Permit CITY TIGARD MECHANICAL PERMIT
7 ° I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00006
S� 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/6/2005
PARCEL: 1 S135AA -03705
SITE ADDRESS: 10385 SW 87TH AVE
SUBDIVISION: ASHBROOK FARM ZONING: R -4.5
BLOCK: LOT: 012 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Reconnect furnace.
Owner: FEES
ROMERO, MERCEDES G AND Description Date Amount
MOLINA, MARTHA A [MECH] Permit Fee 1/6/2005 $72.50
10385 SW 87TH AVE [TAX] 8% State Surchari 1/6/2005 $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating 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.
Issued By: �� pG ) Permittee Signature: .Sot pye
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
09/25/2000 09:54 FAX
_ lA001/002
Mechanical Permit Application
FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Nall Blvd., Tigard. OR 9 te NE „
'. ID D.,,,,,,,,, . 05 ..._ Permitt4o,Ak .. - yaks -- -,,,,, ,•
Plan Review t
Phone; 503.639,4171 Fax: 5
Other Permit: •
DatelEty:
Inspection Line, 503.639,4175
,:-..- : . / Date Roady/liy; nets: 2I See Page 2 for
In ternet: www.ci.tigarc1.0r. US
Notifiect/Methodi
1.1 A14 6 V6 i 1( [ Syppleinenter forermatio
:•.-4;:::.:I: ', .: r•Ilu: ,, ,111;"i7;,r':•::-1:7'1.t.'"'''.1;41.1,1',", ,1 •'''',. ;;VPIO1)121aiiCkAt * *Ei' ..; ,'SCAP1•1 4 .1th:E TaSEiCI:MCI
I I' . NY
0 New construcrioll t .pr" ' 1test‘t Mechanical permit fees* are based on the value of the work
CI Demolition 111 • sm.. G D performed, Indicate the value (rounded to the nearest dollar) of all
th
mechanical mitten:Is, equipment, labor, overhead, and profit.
:,. ;.",", : • 1 . ,- ,700iitl i y. " 0 1 :0 01• 4.571MC - 00/4',' 51 1[..P: -. • , '-'■4:'',.8,';;',Iilr ..',.7, ; • . , . . Vallie: S '
I (I
Itii10034:44, t.irPNT i SYSTEMS-FES
11 O n*
IC] 1 - and 2-family dwelling 1:1 Commercial/indusrrial 0 Accessory building
For special utformation use citercklisi,
El Multi-family Ej Master builder 0 Other:
Description Ea
---- Qty. : 1 71 Total
04, 4fi O rli :.P , Q...: 7 .11' . .':' -' ''' Fleming/cooling
Job site address: ) 03 Cr Sc/,./ .••. 7. fr . k 035(c Air conditioning or heat pump
(rguires site plan showing ptacemon0 ... 14.00
City/Srate/Z1P: 14; r( 0-At-. , Fumace 100,000 BTU (duets/ve i nts) 14.00
,
Furnace l00,000+ BTU caws/vents) 17,90
Suite/bldg./apt. no.: 1 Project name:
Gas heat pump 14.00
Cross street/directions to job site:
Duct work 14 00
Hydronic hot water system 14,00
Residential boiler (radiator or
hydronic) _ 14.00
Unit heaters (fuel-type, tripe not elecc)]
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above _ 10.00
Subclivision: J Lot
no.:
Other: 10.00
Tax map/parcel no.:
Other fuel appliances
,, i ,—iiW O
c t urr io i 4 -op wokK,..... ,:....,, 10.
' ,::•L ; N.C . . .'ik; .. - ..- ..,..,.... • . '!‘:' ., . . `r •4 Water heater 00 • ••3 , . % ,..1 %. , ...tig, ". lei . - '
Gas fireplace _ 10.00
Flue vent for water heater or gas
i-e/LALAA—At
'1.----- fireplace
------. Log lighter (gas) 10.00
10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10,00
. o 10.00
. ,,,.:. Chimney/liner/Sue/vnt
" '.'f':5,1.■ ' .-.A.ct- ...tv':ut!" ,,' i'''''''4"' Ocher: 10.00 .
Nate: r." 6 e9,4_,..}.4 Enviroarriental ezhauSt And ventilation
•
Range hood/other kitchen
Address:
equipment 10,00
Ciry/Statt/ZLF:
Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms.
