Permit 1111 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00520
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/21/2008
PARCEL: 2S 103AD - 06500
SITE ADDRESS: 12715 SW 111TH PL ZONING: R - 4.5
SUBDIVISION: WILDERNESS LOT: 011 JURISDICTION: TIG
PROJECT: DAVIS
Project Description: Furance installation.
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
VALERIE DAVIS Description Date Amount
12715SW111THFL
TIGARD, OR 97223 [MECH] Permit Fee 10/21/20( $72.50
[TAX] 12% State Surch 10/21/20( $8.70
Total $81.20
Phone: 503- 639 -7254
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 681 -0793
PRI 503- 620 -5643
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 1 01111111,Permittee Signature: _ � ,
Call 503. 5 by 7:00 a.m. for inspections that busin s day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
c1CT/20/2008/MON 04:59 PM FAX No. P. 001
Mechanical Permit Application • FOR OFficE' USE ONLY .
City f Tigard E eived 1 ,." 13( , g SHal BlvdTi ard, OR 9 ECEIV E eBy_ fz. Review purer Permit:
Phone. 503.639.4171 Fax: 503.59:1 t Date/By:
1' I t 'Ale Ir Inspection Line: 503.639.4175 q O 2 v ) '.. D a t e ReadyBy: See Pa4e 2 for
Internet www.ttgard or.gov U U I D Notified/Method: , SuppiementaI information
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❑ New construction 11 Addition/alte , ' , ^ f.c cement
Mechanical permit fees” are based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
:,, ^a 'i
r.e '
._: i. T"S,, ?�,.,:;.i ;ij ^,.; �.i., -r'• y* .��� :ii:i ":ia:�:;if1,�, yt6T'i'lii: �','�sF:ilGil... 'Value:$
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1 ', y:l , f . ,i ' , r, `^ ',�x'l .'t ::0k` GQNST;�t17O,1�'JON !!,I , 1• r.. I. {.' ,41:�F�' r , i r , , ,. ,w r ,j , :., , • ,.
1- and 2-family dwelling 17E E t41,7,4 , t4 �Jl[ .MnI�: NI T.P4 ' i314#,
} g ❑ Commercial /industrial ❑ Accessory building
For special Information use checklist.
d Multi - family Q Master builder ❑ Other: Description Qty. Ea, I Total
i`; li ' .4 t' ., I1 07.'04 '#itl ANIi ! LOC4,, fiP'V, f . ,.�, f t I ` , , i _ heating /cooling
Job site address: f Air conditioning or heat pump
si 1 �� . (requires site plan showing placement) 14,00
City /State/ZIP: Furnace 100,000 BTU (ducts/vents ) 1 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: 0e""� �s Gas heat pump 14.00
Cross street/directions to job site: Duct Work 10,00
Hydronic hot water system 14,00,
Residential boiler (radiator or
jydronic) 14.00
Unit heaters (furl -type, not electric),
in - wall, in -duct, suspended, etc. 14.00
Subdivision: I Lot no.: Flue /vent for any of above 6.80
_ Other: I0.00
Tax map /parcel no.: Other fuel appliances
t 77' ,i. �` I ' ion O i' I �!,. .: Water heater ater 10.00
; ,.;' i V. DBSCRLP f7 .- I i ` t . I
. .,. .
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
12- Log lighter (gas) 10.00
Wood /pellet stout 10.00
Wood Fireplace/insert 10.00
_
i I 1 } q, ........... Chimney /liner /flue/vent 10.00
4 1r, ` ',, i - p ,s�! _I _. !ua , Il 1z �� , ,I Other: 10.00
Name: Davis, Valerie R08329 Environmental exhaust and ventilation
Address: 12715 SW 111 place Range hood /other kitchen
equipment 10.00
City /State/ZIP: Tigard, Or. 97223 Clothes dryer exhaust 10,00
(503) 639-7254 Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 6,80
I '4V .r:; ! ll..i "! fiC! l , 'ln, ',, ..y 1{C r $i,Vj, g +i Attic/erawlspacefans 10.00
Other: 10.00
—
Business name:
Fuel piping — „_
Contact name: 55.40 for first foul $1.00 for each additional
—
Address: Furnace, etc.
