Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00591
Ail DATE ISSUED: 9/2/2004
13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102DC -01601
SITE ADDRESS: 09100 SW EDGEWOOD ST
SUBDIVISION: EDGEWOOD ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS WIO 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: 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: Installation of gas furnace, A/C unit, vent & gas water heater.
Owner: FEES
GILCHRIST, EARL J NONA Description Date Amount
9100 SW EDGEWOOD ST [MECH] Permit Fee 9/2/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/2/2004 $5.80
Phone: Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 76359 Misc. Inspection
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: 1�e' Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
1._ , Sep 01 04 08:48a _PAM DALBY 503- 598 -0270 p.1
FOR OFFICE USE ONtiY. � • �' •
Mechanical Perm !.cation it AUe ECW � gar SW ll Blvd., Tigard, OR 97223 P
'hone 503 639.4171 Fax, 503.598.1960 Other Per rut
Its Date,By
' tvns I 0 See Page 2 for
nspection Line 503.639 4175 ,• i . II Date Ready/By. �I (� I Supplemental for
' L Notified/Method: J t `
ntemet: wu ci.Cgard.or us
: : : -1 �' a - M
C Ov ECI
R FEE" 'SCHEDULE• - USE; CHECKLIST
' : —:' , rO F O " ..••. •- .
- • - - Mechanical permit fees' are based or. the value of the work
❑ New
construction Addttion/alteration/replacement performed Indicate the value (rounded to oveeheades t d prof )• of al,
itiOn ❑Other: mechanical
l mzterials, equipment,
❑ Demoittlon Value: S
,,, e'ATEGOR _OFMCONSTRIJCTION :
r . , RESTp NTLa4- EQUIPb•IENT / SYSTEMS FEES"
.,,
l - and 2- fa-'ruly dwelling ❑ Commerctalh F special information ndustrial ❑ Accessory building F eneckltst
❑ Multi- family ❑ Qty ' Ea I Tc:a'
Master builder ❑ Other Description
•. JO -
, I HeatinC*fcoaling
B SITE' .TNEO12Ma;�ION °'�: D R' 'LOC'AT ION - Air or heat pump I
Job site address /0() $ J F619 Ar con
(4.10 CPI I Ai r con site plan showing placement) I I
I Furnace 100,000 BTU (ducts /vens) 14 00 I
City/Slate/Z[1 Z[P Furnace 100,000+ BTU (ducts /vens) 17 90
I Project name: Gas heat pump 14 00
Sulte/bldg /apt. no.. I I buct work
14 00 Cross street/directions to job site: Hydronic hot water system I 14 00 I
Residential boiler (radiator or I 14.00
hydronic)
L Unit heaters 111 (fuel -type, not electric),
in- wall, 10.00
in -duct, suspended, etc
Flue /vent for any of above 10 00 I I
Subdivision:
Lot no.: Other: 10.00 1
I . I Other fuel appliances
Tax map /parcel no.. I Water healer l0 00
- .� pS
, i .. :$.i -
;� ' • GT2SPTZ01� O WORK '' .� . -: Gas fireplace 10.00
f ov Flue vent for water heater or gas / 0 00
7,4/5-rVZ 7lfn .1/,1!4.4 lam/ .,--C.- // €/Y1 fireplace
r.4 ,//1 Log lighter (gas) 10 00
7 /../....o L��' k Wood /pellet stove ` 10 00 l I
Wood fireplace /insert I I 1000 1 1
/liner /f ue''vent I 10.00
Chimney
�� : `„`;' `, , rO t A`N ,, ,.. Other 1 G 00
[ ',P ' •-0,•••,,'
Environmental exhaust and ventilation
Name: .../A--7-,, 6, �G/ �� l S Range hood /other kitchen
r Address:
10 00
7,./d 0 _524.) PV9,euJO4 °Q equipment
/ Clothes dryer exhaust 10 00
City/State/ZIP T 1/4 Single -duct exhaust (bathrooms, I 6 80 I �I
Fax ( ) toilet compartments, utility rooms) 1
Phone: (� , 3y � - Attic /erawlspacc fins 10'00 I
t :, • '• 40, 1CT .S0�`I 10 00
•,- �, :• ; :' 'APF,I.'LCAIYT- i, +;. Other:
Business name Fuel piping
n /� /b / y 55.40 for first four; 51.00 for each additional
Contact name: A�/u (/ I Furnace, etc. /
i Address: I Gas heat pump 1 r
Wall /suspended /unit heater
City /StateiZlP: L Water heater ii
Phone, (� ?) �Oa y U ` I Fax (�O 3) ✓ yf O ; r/1� / I Fireplace I
ail. l Range I I
E m _ +T >. f .,t ;t' '. • r. Barbecue I 1
;; .,i. ' / Clothes dryer (gas)
Business name. n C,, 4 !`'1 6 /LL. iL/•Gi3 - ,i_ 1 i 4/4 Other:
0 6 o k . 3 0 3 1-7 I :,K EE
I Address: I Subtotal I
City State %ZIP 1 li A—,Q_r7 0/— 97�a� { Minimum pe rmit fee (572 50) I c " - 5'$
Phone (c5-6,.3 _ vv-up torevicw• (25% of permit fee)
) (i o z - 7 0 .6 7 Z Fax' ,s98 �°2 �fb o of permit fee)
surcharge (8% �'.
I CCB tic : 7 (- 3.5 9 TOTAL PERMIT FEE 1 , 7 7 O
Authorized signature: ��� �pj�/ hi s ?imp �•ion expires it a permit is not obtained within ISO
U 1 Mintier it has been accepted as complete.
� � rmit Fee methodology set by'rri -County Building Industry Service Board ci f 1
Print name: Il // ti l 6 Date. /
4 ao -4617T (i I O2,COnuwae) B II V
i'. Eiuilyui >U'cmvu,MEC- PcmutAqpdoc 12103
Sep 01 04 08:48a PAM DALBY 503- 598 -0270 p.2
edeumeEhit
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUITE El 10
TIGARD, OR 97223
(503) 6242704
FAX (503) 598 -0270
•
U
•
JOB ADDRESS:
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested AM P BUP
Location TO6 Suite
Contact Person /60 Ph ( ) Ca a J X y 4iar . n (p
Contractor Ph ( ) SWR
BUILDING Tenant/Owner • ELC t' �✓� --
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing t
Insulation
Drywall Nailing (
Firewall INN ` ��L �, 1 '" 4 " L ?
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
itgEa
'o ream �T `
Under Slab V
Ro -
ater Servic
ewer
• Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
ArdW
PART FAIL,
Post& Beam / I 4
Rough-In Y
Gas Line
Smoke Damper
if al _
iiriab PART FAIL
TRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El 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 n�
ADA Date • b -2. 6 Inspector J l/ ° Ext
Approach/Sidewalk
Other:
Final D NOT REMOVE this inspection record from the job site.
PASS PART FAIL