Loading...
Permit CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00409 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/28/2004 PARCEL: 2S103AB -06400 SITE ADDRESS: 12393 SW 114TH TERR SUBDIVISION: WALNUT GLEN ZONING: R -4.5 BLOCK: LOT: 022 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: ELE 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: AC install. Owner: FEES GUYEN, KWANG Description Date Amount 12393 SW 114 TERR. [MECH] Permit Fee 6/28/200 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 6/28/200 $5.80 Phone: 503 490 - 3815 Total $78.30 Contractor: SPECIALTY HEATING & COOLING 1601 SE RIVER RD HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone: 503 Cooling 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: Permittee Signature: 6) Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 1V�eChf nic P ermit Applicati FOR OFFICE USE ONLY Received Mechanical Date/9 a 0 ,d t Permit No.: nirert.. �QOfE Cit y af Ti and Planning pp val Building Date/By: Permit No.: 13125 SW Iran Blvd_ Plan Review Other Tigard, Orc;;on 97223 Dst✓By. PermitNo.; lid Phone! 503.639 -4171 Fax 503.5gg,gg 4 �� �' Post Lan d Use � ,ey�'''\ Date/BY: CaseNo.: Internet: cu�vw ( .ci,tigard_or.us r,�t1t DING ell Contact I Jul.: �l See Page 2 for e 24 -hor Inspection Request: 503 - 6351 =417 ; `' Nuinc/Mcthud. r I Supplemental Information. TYPE OF WORK COMMERCIAL FEE* SCI EDUL]E - USE CHECKLIST a Ne w cc nstruction ❑ Demolition Mechanical permit fees* are based on the total value of the work ❑ Additio n/alteration/replacement J Other: performed. Indicate the value (rounded to the nearest dollar) of all ca.-rleoon:It OF' CONSTRUCTION- ' •. - mechanical materials, equipment, labor, overhead and profit. ❑ I 2't 2 - amily dwelling ❑ Conunercial/Industrial Value: S See Page 2 for Fee Schedule ❑ Ac cessi pry Building , ❑ Multi Family RESIDENTIAL. EQUIPMENT /SYSTEMS FEE* SC1MILE . °• ❑ Master Builder O _ Descring I Qty I Fee(e 1 Total H'atiitg/Cooli . JO B SITE INFORMATION and LOCATION ' Furnace - a d -on a ir cond itiouil '* 14.00 Job si!:e ads cress: z." e 3 • �.;,> f f -/ * TPo-- • Gas heat ou 14.00 Suite ;r: Bldg. /A•t.i : Duct work 1 14 -00 Project Nalne: Hydronic hot water system _ _ 1 4,00 Residential boiler Cross stree:/Direcrions to job site: (for radiator or Hydronic system) t 4.00 Unit heaters (fuel, not electric) (in wall, in -duct, suspended, etc.') 14.00 Flue /vent (for any of above) I 10.00 _ Subdi risio:i: I Lot #: Repair units I 12.15 Tax map/parcel r : Other Fuel Appliances water heater I 10.00 _ DESCRIPTION OF WORK _ Gas fireplace I 10.00 .. Flue vent (Water heater /gas fireplace) I 10.00 Log lighter a5) I 10.00 _( ..� .... — �' '� ...... �: " ...... Wood/Pellet stove I 10.00 Wood fireplacc/insert 1 10.00 Chimney /liner /flue /vent I 10.00 • PROPER TY OWNER . • ( TENANT • . - Other . - 1 10.00 Name.: �� t, a" Environmental Exhaust & Ventilation G (-14' -`---) Range hood/other kitchen equipment I 1 0.00 Address: Cit /:f tcltl', Zlp: Clothes dryer exhaust I 1 0.00 Single duct exhaust Phone: t ( e l a . - /S Fax: (bathrooms, toilet compartments, APP.LICI n'CONTACT PERSON .' utility rooms) 6.80 Name.: Attic /crawl space fans I 10.00 Address: Other: 10.00 1~'uel Piping Ci ly/ talc,'Zip: -- $5.40 for first 4, $1.00 each additional) F urnace, etc. •* Phont:: Fax: - - - . Gas heat pump I "'" E -teal: _ Wall/suspended/unit heater I *- CONTRACTOR ' - Water heater j •• Bus Name: c - , C k i c-., (-� z c -fir Fireplace •• Addruss: 1 ( l a i_ P. i v'Q:• r f' -.c (. Range «« x C. C 3Q Cit /;itatc'. Zip: j-h• ((S t G"1 , 2 , '7 i-/ 2•> Clothes dryer (gas) _ "* Phone: (- -i e - , t ,. c _-, y Fax: 1,,i-l- 0 ? i3 Other; .. l " ' _ CCB Lie. 1 #: it? 1 }. .Iota!; Authorized Mechanical Permit Fees* Signature; i t-.- - C "------ _ Date s j� / k Minimum Permit Fee S7 S 9- ?_. . s L> F2F,t - .` C� ice- -� _ Plan Review Fee (25% of Permit Fee) 5 (Please print name) State Surchar• a 8% of Permit Fcc I S TOTAL PERMIT FEE l S ii. . .?_p Notice: This 1 ermit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building industry Service Board 180 day:i after it has been accepted as complete. * *Sire plan required for exterior A/C units. is \Dsts\P errniI I bmv\lvtec?etmitApp,doc 01/03 Z • d SILO B6S EDS 2u .r4eaH Rz 1 e 10acis eEZ : I I lyn EZ unr SITE PLAN P` . *lc hers. wig- PL OP rot/a-4 c r f PL PL PL - 1 PP l err'ace.- STREET 76avd_ 0le: C 7 zL Specialty Heating & Cooling, Inc. 9528 SW Tigard Street Tigard, OR 97223 Phone 503.620.5643 Fax 503.598.0718 Hillsboro Phone 503.640 -3607 Fax 503.681.0793 E'd 8TL0 86S EES ZutzeaH RzieToadS eEZ :TT 4,61 62 unr CITY OF TIGARD 24 -Hour BUILDING Inspection Line • "' / .39 -4175 INSPECTION DIVISION Business Li 639 -4171 MST p • o1.•-- BUP Received Date Requested 0 - AM BUP Location /0-,75 1 13 /l ' T 41 Suite MECo c(`" eo ci 0 ? Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Fog Drain E LR Crawl Drain Slab Inspection N IT Post & Beam /4'f Shear Anchors / D O Ext Sheath/Shear Int Sheath/Shear Framing n ---{�, f � - — Insulation W Clki 2c∎ 0 - 1-c / �6 4-- ©v 4- 7s'7 Drywall Nailing �, !! �' w �` Firewall /-5/0c4 (\ J k) Fire Sprinkler Fire Alarm R Ceiling d ,' Othe C � C ?6_,..aS2) Other: a_,__ N C V\A `�� U G V PASS PART FAIL PLUMBING G - - `� �-� � 3 J Post & Beam Under Slab v\"...,,,,,., -- 2-/1 - c.....4.;), - C `�-� ) Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL 111 MECHANICAL Post & Beam Rough -In Gas Line • Sm • e Dampers � PART FAIL : RICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Ei Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date IC() / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL