Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00625
,I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/17/2004
PARCEL: 2S 112CD -01300
SITE ADDRESS: 15905 SW 79TH AVE
SUBDIVISION: DURHAM ACRES ZONING: R -12
BLOCK: LOT: 004 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: 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: Installation of gas furnace and gas piping.
Owner: FEES
BUCHANAN, MICHAEL R + SHEILA M Description Date Amount
10525 SW TIGARD ST [MECH] Permit Fee 9/17/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/17/200 $5.80
Total $78.30
Phone:
Contractor:
SUN GLOW INC
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 253
Heating Unt Insp
Reg #: LIC 48131 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 -00 a., OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24: -6699.
Issue. By: • ,p2 y I � � / Permittee Sign. • e:
Call (50 9 -4175 by 7:00 P.M. for inspections needed the next business day
09/16/2004 11:06 5032537693 SUN GLOW INC PAGE 02
unJ JL; eVU4 Ua :40 rl►As bUde`JtUVUV (;l'1'Y Gt TIGARD 2001
k al Permit Aro cat ion FOR OFFICE USE ONLY
City of Tigard
503.b3g -4173 C .` fiareivxl
"''v ` Daed9 - 9 o PermitNe.: � ��
• 13125 SW Nall 131vd_, Nord, OR 97 f1, �C G 1 -
Phony 503,639.41,71 Fax: 503.595 Revin"+
fl, %:11�,A.,7 ,, I+ Pi rgerBy; Other Permit:
I:impaction Liao. l
Xntcrnet: w w.ci_tigard_or.un S r 21 ''� �� A ttto Ae°dY� a rum' R.f gee Page I Information
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El New construction gA.:1i j on a) teration/replacenlent Mechanical perttit fees* are based etc the value of the wink
f
❑ Offer peranrlcd. Indicate the v alue, rounded to the notmsst dollar) of all
❑ Pemolition ( )
mechanical maecrin,ls, equipment, labor, pvrthcxd, and pre - it.
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1- and 2-family d �] Corumercia1/i idustxiai Accessory building ; ' . I e I , i 1°e ° ' c ° !�' ,. o . t /e 3• g g•
ID Multi- ly ❑ Master builder [] Other; For rpec gI information use nlittC(rl tt.
l,• ? Ip.;, gVi; ^llt " "tiVi }':') " ;; " +, ri,L9Lm:c�4:., - - Descriptloll � 6a Tafal
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yob site address: ' 5g Q t / lb ^ t __ - f Air conditiCnitig or heat pump - `" "
1 ( xegdm si[ plan ehaw nk ➢laea 1 - 00
City/State/ZIP: l / 0 Flamm 100 BTU drutaivexts IN
5lutelbldgJapt_ no.: P r o j cct mum: iaee 100, 000" BTU (doece/vente)� 17.90
— - ---. Gras heat Dump 14.00
Cross streeddirections to jab site: - _ � - I Duet work J 14.00
W. dronic hot wa y 14.00 I
Residential boiler (radiatar or
hydrottic) 14.00
Unit beaters (iliel -typo, not electric),
in -wall, in -duel aospended, et.. _ 10.00
-
Subdivision: Lot no.; F1ueJvent for nay of above 10,00
TV Alap/parrel no.:
Other: _ , 10.00 - v_
11;?0jtea: :'I , I - ., ^ a. ^: -.i. � _ I:"" fuel appiiattces
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. - _
•?M,,.1h,.,,. ,ail:' ' L d'At6'l: �l' - y 1i� .., 46 . . fe : irJl�.111 ,. :;I Waterhearxr
�1,i :i15 i "'t�u:;:t:i.•`i1a.�:��.n.i,v,� ,. ;�, �ill,� -1 1 .,, �•r, { 10.00
. r� 1 G as firep 10,00 •
1 • Al / Flue vent for water floater or gas
ft replxaa ._ 10.00
1 ti te ash 10,00
' Wood /pellet stove 10.00
Wood fi'IeplaceJinsert 10,00
p : + • rf1yI` e • 1 " 'I•r;,LT J ::� :y .. 9u p, m, 'i , tyx..^
A! n •r ii +9� i:i7 � 1e „ ;: ,I �,r - +7Ai :. Chittuu)r>liner' /flvavettt l
yl'k' . i,l ..� ,t,,, i.4 . ti i It Ly/ :.6..i r ! I lan 4 , k zl T ' l 0.00
J',h, Y.'.::i:,.1L L. _..rLli r.. u. l,., �rl rt:. a ..;5�r .; .ti
N21312 A21 / A � ,. Other: 10.00
ii � • • +w . A a l ■ i • A Environmental exhaust and ventilation
Address: r .0,0'... 1 R+lnRc 1,00dlother id tchee
ll e4uiPrnr+lt 10.00
City /Stare/ZIP; /rI # • � v 1 .�. i3 Clothes dyer exhaust 10.00
( ,� ! , ray.; Singl&dilut exhaust (bathrooms, • Phone: k a .. • D toilet campsrGncttta, utili rooms) 6.80
l,�, [•.y " ", T�' ^1 °' "f "j' " "5r•:';r�.. 'li: :li ,`l':,'ji7rra :cr +" ,;°: ° �': ' Y' " 'ia - ;: ;'q•i •'1a :7•:d:�r - ^,m --
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� 5 t::'lliil. , , d- F�1 { i , 1;• I LT lilia' i l- ,i." _ , is 6J n�.II � i'x il, � l . Attitl�eraVriAr „e fans 10,00
MIN I
Business male Oth 10,00
- 1 Paw piping
Contact name; 1 $5.40 for Glrst four; $1.00 for each additional ,. -
Address: rum Arc, etc. j . - .r
Gait heat purlre_ - AY
City/State/ZIP: Wail/suspended/unit heater _
Phone: ( ) 1 pax: ; ( ) Water heater --..__K. --
E -mail: Fireplace_
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Business name: (� la (� IDW__ yr r , Clothes drye gaS)
l 1
Addresgl 'Li Z O S r ID D �.(/� Cl her: . „
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ty 1 �Y �Fl."L4 L '" _ } `ti ' ` : rp4,."• w i 4 . . .', , ..... l�. •,r_p , ,.:ii?:::: .�
Ct JBtate zrp! Y _ -7 2 t - - ..
c,� � Subtotal f�t��
Fhetae: �/} 3 - �� p F�,c: r te ) 2�3 - 7 b � -- , -, Minimum permit fL' a (572.50) •?Z -,
/� Q 12 w Nail review (25 °rC, of permit fee)
CC$ 1ir.; 1 t U L y C -- - State su (S% of permit I' ) Y
y n ��� TOTAL FER IT PEE R ...3D
Authorized si,g�naRUC: • , ,, ', RJ �./(IL This peren:e.pplicstior expires ti por.vlt Is not obretn«i within 1 i4
!-- - -^�
days after It Bon been accepted II camprrre,
Print bame: 6in a 4 0,01 0 )12 / )safe; - e h l I " Foe meth6dology het by Tri"r;,•pvnty Swid{ng t„rl, Service lloa ni
mitldinAvermilsVaC •Pnmil Arm,itr 1lm3 ¢tur,`\PJj ono. irr(
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (50461g:4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested ? AM PM BUP
Location /5" S 7' ' Suite p DQ 9 -.0d .2,5
Contact Person c ( ) 0- 77 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ ELC W--(
Footing ( r� — ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes L — — --5'Z _S
Post & Beam ' E =
Shear Anchors `I
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation v V 1^n \ ("A-A /L, � 3
Drywall Nailing
Fi rewall ,)
Fire Sprinkler L 03 �i�r'�` -r '��{ -2:- 23 s. - 4 1._ Mdi %4- �'e'Tc ti
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 RT FAIL
HA AL
Ro Beam
R ft,
o aas
Smo e Dampers
igaiP PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Li Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
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 job site.
PASS PART FAIL