Permit CIT ' ? OF TIGARD MECHANICAL PERMIT
' 6-. 4. � e. DEVELOPMENT SERVICES PERMIT #: MEC2004 - 00098
e-I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/4/04
PARCEL: 1S136DB-01600
SITE ADDRESS: 10855 SW 74TH AVE
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas furnace, duckwork and gas line
Owner: FEES
DORRELL, DON Description Date Amount
10885 SW 74TH ST
TIGARD, OR 97223 [MECH] Permit Fee 3/4/04 $72.50
[TAX] 8% State 3/4/04 $5.80
Phone: 503- 670 -1739 Total $78.30
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503
Duct Inspection
Reg #: LIC 108535 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 (S03) 639 -4175 by 7:00 P.M. for inspections needed the n - business day
' - -03 -04 03 :17P ABLE HEATING & COOLING 503- 579 -9104 P.O1
—. llf, ‘ .._ .—. • - • .
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� Me t+ ' al 'er�mit Application .
r EVE DatL eoeive il . Permit nor / d _ _ D
•}t1 = Ail City af. Tigar. are e
tlappl. no.: Expire date,
City of Tigard Addres"s: NM SO/ illalh yd , Tigard, OR 97223
f�
Phone: (503) 639-4f/1 r{� Date issued: 13y: Rece pt no,:
Fax: (5 (�)` 0 S Case file no.: Payment type: •
(Y) . IGARp — . —
N Lar)C t` th i/ sic Building permit nu_:
TYPE 01 r►:It ii r
54 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
'0 New construction ❑ Additionfalteration/replaeement ❑ Other:
1ORy !1!i1,\IOI4X1:1fION ('O1l,1l1IUltI. 1':1i1.t'1JO, \' S('111Eilla.
Job address: • g Li Indicate equipment quantities in boxes below. Indicate the dollar
_ Bldg. no.: Suit: no.: value of all mechan aI materials, equipment, labor. overhead,
Tax mup/tux lot/account no.: profit. Value $ .
' Lot: Block: 1Subdivision: ''See checklist for important application information and
Project mane: jurisdiction's fee schedule for residential 'crmii fee.
Cit /county: , ' a ZIP: tl 2_2 1 A. 2 4 41111.1 DIVE:I.1.1NC P1111.11 1 11:i M('II h:I)1:LF •
Description and v ocation of work on premises:lrt a t .._. ANI) t (1N1111:111('. ;1. /INfli ti 11. l.O1 l I'MMI�:NTSt'III:I)1'1 I.
Fu./ /K� X Di )c &( } � . f L 4.7K_ 1;ee(ea.) Total
Est_ dare of completionfinspection3 //0/04 r VAC: ____ Ik ctlptlon Qty. Rea. only Res. only
'recant improvement or change of use: N
1s existing space heated or conditioned? D Yes 0 No _ Air handling unit - CF
1s existing space insulated? D Yes Q No Air conditioning (site plan required)
Alteration of existing lIVAC system
Boiler /compressors
Business name: Suite boiler permit no.:
h �� HP Tons BTU /I1
l ,n_ l tin� • CVCierIC. -
Address: \�i c ,..) Sv.;-; Cde4/- .:?<• � Fire /smokedampers/duct smoke detectors
• City: T ; State: &at 1 ZIP'1)Z7 ` neat pump (site plan required) _...
Phone: `iJ5 5)� '?.�Sfl Fax: 3 :7`1 °llacj f 'snail lef{t .L install /replace fun B.ruiH --
Including ductwork/vent linty Ycs U No li
CCB no.: I �4 . .._ - sp
ills I nstall /replace/relocateheaters- suspended,
City /metro tic, no.: _ wall, or floor mounted
Name (please: tint):' { ;,k, • Vent for appliance other than furnace 1
Reffgeatloa:
Absorption units IITU/H —.
Name: Chillers - HP
Address: _ Compressors - HP
. - Environmental mamma and ventilation:
City: State: ZIP: ,_Appliance vent
Phone: Fax: E -mail: Dryer exhaust -
Hoods, Type l/ [tires, kirchcn/hazmat
hood fire suppression system
Name: D 0;3 !rK_li Fxhaust fan with single duct (bath fans)
Mailing address: d e. ' _ 7 Exhaust s . tem a.: from heatin , or AC
City: State Q� Z1P 772. 4 ' ' p ' • and t on (up to 4outlets) I.
Type _ LPG 3 NG Oct
Phone: Mitallinli Fax: E -mail: A i d . i in - each additional, over 4
1.'\f;LN1-.•:11 rocevomp •a (schematic required)
Number of outlets
Name: Other listed appliaiee or egttlpment: —_._
Address: _ Decorative fireplace
City: State: ZIP: [oxen - type '
Phone: / l; mail:
W rorlstove/. llet sto ve
t or:
Applicant's sig ature Date: ey c : + -
Na (. ' nt): • MI,
_
' Not an janadbaicea accept credit cards, please tali inrledkiic i rnr, more inforrne Notice: Phis permit application Permit fee $ �• ' .0
O Visa U MasterCaral expires if a permit is not obtained Minitnutn fee $ --- Coedit card number; f / Plan review (at .. - `76) $
8xplie within I80 days after it has been State surcharge (S%) . . $ S . 'v
Name at ardtcoider as shover on endlc card necepted as complete. $ TOTAL $ 11 c
Csdbolder aipoal.ne wpm
44o46I (6A00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received 2 ' g 0 ? Date Requested AM PM BUP
Location 11 ' � Suite er. — 1l •°
Contact Person 42 Ph (_5.? SSZ? _ 0 a g
Contractor /� Ph ( ) SWR
BUILDING Tenan'Owne 4l 77 cz ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam //DDD2z l
. —�/lit- " e
Shear Anchors 2 7�C ��
-/,/
Ext Sheath/Shear
Int Sheath /Shear
Framing •
Insulation `/` b -
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P Ec FAIL G
UMBI►
Post & Beam
Under Slab
Rough -In
tA?
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other: CNtl \A yj L(�
'ART
ECH L
Post :eam
Rough -In
Gas Line
pers
I an PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 1 1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date ✓ Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from t, Job site.
PASS PART FAIL