Permit C ITY OF TIGARD MECHANICAL PERMIT
' "�' DEVELOPMENT SERVICES PERMIT #: MEC2004 -00795
+�- 6 � l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/6/2004
PARCEL: 2S 112CB -02800
SITE ADDRESS: 08212 SW ASHFORD ST
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7
BLOCK: LOT: 042 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm:
GAS OUTLETS:
Remarks: Replacement of gas furnace.
Owner: FEES
GRASSMAN, KENNETH J Description Date Amount
8212 SW ASHFORD ST [MECH] Permit Fee 12/6/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 12/6/200 $5.80
Phone: 503 634 - 1708 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 76359
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: ��
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b usiness day
Eec 06 04 11:40a PAM DALBY 503-598-0270 p.2
•
Mechanicarrermit Ai 1 • .. ' D li CD FOR OFFICE USE ONLY
City of Tigard D Re a c teB eive y d , a t/ Jo_ Permit No.Wc24vy
,...,
13125 SW Hall Blvd., Tigard, OR 9722
Plan Review -ic _a
Phone: 503.639.4171 Fax: 503.598.1960 DEC 0 1 ,.
Date/By: Other Permit:
Inspection Line: 503.639.4175 __RIX I Date Ready/By: funs: ei See Page 2. for ■
Internet: www.ci.tigard.or.us Notified/Method: .-i I Cr Supplemental Information
CIIGPS
GO 0 s , , \illni■
.:..',!;:;::::`,.'.:1,,,-,;,:?:')z:.,:,7-ii5:-,;:.:;::'k!',.•;!:;:,.,y.,•44;k:Air,,E..,;,..i.VVORELjp;-,.:,':::..:';',4,14*1.L:-:-:,:..:.''.:?...,1:`,:.;.:.-5; '4:0Niy.\ittki:40.-.0BEED...fiLE •-- USE :CHECKLIST
Mechanical permit fees* are based on the value of the work
0 New construction [;SrAdditionialteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
.--i....,..:F...: 31 r 5 CONSWITION ;-. a.. -..-: -,- >:-.- i. -,,, :, Value: $
;-.• -,.•V..1.0gNIWEP.I.IRISTE.NT / SYSTEMS FEES* •
{E4>1 and 2 dwelling El Commercial/industrial E Accessory building
For special information use checklist.
0 Multi El Master builder 0 Other: Description Qty. Ea. 1 Total
- 4013 - - ,SOF, 7 ..:11■IF.91Wr#B9, , .,f, ,, _ _. 49.q., -...,o_tNT...,;., Heating/cooling
i dc:2 / / • . .1 , A C 1 LI . ' Air conditioning or heat pump
Sob site address:
(requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) / 14.00
Furnace 100,000+ BTU (duets/vents) 17 90
Suite/bldg./apt. no.: Project name:
Gas heat pump 14.00 I
Cross street/directions to job site: . Duct work 14.00
Hydronic hot water system • ' 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 10.00
Subdivision: i Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
g_S_040TOL'i..*:.'W-tlii0,4V:•:;;i'l:';;;:..4‘t .:':V. !.::. Water heater 10.00
. '
Gas fireplace , 10.00
4 eff /4 Cc- .?_5 -,_.i 4,,414-7--____.. Flue vent for water heater or gas
fireplace 10 00
Log lighter (gas) 10.00
Wood/pellet stove 10.00 .
Wood fireplace/insert 10 00 1 •
:,--'-'../IC!'fi'"Okb-iiii.tirliNkri■ZE•44''''>•/.:. 0 ‘ti,"•ii'A''.:"•'.•':'.-,1:1-ajf ii*t-'•;::'"'■•/.,4gin/ Chimney/liner/flue/vent 1 10.0G
- -,.... ilt,t,t,,i- . , .,i,....„ i::-:, -....' , .'s`- -,,,-.:%:.,.: '•i'- t':: f4f '''.," ,. • .f fi oth 1 10.00
Name:
/1 6 4 .4 41,5 Ai 4 - .4-11 Environmental exhaust and ventilation T ■
Range hood/other kitchen
Address: F.e .5i.j 45/(P70/Zr) • -t- equipment 10.00 1 .
City/StateiZIP: Clothes dryer exhaust 10.00
- 77 tr"r/ Single-duct exhaust (bathrooms,
-2 /i Fax: ( )
- • • - . q.=? - --"..7_ .ile . .... .. . -.:„,... , . .. ..- . .. toilet compartments, utility rooms) 6.80
ZWkAtgitT1
Attic/crawlspace fans 10.00
Other: 10.00 I
Business name: Fuel piping
Contact name: 1 I /9 aii-a27 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 1 I
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
, Water heater
Phortei9 ) 4 , 2 q ).,.2eyy Fax: : 0 ) ....5 .0., /
Fireplace
E-mail: Range
•:":.igf,•-',.i:,,riAtVif_7.1;:•ir,i7P:l.t.Ait*!1t1':,:':WITiO:RWOW'SF.fre::::,11,W:1:;:qtq:;-;.11:?;;I•-?::F:..'i.,P1 Barbecue
Clothes dryer (gas)
Business name: p 4 ,.. b / -63-77,...14. Ca fi
Other:
Address: /.0 0 6 ,, y , eR 3 e' 3 1' '7 r.11::,,raMi4sigEitixiiidAL:ki'c/giFFkgs4 •
City/State/ZIP: .
Minimum permit fee (572.50)
' Phone: y3) c e 2 5 t ,../ Fax: ) _s_i 9' �C. 7e,
Plan review (25% of permit fee)
CCB lie.: 7 ‘-- 9 5 9 State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1 7 . 7 4
Authorized signature: ,O../".-7"2.--0%.e.■_--P----/Z2 This permit application expires if a permit is not obtained w ISO
days after it has been accepted as complete.
Print name: /22 e L 4. 4 /),,c 7.62/ Date: /2_-6 pc, i e • Fee methodology set by Tri-County Building Industry Service Board
i \Butlding'sPernuts3MIC-PcrmitApp d.oc 12/03 440-4617T (11/02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:.(503) 639 -4175
MST
INSPECTI N DIV ZION Business Line: (503) 639 -4171
BUP
Received Date Requested l 2 7 1 7 A AM PM BUP
Location \ 1 4 Suite c o ( C / -7 9
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Foundation ELC
Ft Drain Access: 1 1 :�u ELR
9
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �
\`
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ` et) V I , FOe
Fire Alarm f o -/—( . P " /2-" i i c / " 1 ! r 1
Susp d Ceiling
Roof O A:( �- 0`/
Other: - —
Final
PASS PART FAIL
PLUMBING ° t
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole -
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
re f N AL
P o s T& eam
R ou gh -I n f S�'
Gas Line
S •. - Da pers
•
(a PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before ne inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
4
SITE Please call for reinspection RE: 0 Unable to inspect – no access
-
Fire Supply Line ,..
ADA
Approach/Sidewalk Date ! ' Inspector 41111i Fait
Other: Other:
Final DO NOT REMOVE this inspection record • =. e job site.
PASS PART FAIL