Permit CITY OF TIGARD
MECHANICAL PERMIT
0. DEVELOPMENT SERVICES PERMIT #: MEC2004 -00639
.4.31.1- .�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/24/2004
PARCEL: 2S1 02C D -02708
SITE ADDRESS: 13560 SW ASH AVE
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R -4.5
BLOCK: LOT: 026 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: I
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Fireplace insert. U f2 9•
Owner: lt)a i1, A./' ■ FEES
THOMAS, ROY F Description Date Amount
13560 SW ASH [MECH] Permit Fee 9/24/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 9/24/200 $5.80
Phone: 503 639 - 5519 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Gas Line lnsp
Mechanical lnsp
Reg #: LIC 66578 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)246 -6699.
Issued By: Permittee Signature: !Y)n C4.42./2-4 d--ecl--
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
\
.
per.hani(al Permit Application . FOR OFFICE USE ONLY
City of Tig ard Received
13 Dateri3y q ouvpii Fern No.: 1)1660.00......exv3, i
125 SW Hall Tigard, OR 9444ECEIVE B
. Plan Review
Phone: 503.639...171 Fax: 503'59a ;No b 1 6\ Date/By: Other Permit:
Inspection Line: 503.639.4175
SEP 2 3 200 44--41 Date Ready/By: fil See Page 2 for
Internet: www.ci tigard.orus
. Notified/Method:
_..., Supplemental Information
• : --'.1-MptliklioaftRi).74, ,. ' . 'iii;;Z:l . ,;' ..§'I. .i...'05 : . 11ttail.,E -.. USE. CHECKLIST
D New constri tcrion 0 t io 1 .. ! &it einearIMIQPient Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
: '
....' . O 1 ' OF .CPNSPPCTI Value S
9 •••%•:' . . .... .. . . • .
, ...,..:Et...EIbE / SYSTEMS FEES*
s 1- and 2-fan Lily dwelling 0 Commercial/industrial 0 Accessory building
For special informaiion use checklist.
0 Multi 0 Master builder 0 Other:
Description [ Qty. I Ea. I Total
..'.:'. :.,,,z si • ..1013,•S1TE:liNtti*.*Tiil*. A .. : ',.,..:" Heating/cooling 1
Air conditioning or heat pump
Job site address: 1 ' --
51,A....) 4 6'"... e tk — ,. 77 PeSt+ AK- (requires site plan showing placement) 14.00
City/StateiZ1P: o y' , 02!( . 2 S--- Furnace 100,000 BTU (ducts/vents1 ._ 14.00
Furnace 100,000+ BTU (ducts/vents) I 7.90
Suite/bldg /apt. r o.: Project name:
. Gas heat pump 14.00
Cross street/dire( tions to job site:
Duct work 1 14.00
Hydronic hot water stem 14.00
Residential boiler (radiator or
hydronic) . 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 1 10.00 1
S ubdivisio 3: ± Lot no.:
Other: I 10.00 I
Tax map/parcel To.:
Other fuel appliances
1
,6t,§eRIF;TiON::01*p -, , ...7: Water heater 10.00 j
Gas fireplace 10.00 I .
Flue vent for water heater or gas
,,L rie,)'-k, tizr4e—(4"- fireplace
Log lighter (gas) , 10.00
I 10.00 I .
Wood/pellet stove I , 10.00 I
Wood fireplace/insert I 10.00 I
::.,•;. - i . .tiN . , i .0:Istj. ;.,.,;.,.. :.:.:, Chin
10.00
10.00
Name: i? n ja.,w1.4
Environmental exhaust and ventilation
Range hood/other kitchen
I
Address:
equipment I 10.00 I
City/State/Zip:
Clothes dryer exhaust 10.00
— .
f ilet compartments, utility rooms) 6.80
!O . *O.E:: "....:: i::Ip.,...'i,"1:p;;': r0igi-y*::.0S;:......::". Attic/crawlspace fans
10.00 ,
Other: j 10.00
Business name: 3 1 ,_,.. L L'e_ ) ( _-,_ , 0 c - i-I f - t 1 ''t Fuel piping
, ,
Contact nane: ! 4
' fr•-t." r - K i i J . 55.40 for first four; $1.00 for each additional
, Furnace, etc.
Address: 4 rx_t. i- ,-- C I _.(* e t.. ■
Gas heat pump
City/State/2:LP: Hi' . 0 , elik / 1 _Wall/suspended/unit heater ,
Phone: (St.; ) i Ci u — 7 (,.., 6 9- 17::: ( 5 G ,f' / - o ?.- 'if , Water heater
Fireplace - I '
E-mail:
Range
* - : .' .. ..4*" , P-4'.:.:'•. -i :',..-:V1:17::-:;•".'... *C-9,'PlIOV.-',..il7.(1'.1'.,1'. ' ; : ., 7 0 4 4& ! :' 1 ..k',.' -- C,l'..::: . ,.. 1 :.,•-1:! Barbec 1 .
Business name: Clothes dryer (gas)
. Other: 1
Address:
OELANIC FEES*
City/StateiZTP.,
Subtotal
Phone: ( )
ax ( ) Minimum permit f , ee (572.50) 7 2.2.
F:
Plan review (25% of perrnit fee) . .
,. .
CCB lic.: /.. t r ; II
State surcharge (8% of permit fee)
....____A.
' ., TOTAL PERMIT FEE
Authorized flignan re: , :._-;".4 (.._ 1/4--:.---e. 2- This permit application e
t 4:4- - i — .
(
....
xpires if a permit is not obtained within ISO
days after it has been accepted as complete.
Prim name: r- , - j.--- e,_,_ C. i (' 4 . Date: /1014 C 1 * Fee methodology set by Td-County Building Industry Service Board
iABuildingWermit;IMEC.1 trmitApp.doc 12/03
4 4 O--6l 7T (TIM/COM/WEB)
a • cl SILO B6S EOS 2uTleaH RaieToacis e9S:60 1,0 ea das
CITY OF TIGARD 24 -Hour
BUILDING Inspection L' e: (503) 639 -4175
INSPECTION DIVISION Busi'ne'ss L' e: (503) 639 -4171 MST
BUP
f �
Received / /'3 Date : e •nested /0• f 0' AM PM BUP
Location .4 i1i A Suite t-9 v_- 0 0 w3?
Contact Person �i�. - Ph (.S ) S
Contractor Ph ( ) SWR / r /
. BUILDING Tenant/Owner /a C nc,1 4_ e' d 61' 006 7� I
Footing
Foundation ELC
Ftg Drain Access: "h c) ELR
. Crawl Drain GILD e^«'G
Slab Inspection Notes: SIT •
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear /� �i ,� //� .0-1.--/ /�� ) /c-S----
Framing G� , `rte �Y C� _/ l /
Insulation
Drywall Nailing
Firewall V'-\ . / o - L , ' 6y
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling
Roof
Other: -
Final
PASS PART FAIL
PLUMBING.
Post & Beam
Under Slab y. i
Rough -Ins t ,
Water Service •
Sanitary Sewer "
Rain Drains
Catch Basin / Manhole
Storm Drain
JI
Shower Pan (
Other:
Final _ --
PASS PART FAIL
C ANIC
Beam
R
moke Dampers
Aitt RT FAIL
- 'AL
Service
Rough -In
UG /Slab
Low Voltage
F larm
Fi •
PART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE - 0 Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line • ADA D / V d Ins actor • �. -' Ext
Approach/Sidewalk p
Other:
Final DO NOT REMOVE this inspection rec . d from the job site.
PASS PART FAIL