Permit H y
CITY TIGARD MECHANICAL PERMIT
IA. DEVELOPMENT SERVICES PERMIT #: MEC2004 - 00058
xtliX . :1/1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/11/04
PARCEL: 2S111 DD -08800
SITE ADDRESS: 15835 SW 87TH AVE
SUBDIVISION: CHESSMAN DOWNS ZONING: R -
BLOCK: LOT: 014 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: 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: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Furnace installation.
Owner: FEES
HILL, LANDY C + TERI L Description Date Amount
15835 SW 87TH AVE
PORTLAND, OR 97224 [MECH] Permit Fee 2/11/04 $72.50
[TAX] 8% State 2/11/04 $5.80
Phone: 503- 624 -4143 Total $78.30
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 71878
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 001 -0100. You may obtain, copies of these rules or direct questions to OUNC by calling
(503)246-66'
Issued By: �� Permittee Signature: (.' �" t � ? - J . Est C 'j;
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
FEB -09 -2004 14 24 A TEMP HEATING 5035572990 P. 02/02
t it LJ [1I/0 LU t7 �i na.• +• - +�
Mechanical Permit Application Received , Mechanical
H LC O V E l) Dawn :. - i -0/ Permit No.: /716C.a -0C# -C -)c 5
Planning Approval Building
City of Tigard , Date/11 : Permit No.:
13125 SW Hall Blvd. FEB 0 9 2004 Other
Tigard, Oregon 97223
Permit Nu -:
past -Review Land Use
Phone: 503 - 639.4171 Fax: gb�YS4EI��tf9'ARD i t)atc /1) : Case No.:
Internet: www.ci.tigard.or.tt$U DIVISI' tti jh D at c 1C t 7uris.: 6 See Page 2 for
-.a Supplemental lnrormrllon•
24 -hour inspection Request: 503-639-4175 "` htuntc�dteaux
- TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST : .
`
New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
' Addition/aileron eplaee Other: performed- Indicate the value (rounded to the nearest dollar) of all
, ''.'••'CATEG RY OF CONSTRUCTION , mechanical materials, equipment, labor, overhead and profit.
V S See Page 2 for Fee Schedule
I & 2- Family dwellin: Commercial/Industrial
RESIDENTIAL EQUIPMENT /SYSTEMS
• Accesso Buildin: • A Multi -Famil Description i Qty Fee(eaj1 Total
Iii M aster Builder I Other' lleatlni Cootlu: _
-.. .J013 SITE INFORMATiON and LOCATION urn • - add -on air conditioning *` 1 14.00
Job site address: 1 5 r6 3 - �1,A—) $ 7 Gas heat pump 14.00
_ B l�• ) d /A t. #: Duct work 14.00
Suite #�: _ -- llydronic hot water system 14.00
Pro Ct Name: — Name: •- -- Residential boiler
Cross street/Directions to j ob site: _(for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
in wall, in -duct, suspended, etc.) _ 14.00
Fiue/vent (for an y of above) 10.00
Repair units 12.15 -
Subdivision: I Lot : _. Other Fuel Appliances
Tax ma /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Flue vent water hcater /las fire.lacc) 10.00
+ Log lighter (gas) 10.00
Wood/Pellet stove 10.00
• • Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
' ROPERTY OWNER • TENANT Other — 10.00
.r_, _ _ t I Environmental Exhaust dt• Veatllatton
• Name: Range hood/other kitchen equipment 10.00
Address. it " . Clothes dryer exhaust . 10.00
Cit /Stete/Zi ' i ;' at_ 9 a-. " - Single duct exhaust
Phone: ( „s. Fax: (bathrooms, toilet compartments,
'J APPLICANT L■ CONTACT PERS N _ utility rooms) 6.80
Attic/crawl space fans 10.00
Name , --- • >= • rig •
lib 10.00
,
Address: • ` ' u�Q Fuel Piping
Cit /State/Zi.:c (* • 4 �. • ! w t .� - ,J 0 I '($5.�t1 for first 4, 51.00 etch addttfonai)
Furnace etc. C«
_3 lvS c (op' l ax: 55's-rl t ««
Phone. • Gas hea pump
E -mail: • • ` _ Wall /suspended /unit heater ••
=;u; RACTOR Water heater 4.•
Business Nam . ► 0 ._ , v,, e, , Fire 'lace s.
• "' R angc
Address: a , 6 0 r _ _ ... BB «'
—City/State/Zip: c.....k _, . � ii ""/ Clothes dryer (gas) ••
Phone: •"10 .. A r ' l id • - tx:,9) rfa.Ci•!i, Other: .• •
Total:
CCB L ie.. Atec r ernllt Fees•
Authorize AM Subtotal; S •
Signs
s ► .it.J 4.— _� -., itei_ . . .�� Minimum Permit Fee 572 -50 S ' —
V Qp.' IL �— P lan R eview Fee 25 °/. of Permit Fee S
v C State Surcharge (8% of ' ermit Fee) S
( prim! name) r TOT PERMIT FEE 5 _
Notice: This permit application expires If a permit is not obtained within l - • - ee . methodology set by Tri- County Building industry Service Board.
180 day, after It has been accepted as complete. **Site plan required for exterior A/C units.
it1Dsts \ Perm itFormx.Mec Fermi tApp.doc 0 1/OJ
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 ^ MST
BUP
Receivecr9 Fe Date Requested c D 4 AM BUP
Location s � - Suite 4 23) y 00.5
Contact Person ____a(1i4.Z, de44 j h ( ) 4P 2 — PAS / PLM
Contractor de"/A-4/ Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam TRY - To C.4 -L e. B :oo A.K, 64oT
Shear Anchors
Ext Sheath/Shear M•4ci•srnl�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL +
PLUMBING L _ -
Post & Beam c\\
Under Slab
Rough -In
Water Service �w
Sanitary Sewer /
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smo e Dampers
F
4 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
Approach/Sidewalk Date 2 Inspector /u 4113kiii.■ Ext
Other:
Final DO NOT REMOVE this inspectio ecord from the Job site.
PASS PART FAIL