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Permit -..4. (( - c7 4 C ITY O T IGARD MECHANICAL PERMIT ni 4, DEVELOPMENT SERVICES PERMIT #: MEC2005 -00720 1312 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/27/2005 PARCEL: 1S135AC-02700 SITE ADDRESS: 10840 SW 95TH AVE ZONING: R -12 SUBDIVISION: ASHBROOK FARM LOT: 019 JURISDICTION: TIG Project Description: Wall heater and gas line. 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: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES • LIZ DAVIS Description Date Amount 10840 SW 95TH AVE [MECH] Permit Fee 10/27/20C $72.50 TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/27/20C $5.80 Phone: 503 702 - 4444 Total $78.30 Contractor: SUBURBAN @ HOME 6014 NE 112TH AVE. REQUIRED ITEMS AND REPORTS PORTLAND, OR 97220 . Phone: 503 257 - 5438 Reg #: LIC 143335 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 or 1- 800 - 332 -2344. Issued By: Permittee Signature: , _ =��� Call 503 - 639 -4175 by 7:00 a.m. for inspection at bush :-.s day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ,` r Mdchanical Permit Application FOR OFFICE USE ONLY 1A City of Tigard u n , - E © Received Date/By: /0 a�' / Permit No•. r 13125 SW HaliBlvd., Tigard, OR 97223 y GS *M. Plan Review Phone: 503.639.4171 Fax: 503.598.1960%T e "7 � / , � (k DateBy: Other Permit: Inspection Line: 503.639.4175 o .' 11 W Date Ready/By: IIM See Page 2 for Internet: www.ci.tigard.or.us NotifiedlMethod: Supplemental information CiTY OF TIGARD a..t: ' ,1,` a, 1 OR`k ».�.. J " IA ": "F . � ` <C MMER E O I; "- "fIED� L '` C >a: �•° "S C U E> °USECHECKLIST*'• 111 New construction ddition/alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. _; _,.. �, , t. rr a�., Value: $ " A ; CATEGORY. 0„.CONSTRUCTION rz a = 'R :" %•'SY F < - a nd 2-family dwelling r'. - „.,._, ...:,. . ..�:,_.: = ,.- .:.:::..,,... >; ": ,. : *; "s. - / ` y g ❑Commercial /industrial ❑Accessory building ° ' For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE MATIO j D .L OC ATIO N ,. , , ,, Heating/cooling Job site address\OV s ') �Jt� Air conditioning or heat pump �/ ll Y�J C, / (requires site plan showing placement) 14.00 City/State/Z[1 " c (z. 2:? Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 1 00,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: 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, not electric), � in -wall, in -duct, suspended, etc. l 10.00 10.W Subdivision: Lot no.: Flue /vent for any of above t 10.00 IQ. • Other: 10.00 Tax map /parcel no.: Other fuel appliances M, n'y,,,y'i,'"" •i1 ` 3 ,r => .a. , +a a :�,. z.. ;-.,�,.s .; ,, 1 _.r.•�:p,< ': ;r - , _ ; ='-> Water heater 10.00 �- =� =DESCRIPTIO OF =, WORK N � >N " "�%'"�. ., .:1,, - >..... < �� '��:, �; �`< .... ; �� _ -,..4, :.�,. ., ., ".,.:gin. ,.... , . ,.' ����r " °;�T ,..�- „•�: -: .= Gas fireplace 10.00 .,,1,1--.;,:,--,, `V f` \� �7 iaQQ J Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 - :n. - . Chimney/liner /flue /vent 10.00 :'. :; :ROPEI2'I i' OWNER T N ° ' a <' -" _ .. �z� .;� E ANT- `.;. ". ` z,. Other: 10.00 Name: L \2 OG\ \c., Environmental exhaust and ventilation Address: Ce• .) CNYIN v�� Range hood/other kitchen v� equipment 10.00 City/State /ZIP �n� � Of--1.2.1--.3 Clothes dryer exhaust 10.00 +;'� Single -duct exhaust (bathrooms, Phone LAIALAL.1 Fax: ( ) toilet compartments, utility rooms) 6.80 ;:;;' Viz'` ..i "" "" ` -< Attic /crawls ace fans 10.00 ; 1; .P�,".• kiICA S: .,". '.' , : 1 CONTACT P 1101. =, Other: 10.00 Business name - �/� .� M,. ��JMf �_ `„ Fuel piping `` � P�P� g ' Contact name $5.40 for first four; $1.00 for each additional Address: )\� ` \ \- (1 i� �'`, ,e� Furnace, etc. �` Gas heat pump City/State /ZIF \\a� CTT1 C(, 0 Wall /suspended /unit heater 1 Phone: ' t)C ,, (-\ Fax: : ` -"-'c. 9 v. Jv, A, .---.\&....-D Water heater Fireplace E -mail: Range _' !. �.. = "BRA =�T " Bar "CONY C, OR!.' ' Barbecue �) t- � @ �� ` Clothes dryer (gas) ■ Business name: , 1 �`� ��_�' , Other: Address. `1 \l_\ 1C' , \` 3 Okr:A\L_C) 1, ` - 1_ +"' ` <LMEGHAIVICAL PERMIT FEES* ? City/State /Z . Y - IL N (l • sJ C),- Subtotal Phone j !�,'C 4 -- c j---;` Fax: 2 3�es . ca;' Minimum (25% fee r mit fee) ) _ Plan review (25 /o of permit fee CCB lie.: �, � ��� �1 -� State surcharge (8% of permit fee) . ✓ TOTAL PERMIT FEE ' • ,ii) Authorized signature' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print nakne: Date: \ 0/2 * Fee methodology set by Tri- County Building Industry Service Board • nnn n4117 /11 inn --nn 4nIrcos 3ii , ,33 „ CITY OF TIGARD _ .. BUILDING DIVISION PERMIT #: MEC2005- 00720 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2005 Phone: (503) 639- 4171 +N °m lpu�iip " � Inspection Requests (24.Hrs.): (503) 639 -4175 �' °V I I I INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 147 SITE ADDRESS: 10B40 SW 95TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK FARM LOT #/ 019 TYPE OF USE: PROJECT NAME: DAVIS DESCRIPTION: Wall heater and gas line, OWNER: DAVIS, LIZ PHONE #: 603-702-4444 CONTRACTOR: SUBURBAN @ HOME PHONE #: 503-257 -5438 Inspection Request Scheduled For: Date: 11/14/2005 Pour Time: Code # Inspection Description. Confirm # Contact # Message 610 Gas line 021053 -01 503- 257 -5438 N Corrections /Comments /Instructions: 4/1' --(4-c -cm 7 6 IQ ./- ,-, el)). u PASS U PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL/\ ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector ✓ Date: 1 li A Phone #: (503) 718- Inspections Required for: 1VfEC2005 -00720 ✓ Code Inspection Description PASS Date By If Code Inspection Description PASS Date By BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground/slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG - Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post/beam structural 150 Hot tub /spa/pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing_ 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG Structure set-up MEC - Mechanical Permit 280 Insulation 605 Post/beam mechanical 285 Drywall nailing X 610 Gas line 1 1 287 Suspended ceiling X 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG - Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection _ 635 Smoke detector shutdown • 640 Exhaust hood 695 Misc. inspection: • X 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 305 Plumbing underslab 915 Fire alarm rough -in . 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 995 Misc. inspection: 320 Plumbing rough -in 998 Alarm final 325 RP/backflow preventer 999 Sprinkler final 330 Water service 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert/catch basin 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \Building \IVR \InspCard- AOP.doc 06/17/2005 , f CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005-00720 •f �l DATE ISSUED: 10/27/2005 � . - '- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S135AC -02700 SITE ADDRESS: 10840 SW 95TH AVE ZONING: R -12 SUBDIVISION: ASHBROOK FARM LOT: 019 JURISDICTION: TIG Project Description: VVall heater and gas line. 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: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES LIZ DAVIS Description Date Amount 10840 SW 95TH AVE TIGARD, OR 97223 [MECH] Permit Fee 10/27/20C $72.50 [TAX] 8% State Surchaq 10/27/200 $5.80 Phone: 503- 702 -4444 Total $78.30 Contractor: SUBURBAN @ HOME 6014 NE 112TH AVE. PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS o -. /1.V ul Phone: 503 257 - 5438 0 f f n I Reg #: LIC 143335 I NJ 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 or 1- 800 - 332 -2344. Issued By: Permittee Signature: -- a -- -_�� � ` , ° - �R.,,,,� Call 503 - 639 -4175 by 7:00 a.m. for inspection at busk :--s day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. •