Permit r.
CITY OF TIGARD
MECHANICAL PERMIT
'lli DEVELOPMENT SERVICES PERMIT #: MEC2004 -00464
'�'�°---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/15/2004
PARCEL: 2S110BC -08500
SITE ADDRESS: 12468 SW ASPEN RIDGE DR
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 056 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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install AC unit.
Owner: • FEES
GREG BENSINGER Description Date Amount
12468 SW ASPEN RIDGE DR [MECH] Permit Fee 7/15/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 7/15/200 $5.80
Phone: 503 614 - 9129 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 640 - 3607
Reg #: LIC 66578
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 business day
l�Iecl'lari gal Permit Application
• •
���, Received
� `' FOR OFFICE USE ONLY
City - of Tigard ENE
11(25 S W Hall l tivd., Tigard, OR 97223 Date By: / � WV �6 , Permit No.: '/
Phone: 503.639 4171 Fax: 503.598 1960 Plan Review 00 V( [
Inspectior. Line: 503.639.4175 1 1 t) �O� � 1�' ��" Date/By: Other Permit. for
Internet: r,vww.c .cigar s � 39.41 3U' Date Ready
/By: [ ,Ready/By: ruris:
' _ Notffietl/ivlethod.
S PP emeutal Information
See Page 2
+':r C'OYT1YIERCAIT. H US
cz��v -• :..,., �,,.� .FE E :. SC EDULE - E'CIIECKL[ST
❑ New constr _lotion ❑ Additto alter Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded co the nearest dollar) of all
❑ Demolition 111 Other:
mechanical materials, equipment, labor, overhead, and profit
d i '' . CATE GtRY; O F`. CONSTRU, e'r,r:
CTION
,... C; :. :`__', V a l ue: 8 •
❑ 1- and 2 -far my dwelling ❑ Commercial /industrial FESIDEt�TI�I :E iI'lytENT / SYSTEMS .FEES*
❑ Accessory budding
T U
Q
❑ Multi- fan / ❑ Master builder ❑ Other: For special information use checklist.
Descnpcion Qty. I Ea. Total
' :' , '' ' '' :'''''' '' JOB SITE, IN 'OR MATION ANVD'LOCA'tIOIY , `'_. -
7 ": Heating cooling
fob site address: f C { s � c J 1-1•c Air conditioning or heat pump
City/State :ZIP: (requires site plan showing placement) 14.00
- L.ti-r"`"`2„ , t 47 f• 1- 2',z- +•- Furnace 100,000 BTU (ducts/vents) 14.00 j
Suite/bldg. /apt. c o.: I Project name: - Furnace 100,000+ BTU (ductsivents) t 7.90
Cross Street/diret lions to job site: Gas heat pump 14.00
Duct work 14.00 j I
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
Subdiv sip a: I Lot no.: Flue /vent for any of above 10.00
Tax map /p creel n,a,: Other:
10.00
:.:... . Other fuel
n l DESCRIPTION OF.t; .F Q12K. •. ',iv- . 1 ., , ,... ;, ...
Ot h fu appliances
;�'�' Water heater 10 00 � I
Gas fireplace 10.00
{. Flue vent for water heater or gas
_y rM �2 �_ 11 Z- 1 - fireplace 10.00
Log lighter (gas) 10.00
,.
10.00
Wood /pellet stove 10.00 fireplace/insert
Wood 10 OU l
EL,I'12E i EERTY' „OW�fER``'`'” ;:, {: :. Chi
,< ,;';. °' IIA.IIN vC rnneviliner /flue /vent
Name: r r r � y, , a,.:::: ::dz::::„ Other: 10.00 —I
C.,•
Address: .0-r Environmental exhaust and ventilation
Range hood /other kitchen
C equipment 10.00
ity /State /2IP:
Clothes dryer exhaust 10.00 I
Phone: ( ) (()/ y CJ / c Fix: ( ) Single -duct exhaust (bathrooms,
.,
toilet compartments, 1
.8, ; -` , toil t compa cots, uti ity rooms) 6.80 • 4PPL'�Ge\NT i ` 'GAT - •
,, ,, ,,, ;;,,,,,,':.. ;= .:...., ;-. :1 , .... . O w e fans •
,... . . � .� :PER'SQN� :, :;:.:'.':'.;.,; !'„ 10.00
Business name: � � Other:
Contact nacre: _ Fuel piping
c } k: j2. t k ,--- i rf . S5,40 for first four; $1.00 for each additional
Address: I + � _tli 1- .4"-- Furnace, etc.
C ( _� C .`
City /State/Z:P I Gas heat pump
(� r C �tL Z 3 Wall /suspended /unit heater
Phone: (51". 5 ) - -�
� E l U y {, } I Fax:: ( fit; )) ) fl: - f ` C Water heater
E -mail: Fireplace
.:.' ;.:: ( - >. ;t Range
: .. : ' : 'CON ; , I. AC ;'i :'�4:11 ',Fi.': _
- "': ;::, �,�• : .- ..; Lr:: , . a , . KL•ns.:a�;:�': " "::'; ?.� w "' B ar b ecue
B Clothes dryer (gas)
Business name:
Other:
•
Address:
City/State /ZIP:
y , m ' . 'i 1 k 1 ECEIANICAI;;' :PERMrr FEES*
Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) - 45-6
!�
CCB lit.; /. � . s --- S� Plan review (25% of permit fee)
4
State surcharge (8% of permit fee)
TOTAL PERMIT FE E
Authorized sinand .`.f. •`C 1 `
�• -}^""' ,' This permit application expires if a permit is not obtained withi n ISO
Prins name: i days after it has been accepted as complete.
l l t' _E C,-. ( ( t Date: • Fee methodology set by Tri -County Building Industry Service Board
e VCEC -Pe tnitApp.dce 12/07
440 -46t7T (I I /eZ/COWWEB)
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Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
E'd BILO B6S EOS 2uigeaH R.IetoadS dTti =EO 170 21 Inc
CITY OF TIGARD 24 -Hour
BUILDINg` Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested g- I-7 AM PM BU -
Location An .. �� s Suite o70 - Q t / q
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int
Sheath/Shear `- J _ [ 7// 93
Framing 1, CJ
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam ��
Rough -In
Gas Line
Smoke Dampers
SS PART FAIL
ELrcc RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final [1] Reinspection fee of $ required before next 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 ` / / " 0 4 — Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL