Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2004 -00559
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/17/2004
PARCEL: 2S 102CA -00230
SITE ADDRESS: 13140 SW ASH DR
SUBDIVISION: VIEWCREST TERRACE ZONING: R -4.5
BLOCK: 02 LOT: 015 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:
LPG 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: 1 AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Remarks: Install new gas furnace and a /c. Gas piping and venting for furnace and water heater.
Owner: FEES
LINDSEY THOMAS Description Date Amount
13140 SW ASH DR
TIGARD, OR 97223 [MECH] Permit Fee 8/17/200 $72.50
[TAX] 8% State Surchart 8/17/200 $5.80
Phone: 503 968 - 9760 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 76359 Heating Unt Insp
Cooling Unt Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 e.rt"thro •h OAR 952 - 001 -0100. You may obtain copies of these rules or direct q,,uestions to OUNC by calling
(50 46 -6699.
Is - ued By: 0 _ 1 O& i i, 4 , Permittee Signature ice_
Call (5034-. ' • -4175 by 7:00 P.M. for inspections needed the next business day
Aug ' 1 7 '04 10:28a PAM DALBY 503- 598 -0270 p.2
iMe-ch -an • cal Permit Application FOR U
FOR nFFICE USE ONLY
City of Tigard Received Q / � �� �
Date/1dy: 0 i 041 4 PermitNo - Q q
13125 SW I-1211 BM., Tigard, OR 97223 /
Phone: 503.439.4171 Fax: 503.598. 1960 Plan R
� � � Date/By: uris: ermic
Inspection Line: 503.639 4175 „
��� Date Ready/By: uris: H See Page 2 for
Internet: wvnv.ci.ugard.or.us Not :, -AJj fl Ready/By: / /1 Supplemental Intormation
...
Q {� c �: s.:, :. * ;:., "' Z ` .014IMERcIAT,;`'PEE" SCHEDULE - USE CHECKLIST
❑ New construction dditior,t$]ht'f replacement Mechanical permit fees* are based on the value of the work
❑ Demolition `` 0�� i performed. Indicate the value (rounded to the nearest dollar) of all
Othe mechanical materials, equipment, labor, overhead, and profit.
-`:. .-... ;r. C:ATE'G.ORX'0..'COr. Value:S
r .
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building " / SYSTEMS FEES*
Multi family ❑ Master builder Ot For special information use checklist,
Other: I Qty Es. Total
Description t
JOB, ST: 7E'I $ Pt F• ORVI'ATION ;'ATTLOCA %. : , ..• .'
,:. . • ..... ... . . ..... .. .: ... <_ O .: •.,... .; .. - -!.. - .' i:'. Heating/cooling
Job site address: ?J (
cJ! f _ A Air conditioning or heat pump I
(requires site plan showing placement) / 14.00
City /S[ate'ZIP: Furnace 100,000 BTU (ducts/vents) 1 / 14.00 '
Furnace 100,000- BTU (ducts /vents) 17.90
Suite /bldg.iapt. no.:. Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work
!4.00
Hydronic hot water system I 14.00
I Residential boiler (radiator or (,
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. ■ 10 00 :
Subdivision: Lot no.: Flue /vent for any of above / 10.00
Other: _ 10.00 I
Tax map /parcel no.: Other fuel appliances
,t • 't• ' ''DES RP ,,. :.,.,,aa- :r
...... . m•...IOtY .O.F:; W0.2IC. ; r ' Gas Water ep 10.00
• �- T.9 f�j � - G firepla ; I C.00
/4/
- �//L�Y7 /._C_J Flue vent for water heater or gas
fireplace 10 00
,/// 7r"- - "4 � Log lighter (gas) 1 0.00
Wood /pellet stove 1 0
Wood fireplace /insert j 10 00 I
N: ; PI201',ERTiC ljw. 10ER ` "15'. •' ;l: - : ; iq' - Chimney /liner /flue/vent 10 00
,.,:. max... D. T�i•,''ANT'..'i''= �::'
_.. ' �`��•• • , Other:
Name: / 10.00
�-* ���� r�.�/) Environmental exhaust and ventilation
Address: / � � � � Range hood /other kitchen
/ / e. equipment 10 I
1
City/State/ZIP: Tr Clothes dryer exhaust
Si -du exhaust Phone: ( 94 g Fax: ( ) Single -duct t (bathrooms, 1
. toilet compartments, utility rooms) 6.80
'', ! ?_. ......., ...,. .. :: ` =�cO.QNik.1``'PE• O., :: ; ; % Attic /crawls ace fans 10.00
Business name: Other: 10.00
�) _ Fuel piping
Contact name: /` /qit•I 6 ,` /6 $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. /
City/State/ZIP:
Gas heat pump
Wall /suspended /unit heater
Phone:
(7-.45 ) 47,, q 3 7,2 ,, t, Fax: : (3 Sly � Water heater t
E -mail: Fireplace
-r Range
.,, CONTRACTOR :; : Y t: t
.. . � . - -. y�. „'1t.� : ... . ... 1 •Barbecue
Business name: /u ,`'1 h , . {4'n�Co . • Clothes dryer (gas)
Other:
Address: `� NC..
f J D 6Dk 3 .3 '7 ! ::t ,,,, ..... .
, ; :�.,•• : . *gHAIZ:ICkL'1?LTiMIT'EEES*
City/State/ZIP: 7 i 4- i�.a -17 0/a_. ?7 3 Subtotal
Phone: 1) c. a ti „ 210 / / Fax: (,� Q a Minimum permit tee ($72.50) -AA .
'T � J - fir 9 g 70 Plan review (25% of permit fee)
CCB lic.: 7 , 9 State surcharge (8% of permit fee) clz) I
TOTAL PERMIT FEE i , ?,v
Authorized signature: - .2 - e_a This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: )�/l� C/ ,41- ./7 76 Date: rj / /n • Fee methodology tel h
s/ / 1 ! , gy by Tn- County Building industry Service Board
ac0.46 ;7T (I I /02 /COMJWEB)
B u \ P 1
i lding crrnitsNC -C•PermitApp.doc 12 :0i
is
Aug 17 04 10:28a PAM DALBY 503-598-0270 P . 3
ea.ele nEr
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUITE E110
TIGARD, OR 97223
(503) 624.2704
FAX (503) 598-0270
) \
1
,
, .
\ , .
; .
. ,
..r. .
, ,. •
• .
, .
I .
•
•
. .
i .
, 1 .
• .
1 .
! i
,..
, .
•
. ... . . .. ..-- ... –....--.... — ...___—.....— ...... ..... ...
- ... - -
----•---. r
. . .—........ , - . - .
– .-
A e.' . :-.. t'
JOB ADDRESS „. _.
:, . - / c e-.) <- ., ,
' ‘ .;:'--./.
• -- ,,` - -- (....,',..: ,/,..i......,
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line J503) 639 -4175
INSPECTION DIVISION Business Line: 03) 639 -4171 MST
BUP
Received Date Requested 3 - I AM PM BUP ,,,,,� / i
Location l 3 / T Suite MEC a� -�T� S �
Contact Person PCI4 ( ) 6 A 6 f-,-).- - 76 PLM
Contractor ( ) SWR
BUILDING Tenant/Owner ELC
Footing (l/f.
ELC
Ft Drain
Foundation Access: ii F geiwm n, 4-5 H
9 ELR
Crawl Drain 1/!‘:::* 1 1 66
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear V ► vim\.' '7
Framing
Insulation
Drywall Nailing
Firewall ' ( s 1110. Fire Sprinkler
Fire Alarm
Susp'd Ceiling _
Roof / U R %z/ S C1 r S Go N (-� ��: - --- --
Final
PASS PART FAIL
PLUMBING A 7 C_ OA( ( /-7,4 . 4-0"1
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final AirilialiMEM
PASS PART FAIL -
MECHANICAL
Post& Bea /PM 11.11,1111111r-
Rough -In _
Gas Line
Smoke Dampers /i G
ii
PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before • -1 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
Approach/Sidewalk Date C./ Ins pector �! Est
Other:
Final DO NOT REMOVE this inspection record fro :. Job site.
PASS PART FAIL