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Permit J 1 CITY TI GARS MECHANICAL PERMIT �4 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00561 ,a °� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/8/2005 PARCEL: 2S104CC -01900 SITE ADDRESS: 13899 SW HILLSHIRE DR ZONING: R -7 SUBDIVISION: HILLSHIRE ESTATES NO. 2 LOT: 125 JURISDICTION: TIG Project Description: Gas line add -on to pool heater. CLASS OF WORK: OTR 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: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: • FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Owner: FEES • MARK & AUD BAY Description Date Amount 13899 SW HILLSHIRE DR TIGARD, OR 97224 [MECH] Permit Fee 9/8/2005 $72.50 [TAX] 8% State Surcha 9/8/2005 $5.80 Total $78.30 Phone: Contractor: ALINE INC. 4221 SE 113TH PORTLAND, OR 97266 REQUIRED ITEMS AND REPORTS Phone: 503 - 760 -8433 Reg #: LIC 138272 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 or 1- 800 - 332 -2344. Issued By: �� / ea/ Permittee Signature: scse Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 1' Mechanical Permit Application /<� t oR OFFICE USE ONLY City of Tigard �1 natcBY: / / �� / 13125 SW Hall Blvd., Tigard, OR 97223 �L'» ® Plan Review Other Permit: Phone: 503.639,417) Fax: 503,598 -1960 "ra ,0 �'' .,r, t �I A Date/Ely: Inspection Linc: 503.639.4M 0 8 � Date Ready /1:1y: S gee Pace for FM n Internet: vvww ci.tigard•or.us ( g Notified/Method: Supplemental Information r 's ,E . tUUSE rr e ,ik M+ - • ".�i��Ai . \vf,a ::,...iy--Ca�y_ — F�W[(��7}[�,.� A1 rt!, : : :.,i,, : :?i;% '. ., - 4..ibO •t E ?;BE�.L" = . :s fr.g. CIIECKLIST' ' i '�A' r" �� S.,: 1 .fi � a .7��il h�? l� : S1' �� ,�'^�S•��� :�'• "liY1- ':•,'i :'�.)��'i;;i .. •iP �• "' '1:;' , ,t N!, .. ... — v1Jt( ihi Mechanical permit fees" arc based on the value of the work ❑ New construction ❑ Addition /a lter erattoni alinement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ® Other: Go l.\n -. e_. 4 bi) - 0Y 1 . mechanical materials, equipment, labor, overhead, and profit. � a, �. r v , ne value; a p .j :i i ` . � 1d,) .�t7ht: r,CC • Y� 1 ::Q � 'i�''i;f7al.lrl i a .;: l: ' . , i : ;;, :: .r .. , . - ... . S* t1,:, 9c n • $.4'_r''. ,t+ ' %i : '.. t" /' TE S••FEE. � ,-•,• ; -� .;,�Itlu5'1(DENTIAT. EQUIP1v�NT SXS M I. I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building F special information use checklist. 0 Multi - family - LJ Master builder ❑ Other: Description Qty. Ea 1 'loud T g , . •. tr_�,••'.: ; i o v �re-c iib - ); : d i,;...:1.;1' Heating/cooling Air conditioning or heat pump Job site address: � � S U t l ' \ f tee ' , (wires site plan shoving placement) 14.00 City /State/ZIP: � • • r 1 Furnace 100,000 BTU (ducts/vents) 14.00 eV Furnace 100,000+ BTU (ducts/venr_t 17.90 Suite/hit-lg./apt. no.: Project name: C;ns 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 - Flue /vent for any of above • 10.00 Subdivision: Lot no.: Other: 10.00 Other fuel appliances Tax map /parcel no.: 10.00 e -, ., . ,..,.. �.�, r : - ,'. {: Water heater f , ..`1 r , y :: %; : , 45 r!. 'Ga , 0 F :WO ,:n :;':;;.: ,, fkA t , , 7 :i i; . ,, ... >G(�;�t,i;elt ' r. : ..' :k :ia;� : :. n:;,.,!�- ,..v..f. ,....> a•' :' :. +'•'r G a5 fi rep l ace 10.00 (G- 0.-S L 4h A bO 0 ry )-(-)1--- ?n 144-r Flue vent for water heater or gas fireplace 10.00 • • _ Log lignter (gas) 10.00 - Wood /pellet stove 10.00 - Wood fireplace /insert 10.00 — — Cntmney/linci /(lac /vent 1000 ,. a•fir r .l.+ � 'S••il .;i .. ,�r..1 Jh�� 6 ':., e e,n��,i j C , : ; h % ''ii; 3��V.,Q � ;.5 t t.' - i 1 ' : 10.00 tf!