Permit Ak 6
e CITY OF TIGARD MECHANICAL PERMIT
A I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00666
� � 111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/5/2004
PARCEL: 2S 102 D D -04400
SITE ADDRESS: 08539 SW JOHN CT
SUBDIVISION: BRIDGEPARK ZONING: R -7
BLOCK: LOT: 004 JURISDICTION: TIG
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: 1 DOMES. INCIN:
ELE 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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of a/c unit.
Owner: FEES
CAVILLIOGLU, YILDIZ Description Date Amount
8539 SW JOHN CT [MECH] Permit Fee 10/5/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 10/5/200 $5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
Final Inspection
Reg #: LIC 66578
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) - -6699.
4 , F %; i i Permittee Si na 1_d : g ��.�..�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
.,,,.
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Mech l o&ica .P-ei'mit Appli
car '- 1 i
o . . . FOR OFFICE USE ONLY
City of Tigard Received
Date/Dy: ' 1=11=1
13123 SW Hall /041070C/ //
Blvd., Tigard, OR. 97223 OCT 4 24 Plan Review
Phone: 503.63(.4171 Fax: 503.598.1960 Other Permit:
t, l eit Date/13y: -
inspection Line 503.( 39.4175 CITY OFT Date Ready/By: J . ' El See Page 2 for
Internet: www.:.i.tigat tor.us
BUILDING DIVISION Notified/Method: fr Supplemental information
.
.......,.,....-,..„......:.,.:..„, ..-;. ! ..!,..,4,...,.. 7:rq :•:'-'•.-.;.,-..:',.:•:::::,••:-:: :, ",.:', ;' c ,•,- ,-: c fammo.cfAL..EREt. SCHEDULE - USE CHECKLIST
.__
Mechanical permit fees* are based on the value of the work
rj New cons :ructic n 0 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition El Other: - mechanical materials, equipment, labor, overhead, and profit.
.: ':'..::;:: - :•::',•, 2:• c*:ce,*:rivi - :.::! , , ,, _ '-::_::,,,:.,.,,,;:,,,•,..:. .:i_. value: s •
For special special information use c Q.I.TIVIVIENT / SYSTEMS FEES* 0 1- and 2-family dwelling 0 Commercial/industrial E] Accessory building
0 Multi-family 0 Master builder (11 Other: , Description Qty I Ea. Total
460 snpflioor*qic0. topi0t6S:. ' • ,;t;'''',*:, fleeting/cooling I
Job site addreiTg ic 3c7 c(,) jb kA, e , j_. Asr conditioning or heat pump
(requires site plan showing placement) 1 14.00
.-...../
City/State/ZIP: , .. 5,... .4..94 ( 1-2-) Furnace 100,000 BTU (ducts/vents) 14 00
1
Furnace L00,000+ BTU Oucts/vents) 17.90
Suite/bldglar t. no.: Project name: C 11 1 U., ea
4 caw_
Gas ht pump 14.00
Cross street/d irectic ns to job site: Duct work 14.00
fiydtortic 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 I 10.00
Subdivision: Lot no.: Other: I I 10.00 1
1
Tax map/par:el no.. Other fuel appliances
- ...,... .3 '71' :' •-. .• ,- - • • 1)ESCRIPT OR WORK .• • - . :.- :, ., , ,. ' : . - 10.00
Gas fireplace 10.00 .
I
Flue vent for water heater or gas
9_,o4-1Ctf-uk 4C-- fireplace 10.00
______c Log lighter (gas) , 10 00
Wood/pellet stove I 10,00
Wood fireplace/insert 10.00
-- • - - - ' 1. .. -.. ''' -- '1' .11 - - -:"• :- I .-- ' ' '1=71' ,, .-- -- ..--,-...7:;,;r,;.•,•. ..], - - Chimney/liner'flue/vent I 10.00 I
•.„;',140.:Plt) PER' L : 6111 : 11 rfg::: :'`: : :''f.. .i.e-7- ..NO .I''-`0 .•:. ,,:: ..•,I,::: oth„: -I 10.00
. ,• - ..____. - ... •:• .
Name: 4 . i I d ,,, ce-tv,y, e‘.04.1...,,. Environmental exhaust and ventilation 1
Range hood/other kitchen I
Address: equipment 1
10.00 1
City/State/ZIP : Clothes dryer exhaust 10.00 1
Single-duct exhaust (bathrooms. I 1
Phone: ( ) i, 3 -), ‘,..vg 1 Fax: ( ) toilet compartments, utility rooms) I 6.80 i I
.' :• :4": '''''':•: .': a 2.tii1CAd:it:......t .-,•:,,.:,.,.:, . 6 isii§oN,:..:::-.:-.,-:•: Attic/crawlspace tans 10.00
..- Other: 10.00
Business mune: S ,.,_(' i , ,..._ i 1.- i. 14 l t' i'l ' d 1 '") Fuel piping
- i " '. ' ) J
Contact name: I,. (*) i S C 12_ i V't t - 12. ( I $5.40 for first four; $1.00 for each additional
Furnace. etc.
Address: A i kii- J'A 4.. (2. i .0 e-i. \ Gas heat pump
City/State/ IT: H.,. , , 6 ,.... ,-( cl,c_ , ci ?- / 2-- 3 Wall/suspended/unit heater
Phone:( SIC• ) G L o ._ 7 c „, c )._ Fax: : ( 9:-'? ) G-f S" i - 0 1- 1 I Water heater
Fireplace
E-mail:
Range
''''.- ".-, ' '.:' 'J ....'..!'." ; '•':" • • CONTRACTafrP;.C.,•''''4. .., • i`'4,'!1,:e4:" ,.,, ....:- , ..i i t', ;-•;:,. Barbecue
Clothes dryer t as
Business name: ______ - Other: ._
--,•- - • -
Address: :,::.;:, ;,-;-. :,- : EgRINTrr FEES*
.-.•. -. -.•
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( )
Minimum permit fee (572.50) '-'?-- Z. KO
I
Plan review (25% of permit fee)
CCB lie.: 6- 6 r k - - State surcharge (8% of permit fee)
, .. TOTAL PERMIT FEE
Authorized signature: ti....;At ' - C (......c--"; 4 "--- •
This permit application expires if a permit k not obtained with 180
days after it has been accepted as complete.
Print name: .1'- ; la ;.--. € t. (... 1 S" c • ,._ -1 Date: (01410 ..( I • Fee methodology set by Tri-Coonty Building Industry Service Board
i.‘Buildiag\P■Treitst NI: iC-PertnitApp.doe 12/53 440 (II/02/COM/WEB)
2 " d 8iL0 B6S EOS 2ur4.eaH R.zieToacils eS:IT .170 170 400
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SITE PLAN .
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STREET
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A Imo'
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
E'd BTLO B6S EDS 2 utgeaH R4TetoedS e92 :TT t..0 'D 400
CITY OF TIGARD 24 -Hour
BUILDING p Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 - 4171
l BUP
Received Date Requested 1/ AM PM BUP
Location n �J - Suite MEC .- (
Contact Person Ph ( ) 6 %4 3‘, D 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Drain Ftg � ' ELR
Crawl Drain .
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling = ---
Roof
Other:
Final
PASS PART FAIL
PLUMBING °" m .
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° w °;= °:
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
CTRICAL
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 ri Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date // z " Inspector _ Ext
Other:
Final DO NOT REMOVE this inspection record from the job site. .
PASS PART FAIL •