Permit CITY OF TIGARD
MECHANICAL PERMIT
rrA DEVELOPMENT SERVICES PERMIT #: MEC2004 -00219
�` „ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/27/2004
PARCEL: 1 S136AD -02200
SITE ADDRESS: 10450 SW 71ST AVE
SUBDIVISION: VILLA RIDGE ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
LPG 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: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Furnace and AC install. (1) gas outlet.
Owner: FEES
SAMPSON, GENE E AND MARY K Description Date Amount
10450 SW 71ST [MECH] Permit Fee 4/27/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 4/27/200 $5.80
Phone: 503 244 - 3751 Total $78.30
Contractor:
ADVANCED HEATING & AIR COND
5825 SE FOSTER
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 - 235 - 0060 Gas Line lnsp
Heating Unt lnsp
Reg #: LIC 98573 Cooling Unt lnsp
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Sent By: HP LaserJet 3100; 503 774 4391; Apr -26 -04 4:34PM; Page 2/3
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 2 ° Date Requested VAM PM BUP
Location l 4 6' � 2/ S7 Suite s f(0,2 —
Contact Person Ph ( ) 7 T�/6 PLM
Contractor Ph ( ) e7/V- & 757 SWR
BUILDING Tena • 0 ner ✓i ,.. &,Pday--00.?-f
Footing ,,/ ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors /J►z c_
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
172
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam h ' ('� '
Under Sl ` ��,`' <' S
Rough -In t j V
Water Service � GSA
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
. ..._... Dampers
Fin. _
4 ' . - T FAIL
LECTRIC
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
1 PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line _ /
ADA Approach/Sidewalk Date-- O Inspect' � - / L� . " Ext
Other:
Final DO NOT REMOVE this Inspection record rom the ob site.
PASS PART FAIL
Sent By: HP LaserJet 3100; 503 774 4391; Apr -26 -04 4:35PM; Page 3/3
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