�,.._cl'� 7 t j�Itf� ;. [ ;i, rc�''.'k;'17, � Qthei: Name: • Environmental exhaust and ventilation in 0.r l � RanQn hood /other kitchen c• ui . meat 10.00! Address: I �� 9 �� (. , t4 . .� I ,S � f —7 e , ) r ■ Clothes d er exhaust 10.00 City/State/ZIP: �1 f� 0 12 , 7 Single -duct exhaust (bathrooms, Phone: (50 q 6Q � So S'7 Fax: ( ) Collet compatCtrtcnU, utility room?) 6,60 i�- �" I� .r� . a Attic /crawls fans + 10,00 t! '1r'{ r"-' z y , - .' r u . , 1 ; 14"1ll4 ,.∎;7 1 j4 * 1 tr�i e % • 'tl . , vt iv © m" - r AL � t !p... .a. ..1..,,,;,.. .&r,i_.. 10.00 ��tiiw#, ' ®c " Y ^ :h i.... y f•'7 : i ;: : : I �i�f :' , .:1,;. 4�'. Other. Business ttatna nn II ( Fuel piping; Contact name: $Gc,• 14 Ue f t l l $5.40 for first four; $t.00 for each additional Furnace, etc. Address: Gas h eat Putnp City /State /ZIP: Wali /suspended /unit heater Water heater Phone: (sD ?,) 3 ■-{ S , $ /4 Fax:: ( ) Fire lace E -mail: Range _ t:, ..,. .r'r ' c „�„ k'` +'� � :i > , , :� !: ; y i ts ;;r y 1; ' u N .: O i ' ' "` "; •' , :^ -" .l Barbecue . _ ,.'s;'I. sic !f.,_ ;, .{ .:, 'Yr' ,. Clothes dryer (gas Business name- Sy L \ t,\ - . .1., C ,. Other: - . , 0 ME -- Address: \ a \ s C I ! _ wf' ,1' F :i " :]f7E #410 L . WO — PT E ES* - - " O r "V . 1Z ^ 7 6 Subtotal City/State/ZIP: `'� � r 7 Plan review M inimum permit fee ($72(S72.50) *�a,$U Phone: ( .503) 3 "l ._ g ;t 4( 3 Fax: ( :�3) i (10' L1.- _ (25% of permit fee) _ State surcharge (S% of permit fee) J` , FO CCB lie.: i 3 d `� - 'TOTA PERMIT F " O This permit application expires if u p Is not ob tained within , 1 80 Authorized signature: day' after It ha■ been accepted as complete. J r Fee ,,,.,<hodobgy +., by Tri- Cnwrty Building industry Service: Board • L Print name: \ li , • f e -E. e .y. , t. I Date: ` i r - U 1 _.. 1 i :\ Building \i'c.,.,m,EC•t'esmitApp.40t 12/03 440- 4017T /021CUM /wED) 1 01 EE'8- 09L -(EOS) ••ooS e0d:80 SO BO daS CITY OF TIGARD- - BUILDING DIVISION PERMIT #: MEC2005 00561 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6I2005 Phone: (503) 639 -4171 gym. 4�il��•IIi Inspection Requests (24 Hrs.): (503) 639 -4175 _�� :_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 9/26/2005 7:12AM 94 SITE ADDRESS: 13899 SW HILLSHIRE DR CLASS OF WORK: SUBDIVISION: HILLSHIRE ESTATES NO. 2 LOT #: . i26 TYPE OF USE: PROJECT NAME: BAY DESCRIPTION: Gas line add-on to pool heater. OWNER: BAY, MARK & AUDREY PHONE #: CONTRACTOR: ALINE INC PHONE # : 503-760-8433 Inspection Request Scheduled For: Date: 9/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 016517 -01 _. 503-96 5057 Y Corrections /Comments /Instructions: (--) i , 17.4 . ,.. . .....y 420/itti a iiiiv o vi / I S n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL n / , L FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Q-- 67- 6'� Phone #: (503) 718- CITY OF TIG,ARD ` 's BUILDING DIVISION , PERMIT #: MEG2005 00561 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2005 Phone: (503) 639 -4171 44,11110 i t* Inspection Requests (24 Hrs.): (503) 639 -4175 U- FILL INSPECTION WORKSHEET FOR DATE: TIME: 7 :12AM PAGE: 26 SITE ADDRESS: 13899 r HILLSHIRE DR OF WORK: SUBDIVISION: HILLSHIRE ESTATES NO. 2 LOT #: .i25 TYPE OF USE: PROJECT NAME: BAY DESCRIPTION: Gas line add-on to pool heater, OWNER: BAY, MARK & AUDREY PHONE #: CONTRACTOR: ALINE INC PHONE # : 503 -760 -8433 Inspection Request Scheduled For: Date: 222005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 016359.01 503 -349 -8243 • N Corrections /Comments /Instructions: S AID B.v s 4 s , .0c 3a 1 PA I J PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED r 1 Inspector: -,a Date: 9=22 -0S Phone #: (503) 718-