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Permit , .14, CITY Tr E ARD MECHANICAL PERMIT DEVELOPMENT SERVICES �,II PERMIT #: MEC2003-00552 ISSUED: 9/10/03 "" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110DD -09400 SITE ADDRESS: 15835 SW HIGHLAND CT SUBDIVISION: SUMMERFIELD NO.6 ZONING: R -7 BLOCK: LOT: 310 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 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: 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: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of gas fireplace insert and gas piping. Owner: FEES FOSTER, RICHARD S + VIRGINIA L Description Date Amount 15835 SW HIGHLAND CT [MECH] Permit Fee 9/10/03 $72.50 TIGARD, OR 97224 [TAX] 8% StateTax 9/10/03 $5.80 Phone: Total $78.30 Contractor: SUBURBAN @HOME 6014 NE 112TH AVE. PORTLAND, OR 97220 REQUIRED INSPECTIONS Phone: 503 Gas Line Insp Final Inspection Reg #: LIC 143335 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 -00 Issued By: a4::,...___ Permittee Signature: 60i,/ .6"- e ice© N Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 10/03/00 TIDE 14:59 FAX 503 598 1960 CITY OF TIGARD a 002 t. •. d w • w Mechanical Permit Application 1. ` y 3 oss tiltUEiVLU Date received: 9 �p� ii i • rm it no.: �a,Qp Awl 4 : 1 1 1 City of Tigard ProjecUappl. no.: Expire date: City of Tigard Address: 13125 SW Hallpv Ti and 9 97223 - Phone: (503)- 639 -4171 Jtr v ti L U� J Date issued: • By: - Receiptno.: Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type: Land use approval. JILWING DIVISION Building permit no.: . I T1(PE OF PLRIVIIT ,ll & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement O New construction 0 Addition/alteration/replacement 0 Other: JOB SITE INFORMATION I COMMERCIAL VALUATION SCHEDULE Job address: 16q35 SW 1-11 G1-4 LAN] b CT. " Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot /account no.: profit. Value $ _ . Lot: IBlock: !Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: - f G AQD I ZIP: qu 1 &:2 FAMILY DWELLLNG- PERMIT FEE SCHEDULE, Description and location of work on premises: Jvfr 'tti. G1z AND COMMERICAIJINDIJSTRIAL EQUIPMENT SCHEDULE Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? 0 Yes 0 Na handling unit CFM Air conditioning (site plan required) Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system MECHANICAL CONTRACTOR , I. Boiler /compressors Business name: State boil permit no.: l)3L)12f'�AtJNU.M� HP Tons BTU/H Address: 1.0004 i4 , US ■ \-' F" H J , Fire/smoke dampers /duct smoke detectors City: 1,0'_ (_ A KI p j State: Oa I ZIP: q r 1aa0 Heat pump (site plan required) Phone: , - . 7 -5tr I Fax: 7 -513 -mail: Install/replace furnace/burner BTU/H (y J33 Including ductwork/vent liner U Yes U No CCB no.: Install/replace/relocate suspended, ■ City /metro tic. no.: � wall, or floor mounted Name (please print): Vent for appliance other than furnace CONTACT PERSON I I Refrigeration: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER I , Hoods, Type I/ IUres. kitchen/hazmat hood fire suppression system Name: 2 \ C1 A Tap Fosi-Eiz Exhaust fan with single duct (bath fans) • Mailing address: 1 rDS r \ C;1 L1\ 1J 7 C.T. Exhaust system apart from heating or AC City: '1" iS, (Z) I State:02 I ZIP: 4-7g.1-4 Fuel piping and distribution n to 4 outlets) • Phone: 1-.) a7Zl a•``J Fax: I E - mail: Type: LPG over Oil 1 Fuel piping each additional ov 4 outlets ENGINEER I I Process piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert- type 1 Phone: Fax: E -mail: Woodstove/pellet i �� �� Other. Applicant's signature: ,. /1 +� VMS Bate: O 03 0L-1 Other: Name (print): C2ysi -- AL A taNse S Not alt jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ Notice: This permit application Q ❑ Visa 0 MasterCard Minimum fee $ _ - 7.2, expires if a permit is not obtained Credit card Dumber: / / p � Plan review (at %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ • `5 Name of cardholder as shown on credit card accepted as complete. TOTAL $ 1 • U Cardholder signature Amount 440•4617 (6/00/COM) CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Bushness Line: (503) 639 -4171 BUP Received Date Requested 9 AM PM BUP Location / 5 3.$ ) . $ Suite 3 - 8v Contact Person J � - Ph ( ) aS 7 — ,5 -4 13r PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC (PAS- Footing ELC Foundation Access: Ft Drain' £ te ;� �. "' g d � ..�c��v�v�` � r� , .�: ` ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam _ Shear Anchors �'�h Ext Sheath /Shear � r �� Int Sheath/Shear Framing Insulation Drywall Nailing Fi rewal I j 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 Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASO P RT FAIL CHAN L Post & Beam Q Rough -In as Lin4a Smoke Dampers in- PART FAIL TRICAL • 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: 0 Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date / t Inspector Ext Other: Final DO NOT REMOVE this inspection record fromithe job site. • PASS PART FAIL