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Permit
c ' CITY OF TI GAR MECHANICAL PERMIT . „I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00346 I— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/8/2004 PARCEL: 2S104CB -02900 SITE ADDRESS: 13092 SW ASCENSION DR SUBDIVISION: HILLSHIRE WOODS ZONING: R -7 BLOCK: LOT: 075 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: 1 STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Extend (2) heat runs, extend range and dryer vents and relocate a/c unit for new addition. Owner: FEES LUSK, KIMETHY D Description Date Amount 13092 SW ASCENSION [MECH] Permit Fee 6/8/2004 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchart 6/8/2004 $5.80 Phone: 503 880 - 0781 Total $78.30 Contractor: ROTH HEATING & COOLING P.O. BOX 1265 CANBY, OR 97013 REQUIRED INSPECTIONS Phone: 503 Mechanical Insp Cooling Unt Insp Reg #: LIC 14008 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)24- : Issue By: . , % •i / j� :� Permittee Signature: Call (51 . 639 -4175 by 7:00 P.M. for inspections needed the next business day Sent by: ROTH HEATING 503 266 3478; 06/04/04 1 : 19PM; JetFa/t #337;Page 1/2 Recc:i.vo0: 6/25/02 1O :02AM; 6055961980 -� ROTH HEATING & A /C; Page 2 06/25/ '002 09:3 FAX 5035981960 , CITY' OF TIGARD I j002 - c *9 z 371/C...�P _ : , p ^ i ; t �; K ®n �C�IA i �-y1 ., Ie�Y 111 , , Dato recolvrd: ©M Permit no.: M , -:0'340 nl.,' . P Cit of f 'I`#ga rt Prgi dappt. na.: Expire date: Cloy afTipard Address: 13125 SW Tull • d, j ar ', ,# ` - -,'' - . ?bane: (503) 639 - }17 Date issued: _ By: 1Rceupr no.: Fax: (503) 598 / IAUly 4 Mk Case file no,: Paymonctybe: • -and isc appro _ Building permit no.: - , •F IGA'' TYPE OF PERMIT & 2 family dwelling or accessory Q Commercial/industrial Q Multi- family Q Tenant improvement Q New construction ddipon/alteratian / rePlaccrnent O Ctht- .1()B SITE INFORMATION COMMERCIAL VALUATION SCIIF,IDI I lob address; �.� / Sc._e'Y15 i♦�i Indicate equipment quantities in boxes below. Indicate the dollar Bldg_ no__ Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax mar tax lat/account no.: profit 'Valut: $ . IEMIIIIIMDIMIIIIIII Subdivision: "Sea checklist for important application information and Project name: t jurisdiction's fee schedule for residential •ermlt fee" • City /county: ZIP: I 3. 2 FAMI1.1' DWELLING PLR MIT FEE Set 1l!;1)1l Description arid location of work on itemises: - • z •. •L_ , AND COM;MILAlt :.A1,,1NI)I i5'I'I{IA I Qt1It \1L,NTSCHEI1111.E t r i , `∎ �.. L., ►-- k - •�. . u .. rot. L 11 11 . !'o a Fest(ea.) TO a] r l' Est. d=! of corn. etion/i section: • .a E,. a a ' ..' neseri uoo ' Res.ortl Rea. onl Tenant improvement or change of use: ■ IS existing space heated or conditioned? ❑ Yes ❑ No ' Air conditioning (site .1an re. uire ) Is existing space insulated? O Yes O No Alteration ofexistsn= ' A System = — N11::('FI(ANI('',!. ( "o>\ "CRA('T()I2 oft compressors . ■ Business name: „ a a St6ta boil; =oiler no" : i ne'rltFi Tons _ - BTLYH A: a /� j Pi smoke . am.; - •uctsmo a •ctcew s ME aa��rN State: Je A ZIP: �j� eat • um • (s n e , Ian re • uincd) ■ � o e : - . Oyu .."1 Instal replacufurna •urner BTU /H . tul . A 1/,I Inciceding ductwork/vent l Cl Yee O Iso CCB no.: / Ii •nsta 1 rep lace /relocate heaters suspend ■ _- City /metro lie. no.: / . .. wall, or Uoor mounted _ _ • ent or a 3. lance other chap armee Name (please " • T): J I , /Q ftigeraben: ■ CONTACT PERSON . BTU/ Abttotpcionunita Name: Chillers HP M IMMO Corn Address: .sessors HP = � � i total , us): au. veu I teen: 7rs� State: ZIP: A••lianeevent ■� Phone: P -mail: = f) \ti1V1?`t Hot b, pe ( Um. kitcheNhazsTsat h IIII ood fire suppresaion system . n. ` Exhaust tin with sln :led= (bath fans) Mailin: addrea =a gust system a 1 art out heating nrAC �� P plug sad • . • on up to 4 outlets) • City: r rtr P ; • Typo: IlG NfG Oil ' 1111 Phone: ' I - � J l E1risi1: Fad . i •ins each ndditiona over outlets E • I:NCI N t-•a,ft ' rucessp ping se ermine requre — ENIIIIIMMENIMMIIIME mailliilli — Number of outlets i r app ante or equ mom Address: .— Decotativefl • ace IIIIIII City State: ZIP: men- !. 111111=111. - Phone': � I /MI Woodstov pe letsrove _ IL/MIN Mill . Applicant's signatu 10 Date: . D Other; M. L Name • tint): , � - M I Pcratit fee $ Notice: This permit application Minimum fee.• .............. $ ,_ expires if a permit is not obtained plan rrsviaw (at . 96) $ within ISO days after it has been State surcharge (8%) .... $ ------r---- " _ accepted as complete" TOTAL TTOTAL $ • --= 446t6 v41C0 Sent by: ROTH HEATING 503 266 3478; 06/04/04 1 :1 9PM ; JetFax #337; Page 2/2 w S 1 / ' L L ,A) c . . . . , . , " ....". "" . ".. . ., ado 'fib" y el,P, ,..„ ___, ) 4..... . _, 1. rlD ` Olt) � DIZEG7I03.2 7 0 Aivd 1 . /0e4.40 ,,—„,__ . • rim o -r . • . STREET; . . • r CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 3. 4 ` INSPECTION DIVISION Business Line: (503 6.9 71 MST BUP Received Date Requested 6AY AM PM BUP Location 2',c71-- ��5 £� . Suite O�� ` � 'C35/� Contact Person Ph ( ) PLM Contractor Ph ( ) SWR' BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing • Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final P ASS PART FAIL ; \ PLUMBING V \--/ Post & Beam Under Slab / Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS, ,BART FAIL M' C. ±_ '' AL Post & Beam Rough -In Gas Line Smoke Dampers gp ART FAIL AL 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: El Unable to inspect — no access Fire Supply Line ADA / / / f/ Approach/Sidewalk Date Inspector , - PP Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL