Permit a '
CITY OF TIGARD
MECHANICAL PERMIT
$ 41111. DEVELOPMENT SERVICES PERMIT #: MEC2003 -00665
= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/24/03
PARCEL: 1S126DC-04400
SITE ADDRESS: 09430 SW CORAL ST 150
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: _ VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 2 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Add (2) VAV boxes, relocate ducts, grilles & registers. Project value: $7,500
Owner: FEES
RENAISSANCE DEVELOPMENT Description Date Amount
1672 SW WILLAMETTE FALLS DR. [MECH] Permit Fee 11/24/03 $186.50
[TAX] 8% State 11/24/03 $14.92
Phone: 503 -557 -8000 Total $201.42
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
•
Phone: 503-266-1249 Heating Unt Insp
Duct Inspection
Reg #: LIC 14008 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 quest' o UNC by calling
(503)246 -6699.
Issued By: Permittee Signature:, I l -----
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Received: 11/19/03 12:05PM; 5035981960 -> ROTH HEATING; Page 1
11/19/2003' 11:42 FAX 5035981960 CITY OF TIGARD 421001
A.
•
r ; ..: -- M Pe �p1 , ��iola FO 0Frlc " '<<sc 5;
;. r6 � . Received Mechanical , ems ��' e , /_ / •
. r ., Date/B D SO 7%' Permit No.. u pr c1,�KX•66..5
• Planning A •rove Building
y ;. City of Tigard NOV , V 2003 Date/B g P Permit No.:
s z }:= 13125 SW Hall Blvd. Plan Revi w �s 2 Other
_ l 'Tigard, Oregon 97223 Dates : Z /`0 �� � Permit No -.
t ARD
Post-Review Land Use
v.
f''
' 't 5
g y,i I :
r . P 50 639 -4171 Fax:
• , xlsa • �I ,. +. D ateBy: • Case No.: . ■ - Internet: www•ci.tig;ard.or.us •
I., Contact �_� See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 - -- Name/Method: • / / Su . lemental Information.' 01
/ t 4 5 ‘ 1 . gi-k w / h i s ,IN' // . - --
0 E: OFI WORK. -,. ;; : ::CO nvtERc * saIEDUF. X
El New construction Demolition Mechanical permit fees* are based on the total value of Li ..e work
. p erfor med. Indicate the value (rounded to the nearest c .: n it .
,, Addition /alteration/replacement Ot
' '-':C:TEORYtO>f:ONSTRUCFTOhI' '= '';:' ' :; mechanical materials, equipmt, labor, overhead and profit:'.
fl 1 & 2- Family dwelling Commercial/Industrial Value: `S_ - 7, SO d � See Page 2 for Fee Schedule
� ::::: RESIDENTIAL'EQ T /SYSFS Sal :SCHEDU • '.,;,::
El Accessory Building Multi - Family Description I Qty Fee(ea.) Total '
ILI Master Builder _ ❑ Other: .. . • . . •HeatingJcooliog : , • -
...'.;I:i =JOBSPZ.t. NFORMA `ION',audiL C:ATIOIY': `,- "A >� ':±: Furnace - add -on air conditioning • 14,00 1
Job site address: =' S (.Q („, S Gas heat pump 14:00
r Duct work 14.00 - •
Suite #: /5 �. ` � � B /A pt. #
�^ t Hydronic hot water system 14.00 • .
Project Name: /7) , ,.o "1�,Lp
' ,to_ .mil.-.
c,. ` Cro street/Dirctions to job site: Residential boiler '. _
• , e 14.00 .
] (for radiator or hydronic system) ' - i ,
Z ,,„ ` , Unit heaters (fuel, not electric) • r % , } ; : :, %• . (in wall, in -duct, suspended, etc.) 14.00 • . �--- -•
Flue /vent (for any of above) 10.00 .
� i.; . Subdivision Lot #: Repair units 12 -15 '
t ;, .ra Other Fuel Appliances . _
F . , - ' Tax map /parcel #: Water heater ., 0 0 .10.00 .
