11105 SW 109TH AVENUE i
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11105 SW 109"' Avenue
\ CITY OF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SEWCES PERMIT#: NIEC2002-00136
- 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/5/02
PARCEL: 1 S134DB-04200
SITE ADDRESS: 11105 SW 109TH AVE
SUBCiviCION: CARNAHANS ADDITIO,J ZONING: R-4.5
BI.JCK: LUT: 004 JURISDICTION: TIG
C!ASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCU !�NCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: SOIL ERS/COMPR ESSOR_S_ HOODS:
FUEL TYPES 0 - 3 HP: DOVES. iNCIN:
LPG 3 - 15 HP: C ON".,VIL. INCIN:
MAX INPUT: BTU 15 -3) HP:
REPAIR UNITS
FIRE DAMPERS?: "0 -50 HP:
WOODSTOVES
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN -� 100K RTU: 1 AIR HANDLIN 3 UNITS _ OTHER UNITS: 1
FURN —100K BTU: `<= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas fui nace and install exterior A/C unit. Do not install
A/C within the required setback
Owner: _ FEES
LUTA, MICHAEL P Type By Uate Amount Receipt
11105 SW 109TH PRMT CTR 4/5/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 4/5/02 $5.80 272002000C
Phone:503-6P4-7875 L Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:620-5643 Final Inspection
Reg#:LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All wort: will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions .o OUNC by calling (503)246-9189.
Issue Ely: E' Permittee Signature: 6'
Call (506)639.4175 by 7:00 P.M.for Inspections needed the rf'ex business day
Flier t)3 0I;, 1 O: 1 0 a 5peo i a l t�j Hearing 503 598 0719
p•
Mechanical Verniit Application
City of Tigard
Pcrmi
City ofj1gard Address: 13125 S W Hall Blvd,Tigard,OR 91223 �oaeL�e PL no.: Expire date:
Phone: (503) 639.4171
Fax: (503) 598.1960 Dace issued;
BYE Receit,[no.:
i�yca t!(.. C Crse the no,: - _— -
Land use .Ipproval:BtTILD ► paymemcy�_
_ - - Bul,ding permit no
y4► &2 family dwellim� ercil/iI
Or accessory Ct::ommandustrial
n
0 New rotlatructiu �-1 Addition/al(cration/te lacement tiulG-f.1mi1
Y Q Tenant improv mcntt 14 1 gig= U Other.
Job address: Uzi
5 '-
Iadk4te equipment quantities in boxes below,I[,dicat>the,dcllar
Tux map/tax lot/account no.; sort[ no. value of all mechanical materials,equipn)enr labor,c cerhead,
Lot: Block; ptroftt. Value$
Pro•ect name Z Subdivision: 'Sae checklist for in, o
/� p tt[tr)t application into ration.red
Ciry/coo: 7- jurisdiction's fee schedule for residentful permit fre.
N ZIP: 9�.� A 3_
De riptinrr `n�1 lnC�iln 1 Of,uO , 1 t
promi e ;
E It.date of co IetioNinspection: ~'
Tenant improvement ur changeof use: Descriptleo Feet e) focal
Is existing space heated or conditioned'' vA St-c*J Res.on(v
Yes Q No Air handling unit ` _CFM
Is existing spice insulated?Aryes Cl No A[rcondiuonin sue plan rc ulrr
A teration n exesUn v a eten=-
Business(tamer C dol cr/compressors ^•.
�r-�-+ 01 Q yl State boiler permit no.:
�,.� LSI B7 sT --- HP
Tons
Address: GBTU/H
Ciry: ) i27 4' _ State: 4 �-�, ►rtJnulu c am ersi uct smo c electors
Phone C17o�a 3 eru um s to p an re
�3 G+,i05 F u;Sq ti,
1 C•mail: nstnl rep ace rirrnac urncr /
':CS OU.' S Including ductwork/vcnt liner
Cit /metro Tic nom. _ �' Instal replacc/re ovate leatcrs-suspendr , -
Name( le:lse pant) /'MA, t wall,or flour mounted
cn[ ora111ltancc o cr than mace
e 6oradon:
Name; r ue rHAbsorption units
Address: rot. �-w-- —� _ Chillers --- - lipU/ti
KP
C:�y: 7-� <ST Com ressors HP
Sta
Phone- ma! nnroumenul ex1Uht and ren at(on:
l'- yFax, Appliance vent
were aunt
nnic• ype i rcaTcitcheN� atm
Nie' q IILC— Z4 hood fire suppression system
Ai in Address: 111o5 44, Exhaust fan with sin le duct bath fans)
- - - •ehausc syseem opart oto hCrt ng or e
City, , c _b�_
Phone; -- state e Is u l an(up to�tiu(els) -
-9Y a rf i• fi m:�ih 1y- 'e �^� N0 Oil
x uel t In each ulnn over 4 out its
Name: "'j1b Ptp else emaner»�nirr )
Numbrr of outlets
- - -
Ot appi[Mice of eq pmro(:
_ J_7ecor'ativefire lace
.PM
_ st7(e; �Iv~ overt a
aX l;mall: tov a etstove
Ap Ilcant's sign ure qt �--_--
7 Date 4' Cr
�3
Na[nr 1_
( int): yK<< . /
• 'e.e,e call iwt�dieticn rx more initxmeyurt
Notice Ill's permit application Permit fee _ • •�,
<xplret if a permit in not obwwea Cvlittimum fee............... —
wilhin 110 days atter it hay beau Plait review tat `_ `,) $ -
accepted as compietc. State surcharge(8%) ... .$
TOTAL .......................$ _ 4_.
4-41•111 1 ltlmlcoM)
f1pr 03 02 1U: 1On Specialty Heating 503 5S8 0718 p. 3
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Specialty heating & Cooling, Inc
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640.3607 Fax 503.681 .079:
CITY OF TIGARD 24-Flour
BUILDING Inspection Line- (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)6394171 BLIP - -- - —
Received _ _ Date Requested_—� -- AM - PM — BLIP
Suite MEC
+_ocation _- 5- --- -
[�Q� i 'p� F'h( _ _--_) �- -� �--- PLM
Contact Person /,
Contractor___
_ Ph(_ ) �.._ �.— - SWR -----
ELC
BUILDING _
Tenant/Owner ---
Foot'ng J 5 LU ELC
Foundation CCt35S. ELR
Ftg Drain
Crawl Drain -- SIT
Slab Inspect n Notes:
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
PASS PART FAIL
MECHANICAL -- - --
Post&Beam
Rough-In --
Gas Line
Smoke Dampers
S PART =AIL -
-ECTRICAL
Service _
,. Rough-In
UG/Slab ---
Low Voltage - --
Fire Alarm
Final n,'•spectlon fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd.
PASS PART FAIL Unable to Inspect-no access
SITE El Pleat yell for reinspection RE.
Fire Supply Line Ext
ADA Date jS _ `�-.. Inspector
Approach/Sidewalk
Other: --- -- ---- -
Final DO NOT REMOVE this Inspectlo►t record from the Jobst®.
PASS PART FAIL