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Permit CITY TIGARD MECHANICAL PERMIT i DEVELOPMENT SERVICES PERMIT #: MEC2004 -00500 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/2004 PARCEL: 2S 109AA -04000 SITE ADDRESS: 14455 SW 128TH PL SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 006 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: 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: Remarks: Installation of A/C. Owner: FEES CORNWALL, KAREN KAY Description Date Amount 14455 SW 128TH PL [MECH] Permit Fee 7/26/200 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchar€ 7/26/200 $5.80 Phone: 503 620 - 2835 Total $78.30 Contractor: TRI COUNTY TEMP CONTROL 13150 S. CLACKAMAS RIVER DR OREGON CITY, OR 97045 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Final Inspection Reg #: LIC 72623 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: /`ZISzP o Permittee Signature: Qy .� Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Jul 25 04 06:38p TriCounty Temp Cntrol 5035570919 p.1 Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard . i Received / 'l 13125 SW Hall Blvd., Tigard, OR 9.7223 ` CE1\ E Davy:7�6 Permiti o.:��(� J 0 � Phone: 503.639.4171 Fax: 503. 598.1960., :t P lan 9 1, .1 ' '-� ' I ,,' Date/By: Outer Permit InInternet: www.ca.tigard.or.us ` 1 2 f11r -- ! Date y: furls: H See Page t for JU L U It Notified/Me�0� S / Supplemental Information - `£.: y:y .s,.:�.5.t�.iyJ. . _v.�.v�`} ' �• w'.w: - •aq : -:+. .. ... ..5 � i :vF -" •.'a '''''‘:,,Ii. , �``i &; F 1 r,''• •ng111,5t:::"!:' tr ,,.. 1 .:, ._ .,� .i. t . ?r. f M'r :_ # : ' + �T a'!4 UyVIIVLFJttr :TEE. * :: SZDCHVL"E .: - 1f` :f'FTFCKI IST ! Mechanic. I permit fees* are based on the value of the work El New construction � ��91L�dnYrepl'acement P ❑ Demolition performed Indicate the value (rounded to then ;crest dollar) of all ❑ Other: mechaniczl materials, equipment, labor, overhe id. and profit. I - and 2- family dwelling ❑ Commercial/industrial ❑Accessory building i '.- ,..RE rPMENT: /SYSTEMS FE ES * ❑ Multi vlaste ❑Other. Descriptiot. I Qty. special information use died ❑ Master builder :.i fi, ... y I Ea. I Total 1 . a ...At :' '708. &,}•'.' •'ts "� •��S1T:P.er�0).:,�., -.tq 0 CiYT :s :.:' ; r' . i•';i4 1•Ieatin*/ctoling Job site address: j� Air conditi ming or heat pump '�'` �^ W I �� (requires site plan showing placement) ' 14.00 City/State/ZIP: 1 Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg./apt. Furnace 10),000+ BTU (ducts/veins) 17.90 I n o.: Project name: Gas heat pump • 14.00 Cross street/directions to job site: Duct work j 14 Hydronic hat water system 14.00 Residential boiler (radiator or hydronic) 14.00 , Unit heater; (fuel -type, not electric), in -wall, in -Duct, suspended, etc. , 10.00 I I Subdivision: Lot no.: Flue/vent ft r any of above I 10.00 Other: 1 i0.00 Tax leap /parcel no.: Other fuel appliances .:r:::-:''.... . DESCRIPTION OF WORK :A. ---i.• • :. ..,, : Water heater I I 0.00 , , Lrri fri / A Gas fireplace O.DO ! FJ C(�,` Flue vent for water heater or gas fireplace ,0.00 Log lighter 'gas) 0.00 Wood/pelle • stove 0.00 Wood fireplace/insert 0.00 ;:,..,,t . ._ i . � „4„.. � Y UWIV;ER ..... ':.... 1, =. ::, ' a' }. ..= TEIYAi : i•" 1: Chimney/lirer /flue/vent I 0.00 . t►Cl l.! I .. ..•r % .. w :a3i'. .. T: :_ ..- .It' '.iM Other: I I 0. e r I l 00 Name: . (,�J Environmental exhaust and ventilation Address: 6ari N Range hood'other kitchen equipment 0.00 City/ State/ZIP: Clothes dryrr exhaust 0.00 Phone: ( Fax: ( ) Single -duct exhaust (bathrooms, , a toilet comps rtments, utility rooms) 5.80 t ; fAERI z A3!'Tj 14. :,.- 1 ., ' r,1 . ~w - ,,:: Attic/ w Isoace fans • 10.00 Other: ::: .:,.. > f :.: ::1. i� -.ir . CONT CT E,ERSOI r_ crd rr, C t' / "� CO Fuel Business carne: ` U` t `� I M I 10.00 Fuel piping Contact name: 1 55A0 for first four; 51.00 for each adt itionaJ I Address: 1a'f_JO 6 C( Q yy)/I R vc � b tf Furnace, etc I City / State/ZlP: n 0 t ` t ) t f ( f l t: � 7045 ji1 l �J Gas heat pump Wall/suspended/unit heater Phone: (0_,Z) S5"7.- � 290 Fax:: (503) 55• f -O I q Water heater ticJJ J f V"l 7 Fireplace I E -mail: :,;K k =: ° %{{ t' � i ya.+r..•.. r' Wit.. ...:py3 :+ X0.1. 9 Barbecue I Business name: Range ,.: 3. .-' if ?'it-2 `r _ ac..:f.i%'7"a D +"}R s•,r .. ry . y, ', . •�r .. a .s .r� � QFq r.- .. . . ' ,A . r r.. I T control Clothes dryer (gas) i (�� (AGM m (�r D1r1 i'� other: Address: t 1 5C G • t GM 1 ' l V ( 2 _ . . ; , t ,• "� s ; 1ti1E Cf .:,ll') * ". City/ State/ZIP: ©W n/ 0te- Subtotal k Phone: (53) 55-7-222° Fax: (SQE S 7 0 -- V (� Minimum permit fee (572.50 �V :J 1 4'v( Plan review (25 °h of permit fee CCB lic.: 72/ 23 State surcharge (8% of permit fee "/j`� �n �, ,4-40.6-x......._ TO AL PERMIT FE r J ` 1 l Authorized signature: This permit spplicatlon expires If a permit is not obtelne / /���4 days after It has been a ccepted as compete L Print name: _b a .e �QJ3 6 a 7 � I Date: % jpf • Fee methodology set by Tri- County Building tndusa . Service Board islBuiidingiPemtits\? CperntitApp.doc 12'03 440-4617T(I1/02/COM/WE13) r N "± - ; ' CL / . CONTRACTOR A/C-HEAT PUMP --.. UNIT SITE PLAN o 4 1 rf .......................... aciacooram.........■natommamal . m CJ` pirecY n m f 1 n 0 . C 3 C'► ... . . dij ,/c -I ro 3 . 6— 3 ct 1 0 ya • . C, TO STREET m co cn ui • J . ... - r CUSTOMER INFORMATION CD NAME • ADDRESS - . PLEASE REFAX APPLICATION WITH SITE PLAN. 0 0 J O 15 O °' N CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (50 .39-4175 MST INSPECTION DIVISION Business Line: • 1 3) 639 -4171 ` BUP Received Date Requested AM PM // BUP _ Location , Suite 1 . Od f - U S Contact Person /i !1/. Ph ( ) 7 .2 ' 272-0 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC N aviL Footing Foundation Access: $J�-� A� 5 taZ-b ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors -- Ext Sheath/Shear 1 1 M� Int Sheath/Shear VV k � y �� n * E 7 r S 'I "S Framing Y `� ` , v`r c i V l� I 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 1 `I Gas Line Smoke Dampers ASS 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 Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line / ADA ZZ Approach/Sidewalk Date I nspector i L__ Ext Other: Final DO NOT REMOVE this inspection reco rom the job site. PASS PART FAIL