Permit i
IT MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00494
e•� DATE ISSUED: 7/23/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 102 B C -00108
SITE ADDRESS: 10265 SW BROOKSIDE CT
SUBDIVISION: WALNUT ACRES ZONING: R -4.5
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install A/C unit.
Owner: FEES
BOGNER, LES Description Date Amount
10265 SW BROOKSIDE CT [MECH] Permit Fee 7/23/2002 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 7/23/200 $5.80
Phone: 503 380 - 0608 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
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 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Permittee Signature: Issued By: / � ` � s 9 S4/7-(_, c
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bunss day
<(„
IVIcktlanic al Permit Appl' n
-- --; aN FOR OFFICE USE ONLY
...._-___
City of Tip trd t-t,v Received, ..,
.....
Phone: 5(
Datc/By: i --,/ WV Permit tslo,1\r‘Uf_a0 a ,./96/
13125SW Hall 8 vd., Tigard, OR 9: ,... C) C 0**C)'" Plan Review
Y...639.4171 Fax: 503. ::7 N...
Other Permit:
Inspection . _.ine: 103.639A175 \\\■ <,;S - :A:silltilfif\ Date/By:
Internet: www.ci. igard.or.us 'Sy, th
r io .....-_,.. ........... Date Ready/13y:
. NotifiecVMeod: Juris: See Page Z for
-1(/ lil
Supplemental tnformation
A''',C, -
. • • ?..:.... •, ; • .• .:•: •.:.';T RK .... '-q• : •:.C:011 , 1tNIERCiAL FEE* 'SCHEDULE - USE CHECKLIST
New c)nstru :lion Additio alteration/replacement
Mechanical permit fees* are based on the value of the work
[..] E
performed. indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other
mechanical materials, equipment, labor, overhead, and profit.
-'. .:' ,,:„ • . :',-.: ::'‘ .,CATEGORY Or o NISTRUCEIOIst ', - • .' ..:‘,:',i• •••:• , Value: S '
. - .• , .............,- •. . .••• •• ,.. •:. • ,■••.-- - . : :.- • • . : • .....',..'• ' '''
, / SYSTEMS FEES*
El 1- and 2 ily dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-,family 0 Master builder 0 Other: ,
Description Qty. I Ea. Total
.. . ..
1.1013; SITE IN.F.ORIVIATte& .;ANT) LOCATION :',.:,''' Y. ' ' ,", ',..' - Heati
I
Air e r h
Job site address: / b-2, , 6.4i
(o s - I ,,, 0 1 . o u ti-
onditio
' ite plan sh eat owing p pump lacement) 1 14.00
' •
City/StatetZIP: .-Utie...„..A..., 91 z_iz, 3 Furnace 100,000 BTU (ducts/vents/ 14.00
Furnace. l00,000+ BTU (ducts)venisl 17.90
Suite/bIdg.'apt. n ).: Project name:
Gas heat pump 14.00
Cross street/direc :ions to job site: Duct work 4.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel n ).:
Other fuel appliances
, . ..
•. . • :• ,.:: • • : . •,: : i . . t ' DESCRTPTIQN. -Or WORK... •. / • '•;•-• ;- ': - •,;.:';„,. •.... 1000
, .. _. , ..... . .• .. , , .,.
Gas fireplace 10.00
Flue vent for water heater or gas
il PZkL/ fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
, - •:. ,,,----- . . „:. • , ,..., , ... :77 , . ..: • . ..,.• , • -••_,..„, - •,, .. , ..., ., ..., • Chimnev/liner/tlue/vent 10.00
- TROPERTV .0\iVNEk':;' ..7 ; ' ' ' • ;, '*''''' , '": ' CrttN•leidili•-:•:••'-'' -":' .. •••:: • Othcr 10.00
Name: ,71 * -"------ 0 .7ela,
I . ° "V Environmental exhaust and ventilation
Range hood/other kitchen
Address:
equipment 10.00 _
City/State/2:LP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) ,.: kt,)- 0 to 0 i & -- Fax: ( ) toilet compartments, utility rooms) 6.80
El AkitkCANT1-. ,-.., . '',"' • " ;! '' , ' ,,,, 'Ll' ,. .COI`irTACT -PERSON' ''.'-;" Attic/crawlspace fans 10.00
Other: 10.00 , 1
Business uame: 3 ..., ,• , ,....,; _I .
e fl ' Fuel piping
Contact nam v e: t.
i c ta c v-c , .- 1 2 fi J . $5.40 for first four; 31.00 for each additional
Furnace, etc.
Address: 4 fvt i- ,-- ,:.- I .1 ei.,. X
Gas heat pump
City/State/22: 1_1 i , ..r i'- ,_..,^t, '2'14_ ej .- / 2.. .3 Wall/suspended/unit heater
i
Phone: (SD.; ) i Li u .- 7 f, C .1- Fax: : ( ; ) 6 S- i _ -?._ 'si 1. Water heater
'
Fireplace
E-mail:
Range
, .:::, . ,:. - .-'.••: .: ,;.,:i•'cON1F124cTO:p i. :i .:, ,.. , i. ..- • ,--. -: Barbecue
Clothes dryer (gas)
Business name:
Other: i
Address:
, • ...11 FEES*
.. ..
City/State/ZIP:
Subtotal
1 Minimum permit fee (572.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CC B lic.: .'' 6. S State surcharge (8% of permit fee)
' .,
'L L - L..4" - C' t 4:-- •
( . TOTAL PERMIT FEE I . .
Authorized 3ignati re: 6
This permit application expires ir a permit is not obtained within 180
dayS after it has been accepted as complete.
1 Print name: f - 1 - 1,..a . I. --f I, C" f ( c_ . Date: 71, .4 1 • Fee methodology set by Tn-Councy Building Industry Service Board
1Ariiiii4ing2ernuswEc•i errnitApp.doe 12./03 440-4617T (11/02/CONUWEB)
a - ci SILO 8GS E 0 S 2 url.eaH Rq TeT aBE:I0 irCI aa Inc
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SITE PLAN
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STREET
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Specialty Heating & Cooling, Inc.
9528 SW Tigard Street S
Tigard, OR 97223
Phone 503.620.56 4; Fax 50 3.598.0718
Hillsboro Phone 503.640-3607 Fax 503.681.0793
E'd SILO 86S EOS 2ui,eaH R, d6E =T0 bD ZZ ZnC
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
cr
Received Date Requested — / AM PM BUP
Location _/ U C o S Suite . 0 0 1 7 / — X 4 0
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ €nerd ) ELC
Footing a �3D - ®6 ®(S ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain D
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors �I� cc�
Ext Sheath /Shear f''�
Int Sheath /Shear IAA n n �< / Cj 7 4
Insulation S'
Drywall Nailing I �.
Firewall /' D���
Fire Sprinkler ( (_
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final j
PASS PART FAIL C -
PLUMBING
Post & Beam
Under Slab
Rough -In /1/17
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
- R. PART FAIL
CT r; L
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
S RT FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector �� , �� : Ext
Other:
Final DO NOT REMOVE this Inspection record from the b site.
PASS PART FAIL