Permit CITY TIGARD MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2004 -00746
%411 DEVELOPMENT
SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/15/2004
PARCEL: 2S114BA-07200
SITE ADDRESS: 09800 SW COOK CT
SUBDIVISION: COPPER CREEK ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: replace gas furnace.
Owner: FEES
SHELTON, WILLIAM N AND Description Date Amount
DOROTHY P [MECH] Permit Fee 11/15/20( $72.50
9800 SW COOK CT [TAX] 8% State Surcharl 11/15/20( $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 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: T 2 Permittee Signature: Vi
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Nov 15 04 02: 22p PAM DFILBY
,, 503-598-0270
• p . 2
t'' iechanical Permit Apiillatra FOR OFFICE USE °
f- .. .
vti= V EP No
97223 r .
u Ls I.. •••••• I•
2ity of Tigard Received . ....., i _at/ a 1 . ...6
Date/Byt Awl
.3125 SW Hall Blvd., Tigard, OR n A
Plan Review 1
?hor.e: 503.639. Fax: 501598.1960 NOV 1 5 2u,„ ,,„,,, Date/Byt Other Pct:
inspection Line: 503.639.4175
11,4 Date Ready/By
0 ' .
Internet: www.ci.tigard.or.us CITY OF TIG.T.4.-.-_. '--- :
Notilled/Method: kris: ED See Page 1 for
Supplemental Information
BUILDING DIVISION
.., fs-'-',;-`-o*c
g-.E geb*i,iikakiiiiy-7ibilinft.E. - USE ,CHECKLIST
.4.r.rer-;.titrifi,; ,..4. .. refi. — ... • - —, ,...:•-...,' . -.1..r.: ,..ii .-iii - • • - - i•-• -ii.: i. i......• . .-.....--- ..• - • • i
Mechanical permit fees* are based on the value of the work
0 New construction C5.1dciition/alterationireplacement performed. Indicate the value (rounded to the nearest dollar) of al;
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and prof.:
Value: $
EQvNT/ SYSTEMS FEES
• i ii:%.*pr.;:0'•'',A5000V.tvo.07:':41'.64■da'..;. i ■ ! 0 i; '..,.. - ,_. „.,,,,..,... ,-.. •"•.• .• i' • . .:• • .,... • — • •••••• : , • • " .
I- and 2-family dwelling 0 Corrumercial/industrial n Accessory building '
• Multi-family 0 Master builder 0 Other: For special information use checklisi.
Descripuon 1 Qty. 1 Ea 7otal
.:. f.L;;:1;:,71/...:,„...:::iiil He , „ ng/ coo „ n g
Air conditioning or heat pump 1 I •
. Job site address:
9 * O _S C p e.) (c ._ C.71 (requires site plan showing placement) : 14.00
City/StateiZEP: Furnace 100,000 BTU (duct.s/vents) / 1 14.00
Furnace 100,000+ BTU (ductsivents) 1 17 90
Suite/bldg./apt. no 1 Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work i 14.00
Hydronic hot water system 1 14 00
Residential boiler (radiator or
hydronic) 14 00
Unit heaters (fuel-type, not electric), 1 .
