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Permit CITY TIGARD MECHANICAL PERMIT II DEVELOPMENT SERVICES PERMIT #: MEC2003 -00591 - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/8/03 PARCEL: 1S134AB-01600 SITE ADDRESS: 11333 SW IRONWOOD LP SUBDIVISION: ENGLEWOOD ZONING: R -4.5 BLOCK: LOT: 073 JURISDICTION: TIG CLASS OF WORK: ALT 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: DOMES. INCIN: LPG 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: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replace furnace. Owner: FEES HALL, LYNN H AND VIVIENNE E Description Date Amount 11333 SW IRONWOOD LP TIGARD, OR 97223 [MECH] Permit Fee 10/8/03 $72.50 [TAX] 8% StateTax 10/8/03 $5.80 Phone: Total $78.30 Contractor: AAA HEATING & COOLING 2915 NE MARTIN LUTHER KING BLV PORTLAND, OR 97212 REQUIRED INSPECTIONS Phone: Heating Unt Insp hone: 284 -2173 Final Inspection Reg #: LIC 222 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: � _J Permittee Signature: 777 cr f Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day ' 1`d�ech" • ,,,�, � t • FOR OFFICE USE ONLY Ap: lYCatiOn Received Mechanical rye In I" LU L „ u v Ill EC E v /� E D Date/By: : 0 3 Permit No.� 001.00,3 ar ��'"`/ Cl of Tigard Planning p oval Building `J o (o f 2003 Date/By: Permit No.: 13125 SW Hall Blvd. L• 1 03 P lan Review Other . or { 20 Tigard, Oregon 97223 CITY OFTIGARD Date/By.: Permit No.: Phone: 503- 639 -4171 Fax: 503 =598 �I �-' 960 ' 1.47;10 . 1 5, - Post - Review Land Use � 111 LLJ l l v �a i..); a �� � D ate /B y. Case No.: �t�I Internet: www.ci.tigard.or.us I t ! h I , G ION �ION Contact Juris.: ® Sec Page 2 for 24 -hour Inspection Request: 503 -639 -4175 "`''"'" ' ' Name/Method: 77C\ Supplemental Information. - . . ::: COMMERCIAT FEE *- iSCIIEDULE US R., - E.CHECKLIST. - : 3 ; <. `�. - _. � TY PEOF,WORK F" ' ' - New construct ❑Demolition Mechanical permit fees* are based on the total value of the work Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, over ea and profit. . ".. .- iCATEGURY ,OF CONSTRUOTYOIV ; _ "f$'; , ' _ . 3, 1 & 2- Family dwelling 0 Commercial/Industrial Value: $ See Page 2 for Fee Schedule DI Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT %SYS'1'1!:MS^EEE *?SCHEDUI E : Description j Qty 1. Fee(ea.) 1 Total ❑ Master Builder ❑ Other: Heating/Cooling '° " JOB1SITE INF.ORMATION`and L'O - ** t 14.00 { 4 .00 =� � Furnace - add -on air conditioning Job site address: \ AJ YtxI LJtxxt( L- Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: OL 11 Hydronic hot water system 14.00 job site: (orid radiator boiler Cross street/Directions to .] (for radiator or hydronic system) 14.00 v� ki7 C-- Z Unit heaters (fuel, not electric) (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) t? P \ 10.00 ID .D0 Subdivision: Lot #: Repair units 12:1'5 , #: Other Fuel Appliances . Tax map/parcel Water heater 10.00 - is .::.., -... - r ..;;DESCRIPTION OF'-_ .. ; ORK`` '; .. r ' - :`f '. - '1:g Gas fireplace 10.00 \ \INSk CL \k 'elC V \AX t eLc...e_ 1 Flue vent (water heater /gas fireplace) 10.00 P L'LS 1/ 1 j iAA Log lighter (gas) 10.00 ( Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue/vent 10.00 $ROPERTY OWNER= • ." TENANT � v E ANT.:.'�:< ; °•ham `_: = >::: Other: 10.00 ame: L� V\ \A \ / \ V \et)a \ ` CA i 1 Environmental Exhaust & Ventilation Address: V t- _ f Range hood/other kitchen equipment 10.00 < (333 51.7 Woad Clothes dryer exhaust 10 City /State /Zip: t(i ck4 t ck - C* 2-2 Single duct exhaust Phone: 0 g 2 Fax: (bathrooms, toilet compartments, w0 £1BPL"'ICANT<. "" _h ICON, ' N utility rooms) 6.80 `TACT�PERS.QN''__, �.�� Name: Attic /crawl space fans 10.00 Address: Other: 10.00 J Fuel Piping City /State/Zip: * *($5.40 for first 4, $1.00 each additional) Phone: Fax: Furnace, etc. ** Gas heat pump ** E -mail. Wall /suspended/unit heater ** ' CONTRACTOR. -':- , ` Water heater ** Business Name: /Gl`t Vn CoDL ;, Fireplace ** Address: '7"1S \NE '+t-k -1\--- (-3 \Vc( Range ** City /State /Zip: � - k -\ O. EGA le. O l 20_, Clothes dryer (gas) ** Phone: 'aQ1-i, -a k Fax: 7,04 - 6 Other: ** CCB Lic. #: -"/„.7_,/,_ Total: . Mechanical Permit Fees* Authorized A l 1„ n Subtotal: $ — 2- 1 --1 . t7t, Signature: `'v (XC Date: \,0" r:2 Minimum Permit Fee $72.50 $ p 1C - VA W.Va.( Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) $ S . Sr) TOTAL PERMIT FEE $ °12' ,'- p Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPernitApp.doc 01/03 CITY OF TIGARD 24 -Hour - BUILDING :, Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received / /) Da e t Requ sted / 2-45A �' A PM BUP Location // . ' /vtA,(./-z/27-r...L Suite C 3 — C ()__<1 Contact Person ��tt Ph ( 5 - 03 ) 2 _ Pte- Z l) 3 PLM Contractor /4 �� Ph ( ) SWR BUILDING Tenant/Wner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation • Drywall Nailing - Fi rewall , Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 41, 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 PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line N �� _SmIce�Qampers Final _ART FAIL R AL =,.• Service Rough -In Low Volt tf/© � A 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 re'nspecti• RE: Unable to inspect — no access Fire Supply Line ADA 2 / Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record fr m the Jo site. PASS PART FAIL