Phone: ( ) 1 ( 72 - - 7 17 f- Fox: ( ) toilet compartments, utility rooms) 6.80
117.,4,--;i' e:.:M -14,itlek. ii1 ,.' Attc'icrawisZ114"11n5 10,00
Other: 10.00
, .
__
945iness nan3c: _ fr -4.. C' ._- e- l. ii--i_ (:-/- (7 el- f .. .1 . ti. .1
1 . Fuel piping
-
Contact name: I I S - 14
,-) 1 i.
- R ri . $5.40 for first foul $1.00 for each additional
‘-
ut 6 i t ‘'''''" .
Furnace. etc.
Address: A- rNxi. "-C. z- t:.' i _S" e..i. k
Gas heat pump _
City/Sure/ZIP; 14 1 C i" ,... 011. • q 7. / L. 3 Wall/suspended/unit heater
Water heater
Phone: (50 s ) L ci 0 __ 7 t., c 4_ Fax: : ( 9:q ) u_ ,IL i -. c ... 1
_
Fire - lace
E
Range .
"
7 ;,.4 2 „1„L '. i : P
' Barbecue
Clothes dryer (gas)
Business =me:
Other:
Address:
':.,.iir'--.. " :'
City/State/ZVI
Minimum Subtotal
inimum permit fee ($72.50) 4 ) 7
Phone: ( ) , Fax: ( )
Plan review (25% of permit fee)
CCB tic.: 6: 6- S 7 r State surcharge (8% of permit fee) • Pi)
TOTAL PERMIT FEE - 1- - 3 10
Tide permit ennlicedon sxpirea I[. pocmIt II nut .b1 wIthln 150
Authorized signature: ( kg...K(1z ....L.,' _ C (4.-c.. 1 '
days a fter it has been accepted as complete.
Print name: f; ilSt. P t-t--, C IS C.- 1/ i ft i ` Fee methodology set by Tri-County Building Industry Service Board
kinudoirieiP.miununc-rertni,Aop.aue lams d4:1.2617T ( 1 1/02/COM/wEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: ".(503)•639 -4171 MST
BUP
Received Date Requested 0 - /1° AM VPM BUP
Location / 35?:_c R7 Suite MEC2/ 6 e
Contact Person (. Af-G Ph ( ) Yo - -3(=3. d 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: ��
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear M f N o /� L az _ s 7 g / . �
Framing I
Insulation S
Drywall Nailing
Firewall
Fire Sprinkler
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: G
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S .e Dampers
/- PART FAIL
TRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final L Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: r / III Unable to inspect — no access
Fire Supply Line /� ll r
Approach/Sidewalk D ! " v Insp ector L _� ) Ext
pp dewalk
Other:
Final DO NOT REMOVE this inspection record fr , m he Job site.
PASS PART FAIL
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00006
atig; s 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/6/2005
PARCEL: 1S135AA-03705
SITE ADDRESS: 10385 SW 87TH AVE
SUBDIVISION: ASHBROOK FARM ZONING: R -4.5
BLOCK: LOT: 012 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Reconnect furnace.
Owner: FEES
ROMERO, MERCEDES G AND Description Date Amount
MOLINA, MARTHA A [MECH] Permit Fee 1/6/2005 $72.50
10385 SW 87TH AVE [TAX] 8% State Surchart 1/6/2005 $5.80
TIGARD, OR 97223
Phone: Total $78.30
tik % Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 - 640 - 3607 Heating 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.
issued By: � ?/. 312:, � Permittee Signature: \-� c'\
Call (503) 639 -4175 by 7 :00 P.M. for inspections needed the next business day
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By _ Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls _ Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post /beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing
Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG structure set-up MEC - Mechanical Permit
Insulation
Drywall nailing Inspection Description Date Passed By
Suspended ceiling _ Post/beam mechanical
Engineered soils Gas line
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final _ Duct work
Structural observation _Smoke detector
Fireproofing Lab Final Mechanical final
Final inspection
PLM - Plumbing Permit
Al BUP — Fire Protection System Permit Inspection Description Date Pass By
_ Plumbing underslab —
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab
Sprinkler rough -in Post/beam plumbing
Sprinkler final Plumbing top -out
RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
- 4 Inspection Description Date Passed By _ Culvert /catch basin
Footings Pump/fill septic tank
Foundation walls _ Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils AI Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \forms \InspRecordBUP.doc 04J17/O1