sipaturt Amount N44617 I&OW01
CA I'Y OF TIGARD 24-Hour —
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
—
Rec3ived __ _ Date Requested /_ / 0
— / BUP
AM__::L_ PM BUP
Location _ a ' f tJ /G 7 ` �— _ —
- Suite MEC
Contact Person Ph PLM
Contractor— _ _ Ph(. ) _ SWR
[Ftg
UILDING Tenant/Owner _` ELC r —
ooting —_ ---- -------
oundation ELC
Drain Access:rawl Drain ELR
Slab Inspe tes: 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 - —
PLUMBINd__
Post&Beam--
Under Slab
Rough-In
Water Service
Sanitary Sewer --- _
Rain Drains -
Catch Basin/Manhole ------
Storm Drain -
Shower Pan --
Other:
Final ---- - --— -- — ---
PASS PART FAIL _ --
MECHANICAL_ --
Post& Beam
Rough-In
Gas Line
smoke Dampers
VTASPART_ FAILRICAL _-
Service --_- -- __-- --_ ---
Rough-In --
UG/Slab
Low Voltage -- -
Fire Alarm — -
Final -
-_ ❑
PASS PART FAIL Reinspection fee of$_ uirod before next'nspection. Pay at City Hall, 13125 SW Hall Blvd.
— re 9
SITE —� �� Please call for reinspection RE:
Fire Supply Line - ❑ Unable to inspect-no access
ADA
Approach/Sidewalk
Inspector _ `Ext
Other:_ - - ------- _
Final _ _-_ --- IL- DO NOT REMOVE this Inspection r ord from the)��b site.
PASS PART FAIL