—
Gas heat pump _ _
City /State/ZW: Wall /suspended /unit heater
Phone: ( ) I Fax: : ( )
Water heater
Pi place
E -mail: Range
r�
i , i . :i , , , ,' , r %' „I{ i I� Q7N�7 l iQ ' , , � ∎ i a r 1 l I :�' i „ , Barbecue
Business name: Specialty Heating and Cooling, Inc. Clothes dryer (gas)
- Other:
Address: 7500 SW Tech Center Drive Suite #130 '; ;; ,1 Rif• 10A0:4:li# .. E, f', `,ii .ii :.!
City /State/ZIP: Tigard, Or, 97223 Subt
_ Minimum permit fen ($72.50) p •
Phone: (503) 620-5643 Fax: (503) 681 -0793 Plan review (25o1a of permit fee)
CCB lio.: 66578 State surcharge (12% of permit fee) ; . 7
. TOTAL PEnb1IT FEE !t
Authorized si afore: This permit application expires if a permit Is not obtained within 180
Sn days after i t hes been accepted ae complete.
Print name Andrea Dripps Date; r (( • Fee methodology set by Tri- County Building Industry Service Board
t•1BuildingPennits C- PoratitApp,dua 01/19 /07 440.4617T (11 /02/COM/WEB)
CITY OF TIGARD . . .
BUILDING DIVISION PERMIT #: MEC200&.00a20
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2008
Phone: (503) 639-4171 A
, n alljii 1 •
Inspection Requests (24 Hrs.): (503) 639-4175 ..„....„. ' t .U.,...
INSPECTION WORKSHEET FOR DATE: 10/3012008 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 12715 SW 111TH PL CLASS OF WORK:
SUBDIVISION: WiLDERNFSS LOT #: oil TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Fulance installation,
OWNER: DAVIS, VALERIE . PHONE #: 503-639-7254
CONTRACTOR: SPECIALTY HEATING & COOLING
PHONE #: 503,620.5643
Inspection Request Scheduled For: Date: 1 a n o nam Pour Time:
Code # Inspection Description Confirm # Contact # Message
599 Mechanical final 077366.01 503-639-7264 Y
Corrections/Comments/Instructions:
0 L&77 r4 1... 1,14, i Abo-ve.- LA,6 6-1. Xe - 5-- / 6 t 2„5 a 4,„€
I PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL IN/ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED . .
. i
Inspector: I Date: /6 -30 --- ee Phone #: (503) 718- 1Z-44-6--1
INSPECTOR'S SIGNATURES ARE NOTE
Inspections Required for: r7gc.420/Iii-t0,5 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date B ✓ Code Inspection Description PASS Date B
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 610 Gas line
287 Suspended ceiling 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: ��
699 Mechanical final /40 t3
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
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
1: \Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
•
CITY OF TIGARD MECHANICAL PERMIT ..,.. •
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00520
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/21/2008
PARCEL: 2S103AD - 06500
SITE ADDRESS: 12715 SW 111TH PL ZONING: R - 4.5
SUBDIVISION: WILDERNESS LOT: 011 JURISDICTION: TIG
PROJECT: DAVIS
Project Description: Furance installation.
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: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
VALERIE DAVIS Description Date Amount
12715 SW 111TH PL
TIGARD, OR 97223 [MECH] Permit Fee 10/21/20C $72.50
[TAX] 12% State Surch 10/21/20( $8.70
Phone: 503 - 639 -7254
•
Total $81.20
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130 t
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS ' *
Contact #: FAX 503 - 681 -0793
PRI 503- 620 -5643
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 4.
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:
y: � / f �� Permittee Signature:
Call 503. c ^ 5 by 7:00 a.m. for inspections that busin 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.