in-wall, in-duct, suspended, etc. 10 00 I
Flue/vent for any of above I 10.00 •
Subdi,:ision: Lot no.: Other: I 10.00
Tax map/parcel no.: Other fuel appliances •
•
• • = ...... — 0 .- - .. :i 0,...,.....42• t••=e•r — ir.:!:!so'i'. Water heater
.•-'-' s'. f ' 4P.i s i.i'-] RZe i.,7i.CV7A-i .,s:;;:i':Pt..:%..,...'afikie*eigii".44:.:4k4q I l 0.00
Gas fireplace I 000
/ Cc d- 1-1 C i '• - - - c . lA A Pyn 6 Flue vent for water heater or gas I
fireplace
10.00
Log lighter (gas) 10 00 ;
1 Wood/pellet stove 1 10.00
Wood fireplace/insert 1 10.00
, i i - -ii• Chimney/liner/flue/vent: I 10.00
1 1-1 : - . ' ),-11 ,.. , Ji.2.0,E13,117.NO Osh7zilibli...41:**Iti:,-,;,,,,l.r.s7:446 trmitrAti,r.:,.;,-,{1,,,,.,,l,„:0,:,..,,,„
..,—.....—..:;?!.-4 ,.--- . , .—. 4 ., .....';-„,,,-.,..$, ---- ,,-. - .'4"." . Al •vi-ini Other: 1 10 OC
I Name. / / / I reL.A.f , 5.,< , 7-74e,-) Environmental exhaust and ventilation t
Add.ress: Range hood/other kitchen
9 I/ 5 .5 6.4 r, i / 6-i: equipment 1 10.00
CityiState/ZITP: C1 Clothes d exhaust 1 '10.00
Single-duct exhaust (bathrooms,
1 . Phone::503) LS-6/* 9 /,,..... i4. D, ,. Fax: ( ) toilet compartments, utility rooms) 6.80
1 .•,..: -.41.1.-1";;F--r;'-iittl•Ir.r.iii4M111711C2`,41anj,•:iftrglit Attic/crawlspace fans 1 I 10.00
I f'.. :‘,...:..e..4,-.Y,T.,,,vv--;.10-.. IN;t4 trz,iiv.Hy„kvtfa-Pit.toi,..N•tre..4.NI.6...f..,e .:*41/.:/4i,,
Other: 1 10.0C I
I Business name: Fuel piping
I Contact name: /q/ 0/i /b / $5.40 for first four; $1.00 for each additional
Furnace, etc. I
Address:
Gas heat pump
• I Ciry/State/ZT: - Wall/suspended/unit heater
Phone: 7 ) 02q '2o F ax: : ( .... 7' ‘) 3 ) ...5' i e2,;? /7 , 0 Water heater
Fireplace
1 E-mail: • Range
.'".41::::A.,;Cagnikiil...1.14-iti.ittst$1";1-4,7g96:iit‘44) '44.i.41A"-4....ti10-grail45.2:Dt-ittI?,;41).,,T• Barbecue 1
, Clothes dryer (gas)
Business name: C, 4 .4 .,i 6 in 7 1/..e...,/ -r7 j(c, e. i 4./4
1 Other: , 1 I
ddress: 0 0 x it= 3b 3 7 0.10.45V-Taggg,igeApiti.grr.:F.gFs7
City/State/ZIP: Subtotal
T 4- /9 0/J 9 7,7 Minimum permit fee ($72.50) . I '72. (•,
. Phone: , ) (... c 2 Li , al 0 „..„, 1 Fax:3 ) 5 . , fr °a 7 45 Plan review (25% of permit fee)
1 CCB lic.: State surcharge (8% of permit fee)
TOTAL PERNIIT FEE TC1 , I ei
Authorized signature: ‘/..., 4A This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
I Print name: y '.'9 .. 44 / 7 c / ,4:1 e 76/ Date: / /://v/ f 9 4 7 , • Fec methodology set by Tri-Cocnty Building Indus Service Boar,:
V..Bailding\Permits\MEC-PerMitA.pu.doc i2/03 440-45 I 7T (11/02/CCM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested f �° AM 1-PM BUP
Location q ,s7' d Suite ' ` aGsD- V 7V
Contact Person P 0 YY
�\ Ph ( ) (O c� `t �� d PLM
Contractor Ph ( ) SWR �� D
BUILDING Tenant/Owner ELC
Footing
Foundation Access: b u te-s-ra'v'i f r ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing j v - w ���
V
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 • F
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PA psi: FAIL
• .,. AL
• Beam (fil
Rough-In Line r
Gas Line
Smoke Dampers
PART FAIL
EL RICA L
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 _ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line 1
ADA Cl
Approach/Sidewalk Date / / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record m the Job site.
PASS PART FAIL