Permit P CITY OF TIGARD MECHANICAL PERMIT
riek DEVELOPMENT SERVICES
PERMIT #: MEC2004 -00197
III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/20/2004
PARCEL: 2S1 12 B C -02100
SITE ADDRESS: 14675 SW 84TH CT
SUBDIVISION: HAMBACH PARK ZONING: R-4.5
BLOCK: LOT: 005 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: AC unit install
Owner: FEES
NESBITT, DAN & JOAN Description Date Amount
14675 SW 84TH CT [MECH] Permit Fee 4/20/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchari 4/20/200 $5.80
Phone: 503- 968 -1881 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 - 640 -3607 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. ,� 1
Issued By: Permittee Signature: �j
(4i/ G)
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
rde hanjcaJ Permit Application FOR OFFICE USE ONLY
Received . 4" Mechanical
! • .. Datc /ti : 1 / / p Permit No.: 44-50/97
laity of Tigard ` O Planning - •pro al Building
13125 SW Hall Blvd. `� Date/By: Permit No.:
Tigard, Oregon 97223 Plan Review Other
Dat�y;
Phone: 503 639 - 4171 t` -..D. 3u3 ■t1\�
Post-Review "Permit No.:
Lana Us '
Interne : w �� ',➢ f:4ry ;r4r)41 Datc
ww.ci.tigard. r.us JJ Y Case No.:
Contact 2z:- 110u:• inspection Requeet: 5Q '-639 -�I P ^'• Nap a /Method: - `� 5 � 1 u See Page 2 for
Supplemental Information.
' T1FPE �I2IC.: ' . •COMMERC[AL'FEE' SCi DUI:E - USE CHECKLIST
Li Nei v construction rDemolition Mechanical
permit fees* are based en 'the total value of the work
Adt lition/alter •laeement Other: performed. Indicate the value (rounded to the nearest dollar) of all
•
FM :'C"AT>EGORY CO1�TS)<RUGTXUN ;: ;; ;< . mechanical materials, equipment, labor, overhead and profit_
2- Family dw Commercial/Industrial � Value: $ See Page 2 for Fee Schedule
Accessory Bui ldin • ■ Multi-)~ anvil RESIDOEN, TAL E.QUI P111:Nr/s1 FEE» se
tIEAi i :.
Description "1
C
7y ter Builder ❑Other: Q y Feeler.) [_ Total
. JOB'SITE•INFORMA'Y'10N,i[it1 I:OCATION''': ' Beptin
Job site address: (-1, . - LJ F urnace - d -on air conditi * 1 14.00 _
hr•ai u
Suite II: Bld / � � (i: ig 14.00 '
$. Apt. #: Duct work
14.00
Prue Name:
1i. ydron is h ot water system 14.00
Cross slreet/Directions to job site: Residential boiler
(for radiator or hydronic system) 14
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdiyii,ion: I Lot #: fair units
12.15
Tai; mad /parcel #: Other Fuel Appliances
• .r , D1C5C _ . water heater
RIPTION.OF.1�!'UIZK -: . .. 10.00
Gas fireplace 10,00
L ` L � Flue vent Swayer heater /gas fireplace) 10.00
c7- E� e. t /� Lo li htcr as) 10.00
y
Wood/Pellet stove 10,00
Wood fire lace /inset 10.00
_ [] �ROPI ?RZY.OwxER: .. Chimney/liner /flue/vent
J' :.''ruvANT' .i s :::,,..;:.`,; ,.. her 10.00
�� ` — Other:
10.00
Narne:
e.. (. ' H _ Environmental Exhaust it ventilation
Address C�Lrv-g__ Range hood /other kitchen equipment 10.00
City/Stu .e /Zip; Clothes dryer exhaust 10.00
Phone: 9 (, - g' y Fax: Sinslc duct exhaust
PPG I1:11YT . _ (bathrooms, toilet compartments,
Name: ERSOI!1 °. " :: util rooms)
Attic/crawl s ace fans 6.80
Address: Other: 10
City. /Stat a/ zi p; 10.00
Fuel Pip1a�
Phone: _ **MAO for first 4. S1.00 each additional)
Fax: Furnace, etc. r*
E-mail: Gas heat pump **
1
CONTitACTO ' .i:. " ' Water heater heater
Water heate
Busi cress Name: '--1,,
( • c ..
r Fi re la
Address: J Le i, S< *•
�i v r r F , Ran gy Oth **
• City /State /Zip:_ I-F! 6 (S' 1 6- - c B�Q *.
PlaOne " 4 7 t-, Z � -- Clothes d er as
C Fa�C: (r3�' i -- O ? '1 3 Other: *
CCB Lie. # : - S _ I,*
Authorized Total:
Signature: .Lk-,d-A-.'-2--- t Mechanical Permit Fees
(/ �,. _ Datc:y'e 1 r ~Z Subtotal $
'{ '- �'` D L ��� Minimum Permit Fee $72.50 S - ) \�
'1�
Plan Review Fee 25% of Permit Fee S
(Please print nae) State Surcharge (8% of Permit Fee) _ $ b
Vence: 'this permit application expires if a permit is not obtained within TOT 'PERMIT FEE 4
*Fee methodology set by exterior ounty Building Industry Service Board.
ISO days after it has been accepted as : Dsts P. :rmit Farms\MecPermiitApp.doc 01/03te. *, g
Site plan required for exterior A/C units.
z' d SILO S6S EO � uzzeaH R ieioadS eOSt60 470 ST .ldd
SITE PLAN .
PL
I
\ r ---------- ,---L---1 ..:,...
1
'(
.;
PL � J 0., ,
1
1. 1 PL
i
6p,A L.
to•.�.....
i \ • Iv/ ,
/
.---- 1
/Z ,
PL
STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
F[il:_sboro Phone 503.640 -3607 Fax 503.681.0793
E'd SILO BS COS 2u32eaH RzleIoadS eOG :SO b0 Si -add
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Re ested �( AM PM BUP
Location / lv / � 7 � Suite MEC 4i2o/q
Contact Person . Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing •
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing / ' (:e7( Firewall t i ail // i/, ; / , j / / �; Aft/ G� /
Fire Sprinkler r -
Fire Alarm
Susp'd Ceiling
, (4
Roof fi4d / 2
Other: -
Final
PASS PART FAIL ( / ,i
PLUMBING L ���z r_ 6t LA
Post & Beam
Under Slab
Rough -In S
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P PART FAIL
Post & Beam
Rough -In
Gas Line
Smo.e Dampers
E ic i V PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /� / / -v
Approach/Sidewalk Date ( ` - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24- Hour
BUILDING Inspeclion (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested " ✓ tS AM PM BUP
Location l - ((.0 7 S 0 c Ctt Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 00 y y.3 C
Footing
Foundation ELC
Access:
Ftg Drain S ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling , j
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab -
Rough -In
Water Service
Sanitary Sewer CI 4J r�
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART—TAIL
(ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F = • farm
"ASS PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date , i Inspector (3 j " �`= L Ext
Other: ���JJJ
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL