Permit t.
CITY TIGARD MECHANICAL PERMIT
i, DEVELOPMENT SERVICES PERMIT #: MEC2004 -00472
.f 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/20/2004
PARCEL: 2S111 DC -03700
SITE ADDRESS: 15660 SW ALDERBROOK DR
SUBDIVISION: SUMMERFIELD NO.7 ZONING: R -7
BLOCK: LOT: 382 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: GAS LINE AND GAS FIREPLACE
Owner: FEES
PHILIPS, CLIFFORD M Description Date Amount
DOROTHY M [MECH] Permit Fee 7/20/200 $72.50
15660 SW ALDERBROOK DR [TAX] 8% State Surchart 7/20/200 $7.03
TIGARD, OR 97224
Phone: Total $79.53
Contractor:
T & K MECHANICAL
PO BOX 116
FOREST GROVE, OR 97116 REQUIRED INSPECTIONS
Phone: 503 626 - 4652
Reg #: LIC 121165
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: ,p/ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
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NW/ construction , , r"i\AiditioVilterationiteplacement - ' Mechanical persnit fites" see based Oti tne value elute work 1
- rIM" peiformed, Indira& dal value (roundeal to tho Times dollar) of all
0 Demolition 1M tther rambanical tratariala -Lg. ., labor, nwriaerad as111 .r� t
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frt 7 -7■j); • , $.;ThT;. ;..: .•TriT. , - . - i . ::;: i.-7. AT I " .t r'71,''„ifi Value: $
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0 Multi-fly C:I Ma= builder 0 Oter" Description Qty- Ea. , Total
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ia ll'‘ .4 ''" ? EZ.. ifLi.: 14: a ..: t.. '."A . .....i..: . ' '.• ,. '.1 . '' 1 :' , 54:i4 11 ' A:-., He t man:
Rib Mc address! .- '' (.13 k - - k- 6 Jr- 1,4.0D
-- 7 - ).;1 pinnace 10000 BTU t/vet m) 14.09
Furnace 100,000+ EITU (deprave) 17.90 . ,
se l2=0:1111=1.1111111 Qt4Stat2raii: %. k Prci t ruccar.. GO2i hoot. • . ••• 14-00
Cross StaVot)direoCiors to job Shia: DUO WWII 14.00 UM
- H titanic hot wave J 14.01)
aidential boiler (radiator or
I onic 14.00 .
Unitheaters (it.tel.type, Dot electric),
in-wall, in-dacs, suspenducli am 1O.Q0
• rue/yens for any of allave 10.00
Sub.tlisfieion; Lut.,0„ . -
Other: 10.00
Tax. Maigpaltel r10,1 Rte. el • ..11•ne .
7 - -.. '...7 vi ;.7 ItTi2/ , Water beau?? 10.00 I
_ ,......, i. .2. 1 - ... - . ic.-..... •,. A •.A. ,. ' • . •..tax....:,... • •- ..-t.t....: ...1.....+L-1.-1
Gas flteplaee 10.00
i Fltle vans for wirer heater ce gas
fireplace
MI 10-00
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I 10.00
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City/Stsizrat; -r ... • cn . .. CILACSI dryer exhaust 0 00
, . . Single-duct cabinet (oattu
IMMERMIIMPS Pam ( ) toilet eerepartrainte, utility TOOrn)
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Qiirtgr; I 1040
Svasincas WSW - r- j< mar_1,-,exc e' b, 1 if el . I . in:
Contact =roc . 14 ro rvo e ___ 5.40 tor firgt fear $1.00 i'br each addieknal
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Address: P . 1 8 , MI11111111
Civi5tatorZIP: 4 r , • -f • • . J2_- ,
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P h o n e ! (S c i l ; ) 3 5 - 7- LI ( 0 ) (.4 F L I I - -- tc" - ) Water healer
IMMIMINIMMINME - L W C
Zonal': a RAt ,. 1.111
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Mini permit fee ($724 1 ,Q . •
Phone: ( p) -- 5 --- ) - 1.1-t 0 ii.4 Fax C ct c itta - 8 /S f Finn Torte*. (25% of permit fbe)
CCM 11a.: [ A 1 I State eUrelleese (8% of immix tee) - T. 01
-----"' TOTAL rERMIT FEE 4 4 • C( .3 1
m pprinIt opputuathie outres If g partliftli sat *bitted %vita iti uso
Authorized signature'. . Nir day? OW it tati bten atm:130d ..1 eatepitte,
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
9O UP`
Received Date Requested l .a AM ✓ PM BUP
Location / S 4 (C� �,al 1 Suite i MEC 4 L t - 60(17;--
Contact Person Ph ( ) 3s 7 — ko("7 /- PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 14)-4/ ‘-t--- -- e-t-- ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT a...(f....e.,,,,L.„) Post & Beam
Shear Anchors 1nn , 1 1
Ext Sheath/Shear 9 I� V •
kit Sheath/Shear '' ,C____ i r e 7 / d 66eS 1 SS 1 / Le
Framing
Insulation C i
Drywall Nailing
Firewall ^/S (._ p
— ^Q ( - k
Fire Sprinkler �� -
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING `
Post & Beam
Under Slab I , 14
Rough -In i
Water Service • r a
Sanitary Sewer 6
Rain Drains
Catch Basin / Manhole ; °i
Storm Drain
Shower Pan 4.
Other:
i
Final
PASS PIT FAIL
CHAN L .
Post& Beam
Rough -In
Gas Line
Smoke Dampers
, . I
PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line k/
ADA . vi)
Approach /Sidewalk Date Z� Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site
PASS PART FAIL
•