Permit •
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00448
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/8/2004
PARCEL: 2 S 103AA -01914
SITE ADDRESS: 10490 SW JOHNSON ST
SUBDIVISION: COTTONWOOD PLACE ZONING: R -4.5
BLOCK: LOT: 015 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A /C, do not place within the required setbacks
Owner: FEES
DEBRA BAKER Description Date Amount
10490 SW JOHNSON ST [MECH] Permit Fee 7/8/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 7/8/2004 $5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 640 - 3607 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)246 -6699.
Issued By: Permittee Signature: j / l� I
Call (50 ) 639 -4175 by 7:00 P.M. for inspections needed the next • usiness day
(, Mechanical Permit Application ., FOR OFFICE USE ONLY
City of C1 g and RECEIVED Received
Date/By: Permit No.: % Wff
13125 SW Eall Bh d., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.5 8.1960 4latP iti.ye j » Date/By: Other Permit:
Inspection Line: 5113.639.4175 I 6 2004 .1,�.•,11 Date Ready/By: Juris. See Page 2 for
Internet: vvvrw.ci.t gard.or.us Notified /ivlethod: ®pplement I information
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'��I.. d�D�l���19�,'�€ -... . �>E SCHEDULE — USE cHECZ.7,TST
[I] New construe don 111 Addition /alterationireplacement Mechanical permit Pecs 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.
`: ' ' '•'• - <a CATE OF.60i4- Kiii,UCT i...- 1,e:, - Value: S '
RESIDENTIAL, EQUIYhr`i
IET / SYSTEMS TEES*
" and :1 - fanu ly dwelling 111 Commercial /industrial El } Accessory building For special information use checklist.
ll ❑ Multi -f imily ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOTS..SITE 'INE0,EZIN ,.TCON. :4i4,TD LOC:4,TION,•.:. Heating/cooling 1
Job site address: J Ot—( 7 0 S t) (1 ` [` f - Air conditioning or heat pump
i j S (requires site plan showing placement) ( t 4.00
City /State/2,IP: ( ; �1 ,� _ , , C Z, < 1 } L L 2> Furnace 100,000 BTU (ducts /vents) 14.00
' i�` Furnace 100,000+ BTL (ductsivenu) 17.90 I
Suite/bldg. /apt. nc ,: Project name:
Gas heat pump 1 14.00
Cross street /direct.ons 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 l
Other: 10.00 1
Tax map /parcel nt .: Other fuel appliances
•
a er heater 1
DESCRIPTION 'O)�' V1/0;'2K,�:: � . W t t t 10 00 •
Gas fireplace 10.00
l Flue vent for water heater or gas
0! - 1 - 1.3 Pt.- - , fireplace 10.00
Log lighter (gas) 10 00
Woodipellet stove 10.00
Wood fireplace /insert 10.00
ER( E .OWiYER . " ' Chimney /liner /flue /ven 10.00
: -,: I,,,Y �t. „.: :.:.. El ENA.NZ� 10.00 Othcr,
Name: f )2, / 1 e ' sf, 0.46e,,,r Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment - 10.00
City/State/2TP: Clothes dryer exhaust 10.00 7
� Single -duct exhaust (bathrooms,
'+
Phone: ( ) t . J W — �'� j Fax: ( ) toilet compartments, utility rooms) 6.80
' El AEI;LICANT. = CON,TA T PERSON Attic; crawls ace fans 10 00
Other: 10.00
Business name: _C C C 1 / ` • t L 1 I'� r'
•
S 7
.f J J Fuel piping
Contact name: ` t 6 i ( 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address: t
Gas heat pump
CiryiState /2IP: j ,
�'--} l � i 5 .) ,..1- t� LC , �r ).- / z_.3 Wall /suspended /unit heater
Phone: (5).; ) 1 1 CI 0 .- s (,. 6 .) — r Fax:: ('jO >) 6 S- I _ t: } 7 i Water heater
Fireplace
E -mail: 1
-.. .
: f .. � . . . : , - .. t_ `� .. � . .rf' - . y Barbecue
Business name: Clothes dryer (gas) i
Other:
Address:
• . • :1MECFI.1.NICALP.EI Mrr FEES"*
City/State/2IP: Subtotal
Minimum permit fee (572.50)
Phone: ( ) Fax: ( )� '��
/ I r,
Plan review (25% of permit fee)
CCB lie.:
- 11 6 - .� 3 ^ State surcharge (8% of permit fee) .c-
! I TOTAL PERMIT FEE 'I �'1
Authorized sionati , `-r\( L `--�-d'' :��' (.,.- - i--- This permit application e xpires if a permit Is not obtained within 150
days after it has been accepted as complete.
Print name: t- -1 : cut 1.—r Z,,, Date: * Fee methodology set by Tri County Building Industry Service Board
u\Building\Pcmca \i i :. rrnutApp.Joc 12/03 440-46171 (u /02 /COM/WEE)
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'JUL 6 2004
CITY OF TIGARD
SITE PLAN BUILDING DIVISION
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Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Ti Bard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640-3607 Fax 503.681.0793
E'd BILO B6S COS 2ui4eaH RgjeioadS d6S =T0 170 90 Inc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (5! u .394175
INSPECTION DIVISION • Business Line: 03) 639 -4171 MST
7 BUP
Received Date Requested 1 AM PM BUP
Location / q0 „Am,. Suite MEC - `e ° "Vi
Contact Person Ph ( ) 61 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Fog Drain Access: b./,er.L N/v r s` to 6 - rw DC Svitt4 Sr- S ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors C ) / 7 ' ;l 0 f f , oD �!I (_ _ e
Ext Sheath /Shear i L(� /" -1 G / C-0��
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer C Fr:
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS ART FAIL
MECHANICA
earn
Rough -In
Gas Line V
Smoke Damper
PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: r _ Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date �� Inspector LI Ext
Other:
Final DO NOT REMOVE this inspection rec d from the job site.
PASS PART FAIL