' • • ::: <'DESCRIPTIOM:Ol WORK r::: ? ; ::::, �a' :: .. . .. - Gas fireplace 10.00 ' '
• ' / 1. i p ' y 4 e j -; S .lh� Flue vent (water heater/was fireplace)
.g ," - Ah.44) ,.�.., -_ . Lod lighter (gas) 10.00 ' .
I2. I C.r-L.G: p n yL t r ; l kt ei vI }
Wood/ Pellet stove 10.00
t. e � d _ Wood fireplace/insert 10.00 •
3 S -k r Chimney/liner /flue/vent ' 10.00 ... ,. b
: � ERTY::OWN�EIt:•= ": ;,( �TENAN9E .: = ;. :;k :' ::' . . Other: '10.00 ..
ame: ,/4 rr +S Sle v 4 h S ' . : Environmental Exhaust & Ventilation • ... . -
Address: . S'2(' S, (a.7 , tp't Si,: .e 4 Dt� Range hood/other kitchen equi 10
Clothes dryer exhaust 10.00
City/State/Zip: ? OP-- GI "7-1._c3Lr- Single duct exhaust
Phone: 2- — 1l :g ® Fax: (bathrooms, toilet compartments, .. -
. °! pPL'ICANTT'. : CO ACTIPERSON : :
f :T. :'' utility rooms) • '6.80' '-
Name: 2 e . \ (Q.a te.�i At /crawl space fans 10.00 - -
1 'K� Other: 10.00
Add v® - R.N. V
✓ Fnet•Pipia
:, City /State /Zip Co v Q c i t 3. " "(55.40 for first a, 51.00 each additional)
Phone: 'Z( o —. 2y'\ 1 I Fax: 1�i(o 3(-1 '4- Furnace, etc. ••
'i . , • ` Gas heat pump * r • . , « , : , '
: •.- : .n -mail. Wall/suspended/unit heater a,,
,�. �R ` " : :: s• : Water ®*
;:::..; . : r -.:. CO1V'EItACTOR'; .. ' =; s <::_.... .... er heater _
X ;D::4:•,.., = Bu siness Name: 'g od e-vi r C oo \ Fireplace ** -
; %.. Address: Pc- e 12(e' . , RB Qe , •• �.....s
> .;. , Ci /State /Zip: ‘___ft a l \ 3 -
4 '^ Cl ot h es d ryer (Gas) ""` -
I r ' , ` ,Phone: ' c fit ' 12Li Fax: '2. _3 z f?- Other:
•
CCB Lic- #: /4/ 0 o 8 Total; . 1 .. . .. .
�/f / Me chanical Permit Fees' '
S gnature •
Authorized / // Date: / / /' o 3 Subtotal: $ e— '
Minimum Permit Fee $72 -50 •$ / V • '
, 4'e. - �
•
e l I ) Plan Review Fee (25% of Permit Fee) $ ..4 •/V.,/
. (Please print name) 0 State Surcharge (8% of Permit Fee) $ =it 4 , .9,7-- . .
TOTAL PERMIT FEE $ _/ 2:-
\\ Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Service Board-
180 days after it has been accepted as complete. Site plan required for exterior A/C units. `
i : \Dsts\Pcrmit Forrns\MecPetmitApp.doe 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line. ,i41711 •-4175 ;
INSPECTION DIVISION Business Line: • 39 -4171 MST
BUP
Received / Z� / a ;1 P Date Requested l 2-h a 3 AM PM BUP
Location r)e../o (1.? 51 50 Suite 003 - 60 (o(E
Contact Person )-(4A-(2- Ph ( 5 X73) (�, 3 55 73 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner / c€ o ELC
Footing hF 4 ELC
Foundation Access: ,t- j co
i Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: A,CA (2l vp . t ec SIT
Post & Beam
Shear Anchors ` c L r,,!; t S I et-00.5 •
Ext Sheath /Shear c�1 �( "
Int Sheath/Shear
Framing
Insulation ` c 0 ,
Drywall Nailing 1 �\
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling } }}
Roof 1
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
,• • Dampers
Final y PART FAIL
CTRICAL
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
ADA I
Approach/Sidewalk Date ` 1 (I ( Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site. -
PASS PART FAIL