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16980 SW Matadrir Lane
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002-0,0122
13125 SW Wall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/28/02PARCEL: 2S1 16AD-15700
SITE ADDRESS: 16980 SW MAT/\00R LN
SUBDIVISION: KING CITY NO 17 ZONING:
BLOCK.: 19 LOT: 017 JURISDICTION_KIN
CLA iS OF WORK: OTR V FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL- VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUEL TYPES_ 0 3 HP: DOMES. INCIN:
LPG 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HPWOODSI OVES:
GAS PRESSURE: `'0 + HP- CLU DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: _ GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replace existing air handler with gas furnace.
Owner: i_ _ —�� FEES
MOEN, FRED E AND VIOLET J Type By _ Date Amount Receipt
16980 SW MATADOR LANE PRMT DEB 3/28/02 $7:1.5n KING CITY
KING CITY, OR 972.24 5PCT DELI 3/28/02 ;5.80 KING CITY
Total ---.—-$78.30
Phone: ---
Contractor:
ABLE HEATING + COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone.579-2250 Heating Unt Insp
Reg #:LIC 0011,)8535 Final Inspection
This permit is issued subject to the regulations contained in tht Tigard Municipal Code, State of (Ire.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This perrnit will expire if work is not started within 180 days of issuance, or if work suspended
for more than 180 days. ATTENTION: Oregon law rc Auires you to follow rules adopted in the Oregon
Utility Notificatwn Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-0]01-0080. You,may o4b ainlc pies of these rules or direct questions to C, 'UNC by calling
1.�en� :7dR-Q1R4
Iss a By' _ Permittee Signature:
Call (503) 639=u175 by 7:00 P.M. for inspections needed the n xt business day
03/28/2902 15:53 91036393771 CITY OF KING CITY PAGE 02/02
rkt-COUN
;fRVICEaNTER Mechanical Permit A plication ONLY
— —__� �. Ili,opol.
ureceival: Permit no.:)IVA ,?-eol.Rs
City of King City13125 SW Hall Blvd. 1a�aPPl no: Expiro dater
Tigard,OR 97223 te issued: By: Reexlpt no.:
Clackamas phone: (503)63911171,FAX: (503)F 7
Multnomah r p i lu" ase rile no.: Payment type:
V,',ishington� I3U'FEDIll G MIS! liilding permit no. -
Land use approval:
i C 2 family dwelling or accessary U Cotritnercialltndustrial D Mulri•faniily 0 TenAnt improvement
J New construction 0 Addition/alteration/replacement U ether:
DSITE INFORMATION COMM ' '+ VALUATION
777 Indicate equipment gllMAIUes in boxes below. Indicate the dollar
Bldg.
I)().no.: Suite ,r. value of all mechanical materials,equipment,labor,overhead,
Tax {�
ms /tax lot/account no.: ----�+�_-- profit. Value$
Lot: — Block: TSubdivision: *See checklist for t,. _;rfant application information and
Pro eet name: jurisdirtirm'.r fee vrh.•dule fr,r rerulentuil pernur fee.
City/county: - �,,.j,�t n 1 ZIP:' ")Plau 101
r t
Description ar dq o_cation of work on premises: 1 1 ' 1
CWS�` ace, --- - - Fee(ate.) Total
est.date of compkdon/nan. on; 27/Zvj --- fk_srriptioa Vtv.1 Req.r niv R on,'!
Tenant improvement or change of use: HVAC. 1
Is existing space heated or conditioned?U Yes U No Air handling unit v_-__ Cl_M
Air conditioning(sitelap requirer"
4
Is etisting space irsttlatexl?U Yes Cl No Alteration of existing HVAC sy�,e t
MFCHANICAL CONTRACTORof edcompressor
3usiness rtanie: .N ivic t ,� —_ State boiler permit no.:
_ e HP _ To_ns B TZJM
kdtdms: I aL'20 5,,J r�ir�tVcrnSt' �fJ` irelsmoke dam�erVduct smo a etecton
�lty; State:o(Z zip: �']2 Z,'3 eat pump(site plan required)
ty E-niall: nsta l/rep ace furnace/burner
ACEI no.: -�_ Including ductwork/vent liner Yes J No
`�53$ stn rep ace/re ocate heaters—suspended.
'ity/metro lic_. no —� _ wall,or floor mounted
Lame(please print): 4F 1 ent or tip ianie othei t an wnace
ON Refrigeration:
CONTACT PEM
Absorption units T _BTii/FI
lame: Chillers HP
lddress: Compressors _-- HP
nvironmeotul a east end veni o oa:
State: Zrp: Appliance vent
'hone: I Fax: E-mall: Dr.yer exhaustOWNER — —
R-,;, . 1*.pes ctiertrnazmat
hood fire suppression systrm
acne: r(p�. Twt✓� Exhaust fan with single duct(bath fans)
lalling address: �(v�"b0 St• N�1rl — Exhaust systr..rn�a art from heating or A
--- Ti ` Fuel piping and distribution(up to 4 outlets)
itv: _S� ate: (' ZIP:q 2?�1 — Tylx LPG __NO
Cil _
hotie. .6Y-2:05 1 Fax: F rnai l Fuel piping eac a di 'onal over d outTen
Process piping(schemer c reqL'ired)
Number of outlets _
Other 16ted app Iaoce or equipitd.n : ..�_
ddress- Decorative fireplace
ity: State: 71P: -insert-type,
ione Fax E-maiWoodslove/pellet stove
t e r. —_
yphrant s signature- _. � Daley ;,ZB d't� Other:
line(print). z)-r .•� t'Y� __.— _ -- —
all iurl+dlclee scretu credil card!.pleme✓-all iuri+dicaan Inr more info,"Allon. Permit fee.e...................S
M
Notice:This permit application MiNmum f'er ............S
iso U MasterCard expires if a permit is not obtained
Ill acrd number, — ---•�—�— wimin 180 day after it has been S Plan review(at __ %))
xprres State surcharge(8�).....S
_
Name of cud o der u+ own an credo accepted as complete card P �lettU
_� C44hoidrr. sianarurc 404617 f6ft&'Ohf
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP —
Received Date Requested AM -__ "____ - PM BUP
�� 9 9v' u 61_.Suits MFC c�00 C iv
Location _ -_ ----
Contact Person — Ph( ) PLM _—__—
Contractor__ � — Ph(--) 7 SZ _ SWR --- - - —
BUILDING Tenan r �_ ___--_- ELC
Footing— ------ 7 - -2 Z -r7 ELC
Foundation -
Access:
Ftg Drain7-�; 9 --Z- Z 5Ci / 7 Z ELR
Crawl Drain �__--`_.�
Slab Inspe ion Nates: SIT - -
Post&Beam
Shear Anchors
Ext Sheathl3hear -
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 1
Sanitary Sewer
Rain Drains - -- -- --
Catch Basin/Manhole
Storm Drain ---
Shower Pan --���__--
Other: -—�
Final
PASS PART FAIL —
Rough-In
Gas Line
Smoke Dampers _-
a
PART FAIL -- ---- - - -- ----- ---
L_ ICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm —
Final Ll Reinspection fee of$ _--�_ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd.
PASS PART FAIL
SITE [_V] Please call for reinspection RE:--- _____ Unable to inspect-no access
Fire Supply Line ----
ADA
Approach/Sidewalk Date _. ..___... Inspector ___.�__. Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL