Permit " ivo //1r
CITY TIGARD MECHANICAL PERMIT
"1T 1 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00734
" .il 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/10/2004
PARCEL: 25111 DC -04100
SITE ADDRESS: 15655 SW ALDERBROOK DR
SUBDIVISION: SUMMERFIELD NO.7 ZONING: R -7
BLOCK: LOT: 356 JURISDICTION: TIG
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:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: NO HEAT: Furnace replacement.
Owner: FEES
RADEL, JOSEPH R Description Date Amount
15655 SW ALDERBROOK DR [MECH] Permit Fee 11/10/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 11/10/20( $5.80
Phone: 503 650 - 9602 Total $78.30
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 71878
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: • A. Permittee Signature: dirt DQ 1d�r - 4°
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
NOV-09-2004 17:15 ' TEMP HEATING 5035572990 P.02/02
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-- was , , gto 9)unO ‘Ni Phone: 503-84-6-3476 Fax: 503-846-3993
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155 N. l .. , Suite,350-11 . Inspection Request Line: 503-846-3699
Has .6 6, O ' 97124
nm ) 1%54 vmy.co.washingtooz.us
oitEoe 1,:i. 6 Use App' : : v 6 Project # Perliliqyne.2 c kt)e(-0073
; .'. ; .:.:: : • . ?! " g . . f .Cii t ;? : SkiggIrPCOCAVOrtiCi P OPT 42 4.0**AMORMafe AttitilittOggetarelgre01424 tgraiOttig
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0 New construction 15PAddition/alterati • Trlowegr Mechaalcs1 pemtit fees* are based on the Wilt= of the work
performed Indicate the value (rounded to the near dollar) of Ill
0 Demolition 0 Other: mechanical materials, egu(pment, labor, overhead, and profit.
CATMORY OF 9911011Yg1P,47.1.!!g.'::;;.!'s,',1'...?:;',;;:";'....;i:'? Value S
' 1430PANIOANINentirlatratgAggr
Allffi I - and 2-fautily dwelling 0 Commercial/industrial 0 Accessory building
For spacial iriformarlan um dosalkilst.
0 Multi-family 0 Master builder El Other , Datcripaon I Q9P. 1 Ea. I Total
'JOB:: 5riCittIRMA004.4iWC.0,0110.01tS1:? ,ef Re ,' • ' • ' :
• if.Pri7 or
Job site address: 1 S 5 ak ekultii- . . ,.„ . , air conditianing +
" II
4. - 1 e -.. r12 830
. Duct 8.50
SuitathldgJapt. no,: L-_-) I F.n*et name: 1 Q() work .,
liydnmic hot water systom 8.50
Cross streeddirections to job alto: Residential boiler (radiator
- or hydranic) N/A - State Permit Required
Unit heaters (fuel-type, not
- - electric), in-wall. in-duct,
suspended, etc. 8.50
Fludyeit for any of above 8_50 .
Other:
Subdivision: Lot no.: - -
Other fuel aepilances
Tax map/parcel no.: ' Water heater 8.50
-
' 1 ! . .: :;. : iii".- ..: : •-. '. :,: r . ; t 4F:1 4 ,,!, 7 , - ,.51;kiiiii : 4;a 5 40.44141k Fi Gs lie r v ir : 1 11 : watcr hcaux 850
k p j4.--/'!----(-- elkCA in .A L. J _...._ m
, or g fowls= 8_50
Log lighter (gas) 830
— - - WootVoellet StDVC 830 .
Wood fireplace/insett 8.50 ..- .
• Cnimney/linalfludyent 830
PERTY• OWNER -,!,:, ', ..:..:4- i',,:::':,;•.:,..0. ' ' •,:, ,.
' : • . ,HrZCBRO . i :i.: . .:.:,'...:::;, ,: ::;,..,;..,..,.i.:, AWOKE . . , : ..,,, ,
-.q. ' Environmental exhaust and 'ventilation
Name: :T 4 • Range hood/other kitchen
equipment 850 —
Address: a -C S tAi I 0 ' kPreCe-k- Chiles r■cr exhaust 8.50
CitytState1711t • -- GPM' .D 'g-'11 Single-duct exhaust
(bathrooms, toilet
Phone: (ST)7 (t) rl 4 - -: Fax: ) • compartments, utility moms) 8.50
' 4 7 '''''' ' f uns
;if,: , A.Av, , ,,I.: , ,?, , , of-linv. i5... , , .-,, •• ,.. .•,,,, ..- , : , ., ••• • • - - 1. ± , , , • ; 0,1.=„. 850
Business name ..., (-7:_e_ietkp kA t ($tra \ i A Fuel niping ($830 for fast four, 51.00 for each additional)
V
Contact mune: 11 • 6, , -I vil. 1 • Please indicate rt of fuel ' , • - • ,. '. outlets below:
Furnace, eta By Quart do
AddraW 1 t CO 0 c GULL CA c,;+—* Gas Iscat t„ 8 outlet •
City/StatearP: CA CICC2aAri4 r it r z . , a -70 vi,llis.$4,,,d.yunit Mauer By Oudot*
Water heater/Boilar By outlet a
Phone:) ( T cli Fax: : 503) c5f1 0
Fireplace __ By anima f
E-mail: Range By mini ..1
''':'!';.;:', '.:::•-::::....•:';', .., .. ...". 'i. -Bathcalc By maim •
Clothes dryer (gas) By otfflet it
Business name: Other:
Addsess: JQ-,/ •
IlECHAMCAL MAW FEES' . : - : •
- Subtotal S
City/Stste/ZIP: P4--- Minimum permit fee 560.03
Phone: ( ) ri s. x -• ; ( ) ecarmarmial plan review (95% of permit fee) S . ___.
-
CCD lie.: il l va..6--("74 State 5 . ••■ . :• (9.4 of . -••• t fee) S
--■..- .
Authoriz • . • OaJJce(. tOTAL PERMIT FEE $ •
. '
. I This permit application empires If a permit La not obtained
signature: within 180 days after it has been accepted as complete.
Print name: k - • ua Dail t • ,, ,...,
U A • • FEC EribeldfliOgy tot by_T ' Building backstry Servieo Boned
• Siln Pixo RD:10ra( 440-461'7T ciande0WW% 2
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM �PM BU
Location 4/ S uite E AU — 0073y
Contact Person /0 Ph ( ) PLM
Contractor Ph ( _ t 3�j _ gsg7 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation • ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes-:-. - _. SIT
Post & Beam t
Shear Anchors
Ext Sheath/Shear • ' -
Int Sheath/Shear �� K q ��` 4 `-'I' r
Framing / �J
Insulation
Drywall Nailing
Firewall m � A41 ff
Fire Sprinkler v " �'
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING'. = alf �
Post & Beam ' , WINTRUIMILIA Under Slab
Rough -In !MUM MERU 1W
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
E FAIL
cki
N
Post & Beam
Rough-In
Line /�.t
Gas Line '
Smo Dampers
PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection f •e of ',. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call ta r rein- . ection RE:
0"V 4I Et Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk
Date C Inspector Ext
Other: -
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
•