Permit 4
CITY O TIGARD MECHANICAL PERMIT
abot DEVELOPMENT SERVICES PERMIT #: MEC2004 -00632 '
".f I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/22/2004
PARCEL: 1S126DC-04400
SITE ADDRESS: 09430 SW CORAL ST 230
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Add (1) vav box, install ductwork.
Owner: FEES
MARTIN OFFICE BUILDING Description Date Amount
1672 SW WILLAMETTE FALLS DR [MECH] Permit Fee 9/22/200 $95.50
WEST LINN, OR 97028 [TAX] 8% State Surcharl 9/22/200 $7.64
[MECPLN] Plan Rev 9/22/200 $23.88
Phone: 503 - 557 - 8000 Total $127.02
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503 Mechanical 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 questions to OUNC by calling
(503)246 -6699.
R
` Issued By: ' � Permittee Signature: , //t
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
4/ (15395 . .
• Mecak
ha al Permit Application ' . , T OF ICE FOR USE•ONLY= .
City of Tigard Date /By: Permit No.. e `� 26 40 13125 SW Hall Blvd., Tigard, OR 97223 r � c
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 thii0 Other Permit:
� °�. Date/By:
Inspection Line: 503.639.4175 ,t r1_I I Date Ready /By: 1 s: ® See Page 2 for
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Internet: ww.ci.ti ard.or.us -° " � "
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g Notified /Method: 1 (r Supplemental Information
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T1'PE-�OF EWORK' "• �,. frr.. S' „,0,074VIERCIAL'FEE..SCHEDU_LE ,U_SE =GAE40ki:-.�
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❑ 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. ;
::' ;= it,:: ,: Wit.:- Va $ �� 67) •
x : s"= `" xCATEGURY:OF COIVSTRIJCft0,S`. " ";t' '. .1
3 1...IEM
t R ESIDE' ",p *QUH'MENT 3/§ - w,
-
El 1- and 2- family dwelling ? ommercial /industrial ❑ Accessory building " °` "'"
For special information use checklist.
❑ Multi - family
❑ Master builder ❑ Other: Description Qty. Ea. Total
,. ize - _ �.. x�� >'': °`':t a i .:- ,..v�'i,�k
< . °
JOB Si=Tc* RMATION. AND , LO CATIONS ° i„ t „ t , Heating/cooling
. .. -- ,.y. .... . , is . , : a ,F.
Job site address: - q�L3c � j
/ Air conditioning or heat pump (requires site plan showing placement) 14.00
City/State /ZIP: ' "'77 01 9 9 Z Z-3 Furnace 100,000 BTU (ducts /vents) ,` 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: f D Project name: \ 5 r- ,,, -12./ Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
,Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
�_��� ,�,// I V / � / /�,q -, Gas fireplace 10.00
C(0 ! V , , v 60.E Flue vent for water heater or gas
fireplace . 10.00
/ 5 0 # L/ `^ "" A Log lighter (gas) 10.00
am 1I 1 , U R . te, 4 ff/i Wood/pellet stove 10.00
e °.:,- ":y.,.< Chimney/liner/flue/vent ent 10.00
PROPERTY OWNER" „- ° �'ENANT'
W- mD
;: -
. -- ... -..:.- :,..; ,....,,., 5� Other. 10.00
Name: ?? efoi 5 5C14-7 4--e-ti. Environmental exhaust and ventilation
Z �� '% 1 a At s
Range hood /other kitchen
Address:
/ I� �j ! �(J p
WI equipment 10.00
City/State /ZIP: Wt 61- t___ C- 9 '7) W' Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) 55 7 J 66-6 Fax: ( ) toilet compartments, utility moms) 6.80
r: = ° t .» -MmaT-::'.' •.' , -;.: y:'. r <, Attic /crawl ace fans 10.00
„x�z... PLIGANT•�.3, ,:R ", ,' ; _- " IM.CQN TACT PER80N;; sP
n
y ;= ' :�..��� -.�,, , , . �� � 1
Other 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: • Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
, -
°- 1 . , ;�;, O � � � Barbecue ,� �C NTRACTUR �
�_ __ .�w :.fin -� �;� � �. � �,� - <<.,_� , � � � -_ ° � .�. �._ ;` �= '�o-����..,ma
Business name:
R Oth / / t Clothes dryer (gas)
Other.
.�� /� "" r.
[_CU� •-7.4:+ 1 kf8 -i fieg , ,, ,... '„.
Address: �/� r- � ��r� •� °� * �,,�:.• �:;,��`
City/State /ZIP: eadit 9 70/3 . Subtotal 9S5(.)
Phone: (53) at o(0 -1 2_41 Fax: (5 2 - 3Zi � Minimum permit fee ($72.5
Plan review (25% of permit fee)
Z? s: _
CCB lic.: / 1 Of State surcharge (8% of permit fee) jf`f
SD s.. /L�� TOTAL PERMIT FEE / Z F . OZ
Authorized signature: / � /J /'r/ This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Print name: % / s � 2 a .../ ( MaL,,, Date: I (,9 ( L * Fee methodology set by Tri- County Building Industry Service Board
:-An,, ;,.f.,..,n.....;..\T rr .., .1,.. fl /ni 44rL4n '/T /1 /n' //YIM/WPA/
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
0 a
INSPECTION DIVISION Business Line: (503) 639 -4171 ST
Received Date Requested 0 /� { � A M a PM BUP
Location 9 Y: ? Suite ,� 0 Ii0a -d —
Contact Person J. N /'S Ph ( ) 5 - g 9g PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 0 \ ww t (J, T SIT
Post & Beam l
Shear Anchors
Ext Sheath /Shear / ii ' / -
hit Sheath /Shear i r
Framing � / 5-/�=�JC J c� /6 Liv� _ (--e� 1/4-v`
Insulation _ c --
�-,�
Drywall Nailing
Firewall
Fire Sprinkler " ��_��JV •
Fire Alarm e„ 1 �y� ._Q 9-
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
if _
Water Service
Sanitary Sewer
Rain Drains
03" 101 ( '?'
Catch Basin / Manhole
Storm Drain '
Shower Pan
•
Other:
Final
PASS FAIL
ANIC '
m
ea
Rough -In
Gas Line`
Sm• e Dampers r -
. R. Al
ECTRIC ! 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 ADA 1 Q Z //O `/ Date V Inspector Ext
Other: ,
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL