Permit a �r
CITY TIGARD MECHANICAL PERMIT
0
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00523
AP 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 8/4/2004
PARCEL: 2S112BB -03100
SITE ADDRESS: 08500 SW COLONY CREEK CT
SUBDIVISION: COLONY CREEK ESTATES ZONING: R -7
BLOCK: LOT: 027 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Extend gas line from meter to pool heater.
Owner: FEES
GADDIS, WILLIAM Description Date Amount
8500 SW COLONY CREEK CT [MECH] Permit Fee 8/4/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 8/4/2004 $5.80
Phone: 503 639 - 1930 Total $78.30
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Final Inspection
Reg #: LIC 1441
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: .-e_ ,p
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next lousiness day
FRAM :JacobsHeating FAX NO. Aug. 04 2004 11:23AM P2
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0 84gg - -
Mechanical Permit Appli • • it
l7atcrceelvcd: D Pc rmitno'.: O C{ -
„Ai. ,, City of Tigard
C.'it Address: 13125 SW Unit nlv(1, 7 'ip (.)k 9 ' �i 1.3
1/4. p..(9,..,„ppl-no.: i Expire GU, -�.,
Phone: (501) 639.4171 I) atoissuc(t, lly; i ilec
Fax: (S(13) 59R ig(p 03 � e.ipl nn,_
f .�, ® Case file no,: payment tyre;
Land use approval: `l Q�`� 'bidding °— — -
__ Co‘ VP
s ... g perrnit no,:
1` 'PI: OF PER MIT
U I RE 2 family dwelling or accessory U Commercial /industrial
U New conslnictinri � U Multi-family- U Tenant improvement
Addition/alteration/replacement U Other:
. tO11;S1'iil'IN111t11r1'1'1( >N COMM 1::11['iAf vAI SCHEDULE
. _
Joh address ; O S . A d ri +
' r ► � Indicate _
Bldg. no.: equipment quantities in boxes below. Indicate the duilal
_ �,,, Suite, no 4 value of all mechanical materials, equipment, labor, overhead,
Tax map/lax lot/account nu,: profit. Value $
Lot: Block: SubtliVlsinn: . " — '
Project name: See checklist for important application information and
City/county: 1 jurisdiction's fee schedule for residential perm fee.
rC [ ZIP: ?r�� , I 1 , � L i' DWELLING r
scriptiort nn h> tort of work on `Y PERM!' FEE SCHEDULE
o premises �
De, AN1)('()11 11':121(,►i. /JNI)( UIi'111'
.. - - � •,Cl�.�( t?'tl //• a�,� ��_ (T ( •.N1'SC'lI(1)[.lI
1?st- dale of- completion/inspection; Fee(en,) Total
'Tenant improvement or change of usc: - r Rrs, oml Res. on
;t
Yes
Is existing space healed or conditioned? conditioned? C:1 Yes l 1 No
Air handling unit C'FM
is existing space ihqulaleel'/ U Yes U No A rr coa liiioaing ' (si1G tlnn rc 9 r1v i�� ' � ,
All:;('l CONTRACTOR CONTRACTOR Itc lr ° ex ssting lvn( system
, —. —..—
Business name: f t" / . ! �rn er conipr%ssors -___ _ ",_
Addra, s' _ L f t � / + Stale boiler permit no.:
City ___E aQ I / I1 lobs 11'1 [)nt
St 1 Iti7 o cc ali ters - tasm cietc —
Plannc :��1��_- e(c TT1} . Tin pum i 4ita cloth
g ! ,��. l.'s" -mail: - stall /re`pl ee t ce /burner. }iT[T)I) — .
CO3 rio` �.�� 9 _ i � ace r'i'i�atit .- ,._. --
e v'. - 731 „ .� - � — including ductwork /vent liner C:) U No
City /metro tic, no.; ; �� rep ac re create teeters- sus pende ,
Name ( lease .fiat): _ .. Wall, or floor mounted
of. `. cal or r tce t
n nt ul acr t nr�i ir'rlrnet ,,'
CONTACT PERSON e germ on: ��
Name: Absorption units i3TU /I i II
Name: a; Chiller �� _ I
r
�� Cum ressors _ 11P a ,,,_
City: - . l State: ZIP:
,nv rbnmr:hta mist an vent at on:
Phone: cam E-mail: Aplillyncevcnt II
Dryer exhaust
OWNER Iloods,')'ypc flf7,ce. kiteheulhmmnt ----
` /lj hood fire suppression system
M address: Bahnust fan with single duct (path (stns) -
City: - tx Isusts stem at,slrt ton sent n or
1
Phone: 3 state: e p p np a kg u an up to out cts _
F ax: E-mail: T '°: LPo 4\ NG Oii
ENGINEER 'tic , an: meta• t ona overxe hits �3 JL
Name: roecss 1' P eg sr, ferret c required t r
Numbcr outlets
A 1 e88: t s er app once or eqn patent: ��
City: State: ZIP: Decorative tire lace - --
City: Phone: neert -(y•e
______
`-
F ax: E -mail: "oo stay pe etstuve
Applicant's signature: Date: no
• Name (print): 1(refs
N
MO
M an )ud. w:Ctpr crnAle cord', Icrtte pan u M ., -_
to visa C] MasterCard P 1 t isrllcgam h ,t t aaxe ihlcxmnalp�, Permit Fee
Notice: This permit application - 7� „�
c,.'drt elm maws; expires if a permit is not obtained Minimum fcc
i „ —_ ~� -” a pt a � expire f i days after it leas been
flan review (at -- -M %) ...
e or c
1 ar ,e ra It n.V au crtN a ChM accepted as complete. Re (f %) ..., f, 64-0— .,.
State surchar
(74, optimum s TOTAL �a
Amount Q'. �' 2
•
440 451? (6/170/C OM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested a AM PM B •
Location F 5176 eAuite � 4 efes-R3
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
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 o
a� fr5e
Smoke Dampers
Final •
S PART FAIL
ECTRICAL
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 0 Please call for reinspection RE: 0 Unable to inspect - no access
' Fire Supply Line f 17/0'V
'ADA d 11
Approach /Sidewalk Date ! 1 t Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
ti