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Permit CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 - 00116 N•'ii 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/16/04 PARCEL: 1S134DB-05900 SITE ADDRESS: 11009 SW 110TH PL SUBDIVISION: JEFFREY ESTATES ZONING: R - 4.5 BLOCK: LOT: 018 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Add a/c unit. Owner: FEES CHRISTIAN, K GENE + MICHELE K Description Date Amount 11009 SW 110TH PLACE [MECH] Permit Fee 3/16/04 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchaq 3/16/04 $5.80 Phone: 503- 684 -8381 Total $78.30 Contractor: MILWAUKIE HEATING & COOLING 9961 A HIGHWAY 212 CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Final Inspection Reg #: LIC 104102 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 o.tain copies of these rules or direct questions to OUNC by calling (503)246 -6699. • Issued By: , _ ,'g \ ,y, 41 Permittee Signature: / Call (503) • 9 -4175 by 7:00 P.M. for inspections needed the ne t • usiness day Mar 15 04 08:07a Milwaukie Htg S. Clg 503 - 557 -0790 p.l u5 /3ii uui UN:Lu ciao ouaoavicai ��w �_ A.A. - Mechanical Permit Application V l.ao.: ClryofTr Address: of Tigard 1 25 SW Hall B CD Dam issued: nom Receipt no.: Phone: (543) 639 -4171 C`aacfiletto: °t ype: Fax (503) 598 -19bQ MAR 15 2004 Building permit no.: Land use approval: ___ d maki_familY CI Tenant uupro"ement 1 & 2 family deans G ag or accessory 0 New coosttuOion ❑ Addition/altanAodtep1 aoGrnent O t]thtr JOR SI1 E INFORMATION (- MNILRU CL VALUATION] ION ] S(-HEDL LE !06 address / Q Q .S J /11'1, GT ladicate equipment quantities is boxes below. Indicate the dollar • J 1 [ no.: suite no. value of all apical materials. equipment,. labor. ovcibead, Bldg. no.: � profit_ Value S Tax toaphax lot/account no.: Lot: Btodc Subdivision: 'See checklist for important application information and Project name: jurisdiction's fee schedule for restdeniial permit fee. Gig, /county: : 7 2. Z 3 I & 2 FAMILY. DM LLLI G PERMIT FEE SCHEDULE Description and I of work on premises: AND COMMERICAI.!1NDUSIRI &I. EQL IPSIEN'TSCHIEL)t'LE Ell Fce(ea.) Total _ y Res, only Res. Fes. date of completion/inspection: dion o –6 H A Tenant improvement exchange au= Airhandliagook _ CEM Ts existing space heated or coed? t'! Yes O No Ail conditioning (simpla" required) Is existing space insulated? QYes CI No t Alteration ofexistia.HYA(:system 11 LCHANICAL CONTRACTOR 3.41.,...,.,., � State boiler permit no.: Business name: ill; t J Q,v k l i (1.) 4--- (C:r, c. Hp Toas BTUnl Address: q q )--I • Z Pare/ e dampers/duct smoke detectors —_ city: OPNIMEMMIIIMEENn ZiP. , 2- eat pomp (rite plan required) -1 � Ins • Vrep scefvrna- Phone �$'7 -$�. Fa:c:$57 -079a E-mail: 1ncludingduetworkIvmtlakx 0 Yes 0No • (CB _ /0. 4 /t5 Z. lostalltreplace/telocree heaters - suspended, 111111 c5ty /tlactro lie. no.: 3 e 0 et i waiter flour—mounted Naanc (please print): e r r RI h _ I Ventfor • ■ , Malec ether than furnace (.ON:rACI PERSON itangesatioie Absorption units B111/1-1 NW= [ y r' 1 14 k Cruller' I , r� ors HP Address: . — )E]t � auoamdntl a chant and venta:Wow ZIP Appliance vent D � � Plaogn� ` ilw\ER - " . • •• We f If raid • , ..„ • ■ hood �ac:ppr�sionsYrt L ?fl With i • . duct(balttiam) . — Mailing address: e. , .tn) j / O r sow ` C COM !3 ' Clad piping sal (J O ) h , �� State:() 771P:: " ?22 T . LPG• NG on II • Fax: E- mail: Foe , t • q. a. additio owrr • ea Mil — L,1(., lNF.F.R tits - ) 1 Number ofoutleu Name: Otber listed app or equipment: Ad s. I Decontiveftepisee City: State: ZIP: l a – l'hoae. USIMMINI woudSavelpellet stove INI Applicants sigaatu ,y • OlYc immills Name (print): / `v 7 • pi � i 1 'root al +,ea s carat opts. plena all jo :mean ra .mec later Nodce;: This Fer fee . $ OYw StaauacCsrd ' b M fee $ e dies if a pewit is oat obtained Plea Review (at _ 56) $ Oath ors artaDar J re widths 1110 days after k has been Expires State =chute (84'e) .... 1; xaaae or waaroneer as abeam o. �t ca d aiooeptod ss °°oplete' $ TOTAL .-- .......:. $ Callaider 01016666 Aatwat . 4404617 (6C01031 0 Mar 15 04 08:07a Milwaukie Htg & Clg 503 - 557 -0790 p.2 V , lP 4 aL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (E0,3) 75 INSPECTION DIVISION Business Line: (503) -4171 MST BUP Received fr 2 I qp Date Requested 3 — 29 - 0 AM PM BUP Location /ZOO < l 0 44-` P / Suite CD 0 / (o Contact Person Ph ( 5V3) 5 s 7 — (556 aLM Contractor Ph ( ) n SWR BUILDING Tenan 0 ne r; .�L1 �u Lata l Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab nse - tion ' stes: IT Post & Beam Shear Anchors A g rai 1 illr f2-r✓,A. — c Ext Sheath/Shear Int Sheath/Shear i / � O ,( - ©0 I � C- -) (� — • - V ■ Framing 1/C/ !� 1 / 1? Insulation Per( Zd U — Q o (to © C (/�� ,, - C(' �JN) Drywall Nailing Firewall Fire Sprinkler ■.•-• mow- — — — w Fire Alarm Susp'd Ceiling Roof ry vJ U--{ ASS RT FAIL M G +f `,'1 • Post & Beam Under Slab �p Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: PART FAIL ECHAN L (2)1): Post i Beam I Rough -In (/ Gas Line Smoke Dampers m S PART FAIL LEC TRICAL 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 c ADA 3/ZYZ) Approach/Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL