Permit Z CITY OF TIGARD MECHANICAL PERMIT
1 , i4( DEVELOPMENT SERVICES PERMIT #: MEC2004 -00343
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/7/2004
PARCEL: 2S1 10 D C -02400
SITE ADDRESS: 11565 SW DURHAM RD
SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 252,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 4 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 4
Remarks: Setting of (4) rooftop units. Ductwork to be done by others.
Project Value: $15,000
Owner: FEES
DOUG FRY Description Date Amount
2423 REMINGTON CT [MECH] Permit Fee 6/7/2004 $299.00
WEST LINN, OR 97068 [MECPLN] Plan Rev 6/7/2004 $74.75
[TAX] 8% State Surchari 6/7/2004 $23.92
Phone: 503 348 - 2237 Total $397.67
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Heating Unt Insp
Reg #: LIC 14008 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
MecIiati A ieal Permit 1 ' n .` FOR OFFICE USE ONLY -
A,
Received
City of Tigard Date /By: /3 d Permit No.:�E /E /ln�,
13125 SW Hal T ga 3 l �/"�� -
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
1111
3 Inait 1 4 Date /By: Other Permit
Inspection Line: 503.639.41751 ` L uu ca Date Ready /By:
J ® See Page 2 for
Internet: www.ci.tigard.or.us v � Cj. Supplemental Information
o r' Notified/Method:
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yam= C€ x ; '
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Egi New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
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$:- �� ... x�rs Exit' f�.f. , ^,N: f:.:,ef, fi:':: `�,�3M' «..si„ ��, u� . _. . .. � f�fE, „S @f, x . xhh•`.. .. sn... .0 MPo .::k�`: ,#:f%��`� �•k'- Y". -+' R[.xxiyx .y> ��x..
_ �. � „RESID�NTIAC)M 1:IIPMENT 1 SYSTEMS „FEES,,,'',;. � °
El 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
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�, fE;,��,:,, , °En:�''�JC3B ° ` SI'I�,E<�INFOItMATIUIV,_AND OC IffIV �x:�.:.a.> '� Heating/cooling
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Job site address: i 1 5 -6 5 - LA) - D w , � Air conditioning o heat pump f.
t .yvi � /.4 , (requires site plan showing placement) y 14.00 �+o
City/State /ZIP: -- i w.rc 0 q 72_ Z Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: �� � Project name: ��� L (ppoo(C Gas heat pump 14.00
Cross street/directions to ob site: n ■ , ,
1 Q�. vier tr O, S 1 ' 1 � a r �d Duct work 14.00
Hydronic hot water system 14.00
lt.t.N' 140,YI4 Dill • Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
x
f�', - .., „f..,, ..f:. „ �� r � y €? • -3z� �� ?�f- :z,%,�4 Water heater 10.00
�l�If•...x.:f: ..:�,.�f, H ..:xx.:.. . ' x�.=�:�...�::- .,£,x:: =:: �: x��..:�:; (e���` " r...r, >x�,;..,,..:x; =..��. .
Gas fireplace 10.00
e-t -1 - .•'Id l ct �� (t((,���' (,t 4. 4 S 4.- GA S I,. yl e 0 Flue vent for water heater or gas
�p j fireplace 10.00
/A'`Q n Log lighter (gas) 10.00
(1 dv c.- - 4 i &. do e 17 6 - ,$) Wood/pellet stove 10.00
Wood fireplace /insert 10.00
:.,; ; ; f ; ' _ fF H a R ,, �';'.:,x Chimney /liner /flue /vent 10.00 .
;a; ~n f«, : .0.4R`fY QW 11 _- ';,: �'ENAN R n: ':
�.- �E 1000
Name: > Oc4 t - 4 Environmental exhaust and ventilation
Address: alb �f-- Range hood/other kitchen
t. -il er-tin , equipment 10.00
City/State /ZIP: 6 q 7) (, Clothes dryer exhaust 10.00
-duct exhrms,
5, - ���� Singlecompartments, (uatltyy r r
Phone: oo
Fax: ( ) toilet comprtments, utility ooms) 6.80
n•,, :: :W;;:,, �:������.._ '_� :e�:,:�x -� •• €EEEE,`� > -;tea: "_+�,�ff�f €E :.; �a^„f�.�.' .,Ef:�:
\, : n ti 'ff',EE-- Attic /crawls ace fans 10.00
€fl i rtt:' e f � � � P
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' 1 /� Other: 10.00
Business name:
` t>_l� n A--0 Yl 4- l l' o (t ✓l t • Fuel piping
Contact name: M I Ike ( �I ��� I v $5.40 for first four; $1.00 for each additional
�} _ Furnace, etc.
Address: ff0 S d _l,- 41/ Gas heat um
� pump
City/State /ZIP: l.� e , ,4 t 0 / 97e 13 Wall/suspended/unit heater
Water heater
Phone: (-63 ) "2_ 6G - IZyq Fax:: ($U3 ) 266'3ci76
Fireplace
E -mail: Range
s-� JY . � - , S;; -o-1
- �. ��.,�'_�:�. .,a,x_ ,,, - ...:.:ham ., �.,. _ >..a... >���c�,s`;�a, ,�•.�,.,..:.� ���� Barbecue
Business name: '<`(44/tin + s Clothes dryer (gas)
1 1 �1C Other: 4-I PgWCkt.' un1t'.i 2( 6 2
Address: - `' "�` g ''
C � w � ,�fffff, � M163,;';';'
(o I �I O S l-n d2� f ke ' 1 °fix MEC£ `AI- P R1kiL'I WV'
. ';, @ �..._,.,- ��.�x •���,an��f'�'f,�i= �
City/State /ZIP: Cf4 1,. c. 6 4 ( 70-1 3 Subtotal 9' CO -fi Minimum permit fee ($72.50)
Phone: (s ) Z c t✓ i - 4 - Fax: (z 3 ) Z6 6 - / 7 : Plan review (25% of permit fee) 71,75
1, 7 J
CCB lie.: / ,./00 P State surcharge (8% of permit fee) 9.3, 92
TOTAL PERMIT FEE 39 7, 7
�Authorized signature: 40 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
i:\Building\Permits\MEC- PermitApp.doc 12/03 440 -4617T (11 /02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date R- Guested ' AM PM BUP
Location (( " 6 ;•6 'i ?( Suite MEC Z
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation 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 'r
Fire Sprinkler
Fire Alarm _ A '
Susp'd Ceiling Miliferar W-, Roof Other: -
Final
PASS PART FAIL
PLUMBING
Post & Beam /
Under Slab /
Rough -In
Water Service 1 I I /
Sanitary Sewer , '
Rain Drains r
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
pAS5 PARLFAIL
EC NICAL
Post& Beam � Ipv
Rough -In
Gas Line Cri
S G • • - Dampers
OW PART FAIL
RICAL
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 El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL