Permit / / —/ 7 8c/
CIT OF TIGARD MECHANICAL PERMIT
I k DEVELOPMENT SERVICES PERMIT #: MEC2004 -00645
AA: , I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/27/2004
PARCEL: 2S109AA -00500
SITE ADDRESS: 14215 SW 125TH AVE
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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: 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: 3
Remarks: Remove oil furnace & install gas furnace & gas lines to (3) fireplaces.
Vent fireplace & install insert.
Owner: FEES
JONES, SHIRLEY J TR Description Date Amount
14215 SW 125TH AVE [MECH] Permit Fee 9/27/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchari 9/27/200 $5.80
Phone: Total $78.30
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Heating Unt Insp
Reg #: LIC 71878 Final Inspection
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: -( �0
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
24 -2004 10 06 A TEMP HEATING 5035572990 P.02/02
N licit] Permit Application 7 Ci igard '" i . �i / 89 / mitNo. p 1 vV ( 9 co
13125 SW Ball EIML, Tiga OR 972Z1 Phm Review O ther Permit
PhonC 503.639A171 : F r1"9 w ED I trz - -
!tweefide L3tc `503.639.. ` + . .. )� . ' .` 1 1 Ddte Ready/By: Joel,: 6J See Path 2 for
Tp rrw
.w.dti ord.orus;_ : NatiSed/Method: 1 16- suppiemeataiIdormaao.
yyy� 4 R
: 'C - ....• .. — permit fees' arc based a th e value of th
c�10.1�at +i .
,.... Mechanical *cork Q NCw efdeEtRlGtlon ; > , ■r r • !scam performed. Indicate the value (rounded to the nearest dollar) of all
❑ Dem ? ' i + • Other — .. materials • i • men labor overh _... and , rofit
'f Value: S
1; and 2 3mdlir dwelling ❑ commercial/industrial ❑ Accessory building
❑ MaIR= Iy' =` :,: - O btrilder .. 0 Other Description QtY. IIIIM Total
Fleatla_ cootie:
rob site asddr>esie •' - 1— i __ : conditioning or heat pump
re. 'set site .Jan abawin: •!liniment 14.00
CatylSta6 r24 -^ t '..' :;a Furnace 100 000 BTU deetshv.na EJI 1400
� - `;' 6 Furnace 100 000+ BTU &eta/vents 19.90
Stuttlbldgfapt: no »? :
:::.; ! . , Project name177- s J G as heat • um • 14.00
Croon a atreat/tratections to job site:. Duct work 111. 14.00
H dronic hot water a - 14.00
Residential boiler (radiator or
• h dronic 1400
Unit beaters (fuel -type, not electric),
In -wal in-do a . - etc. — 10.00
., ,„ .... Ftue/vent for an of above 10.00
Snbdivi alon: I Lot no.: Other 10.00
Tasxma e rcdno.:.. ' ....,..:. - Other fuel a' all/flees
, Water heater • 10.00
10.E
Ifh igiatt ..d �.; CO Flue vent for water heater or gas
II . lace 10.00
,� of i ..� �; 10.00
-:;' . ' - I r i �. ..&4 • • Wood/ .cllet En 10.00
�; . ..,;:. " Wood ii •Iacetinsert 10.00
. Chime /liner/flue/vent
10.00
. Other 10.00
Names ti' :r:.'•' =.-• •'•:; : ' e& • -• Environmental exhaust and ventilation
t0.00
�{ .L� Range hood/other kitchen
Add Easi: `.4 r ..: . . - 51A) ems, -� }. _ ',malt
� Glciiies d cr exhaust =I 10.00
City/e.v� ? .iP :7...7. � Sitlwe -duct exhaust (bathrooms„ IMF ' , , wi , 00, . . %. ... Fax:`! ) toilf wm,artrnents utili rooms 6.>S0
�� , . i AttlFJcrawis . ace fans Mir 0•00
o odire Mr 1 D
Siete lbr first StiSibr nail tidldeeat
roliolee de. II MIME Mg
.I r* U. Rent ..., �•
CMyI �1%' " .r te ^y 7 : _1_
im=0,j'imiuMEN =II MI
E=irtei ,• _ - , ..., 1,............... ,._...:. *th EMIT NM - i
16oe tie s tO6V 7. • - rt r_4 ' • Fla role* of permit S e) .,
`. I 4 Mee surcharge . • permit oe] � ilr
• CCS 1 . . , T OTAL P ERMIT FEE �
r •. • : • Thia permit appGdltlea aipirel If a permit is not obtained • . ISO ..
AI R S days after it has been accepted en complete.
• Fee methodology set by Tri•Co®ty Building brdustry Sawioe Board
Print �_. . to �: bate. e � -
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPE DIWSbON Business Line: (503) 639 -4171 MST
CTIO
BUP
I•
�'� 7 Date Requested I � '0 7 AM 074#1/4. BUP
Location < L 1 5 / e Suite M EC c7l6W - GAO 6' /s
Contact Person Ph ( ) PLIti
Contractor Ph ( ) SWR
BUILDING Tenant/Owner / ELC
Footing (. o ? 9 - l r -.S`T ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam W
Shear Anchors "' ILA/I/4;
Ext Sheath/Shear g x 1
Int Sheath/Shear
Framing / �G�1Z ' 4c - £1-/ ,c� D/I f 2 5 2:004-61
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
ELECTRICAL
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 111 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector AL Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL