Permit CITY OF TIGARD
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00629
•��I DATE ISSUED: 9/20/2004
---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 11 AB -06700
SITE ADDRESS: 09255 SW INEZ ST
SUBDIVISION: PENROSE TERRACE ZONING: R -4.5
BLOCK: LOT: 012 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: DOMES. INCIN:
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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: 1 GAS OUTLETS:
> 10000 cfm:
Remarks: Replace air handler.
Owner: FEES
SCOTT, ARLA Description Date Amount
9255 SW INEZ [MECH] Permit Fee 9/20/200 $72.50 •
TIGARD, OR 97224 [TAX] 8% State Surcharl 9/20/2002 $5.80
Total $78.30
Phone:
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: 7 _ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bus ?ness day
•
Mechanic at Permit Application . FOR OFFICE USE ONLY
.....
City CifTigird
D 4 e;249/47 Q 41 Permit N°. \ \ A.6c...,,Z96V - ao ag
.13125 SW Hall Blvd., Tigard, OR 97
Plan Review
Phone: 503.639. 171 Fax: 503R1E
CEIVED 40z iNthilil• Date/By: Other Permit:
Inspection Line: 303.639A175
AIJII„,. .-•,in II Date Ready/By: Juria El See Page 2 for
Internet: wwwici tigard.or.us
17)
. Notified/Method: (r
Supplemental Information
sEP i 7 2004 ..
.:-.,"..:,..:;.-..'.:7777" - :,:.:,,; ::.::. :;.;.: .-7 ' ' :W . ' , -,; :::•:, . , - , .4.4,- . . . . - c m c s , • l i a . , , , i ,,.•: '., .•
0 New constrt ction rehmtltortilVeNcement Mechanical perrnit fees* are based on the value of the work
perforrned. Indicate the value (rounded to the nearest dollar) of all
0 Demolition t er:
mechanical materials, equipment, labor, overhead, and prof t.
Value: $
•
i- 1. :'' , .• ii T'i.i- ',..'": '... ::,:i;.:; i,',. ... ,,....
• : RIPKN;r14 EQIIIPINIENT. / SYSTEMS FEES*
1- and 2-farr ily dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
LEI Multi-famil) 0 Master builder CI Other:
Description I Qty. I Ea. I Total
. .. ,.. . ........ , ...
I - :1 , i : .- •-•,, ! i i: i
Jon SITE u■TowkrroN , :.L. _; ...,. ::-• HentinWcool I ng
Job site address 72, Air conditioning or heat pump
: -.s j ibt z. _ . c. f _
(requires Site plan showing placement) 14.00
City/State/ZIP: i54,1/4e 1 fin • L /1 - 2- 2-41 , Furnace 100,000 BTU (ducts/vents) 14.00
• Furnace 100,000+ BTU (ducts/vents) 17.90 I
Suite/bldg./apt. n ).: Pro name:
Gas heat pump 1 14.00
1
,
Cross street/direr lions 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: 1 Lot no.:
-
Other: f ko-,.) 1 10 00
Tax map/parcel a ).:
Other fuel appliances
; . : : ,;.::•:.;:;: .„1,... OF *4*k..,',.- . . : i) . :: Y'J!:,- - ',.•' Water heater 10.00 I !
Gas fireplace 10.00 I
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 1 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
, 10.00 i
• -:1_,Stt P;;P T7 R
V F4teiP,i 1 .:'Iiii'lie'lf' , _;-. , ' Qt,wr.r I 10
,::,..,-;,., ,-,, .:.„-,,, Other: •
.00 I
. I
Name: v-Cet. c c.„. ti t t.„.e 0 ,0,-,..,.0-/-01. Environmental exhaust and ventilation
;
Range hood/other kitchen
• Address:
equipment 10.00
City/State/2]p.
Clothes dryer exhaust 10.00 '
Single-duct exhaust (bathrooms,
Phone: ( ) it; s -• 4 1 1 e'l e Fax: ( )
toilet compartments, utility rooms) 6.80
• • • . ..ICT',3:',.:11:]:: , .,"": ' i',5`.•;i' i,l:tt1',..t-bii,itigaitlfg,,,: v.. .. ;....: Atticicrawlspace fans 10.00
i , Other: 1 I 10.00
Business name: c •-• . e t ( i•L._
} ii e;
_I Fuel piping
•
Contact name: t c i S t: . d' r - i2 fl 55.40 for first four; 51.00 for each additional
Addres. Furnace., etc.
s: 4 r vet k
Gas heat pump
City/State/ZIP: I i.
FT 1 t .1 t) ..• e l''."1,C e i 9. i 2...3 Wall/suspended/unit heater
,
Phone: (pc, ) ( , (,,, i 0 --,- 7 G., t )-- I Fax: : ( S'e.... ) L., ji. i , .... 0 ..?., 7 y Water heater
Fireplace
E-mail:
Range
- - : - . 1 , - ,,,, .• - I ,, Y ' i ,.---^ COOTIZACTQFV I •ii' .: •::.',' ',..:... : :"..: - , ;41..''.1. - . '.%::- Barbecue
Business mune: Clothes dryer (gas) i
I_
I Other: I '
. i
Address:
;.•` ' • .
City/State./Z _ :P:
Subtotal
I Fax ( ) Minimum permit fee. (S72.50)
Plan review (25% of permit fee)
CCB lie.. 4,.. s-- i- k
. . . State surcharge (8% of permit fee)
I .. Authorized s ignatu ie: ..1/4•_...i•V t ....:...e" -,. (i_ j._.4.: i ..._ •
( I. . TOTAL PERMIT FEE i t-e; 3 0 1
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: H , i ..... ti e ., c . I c (... 4..1
Date: • "A
7 1 1 -11 tilt . Fee methodology set by Td-County Building Industry Service Board
iA lding%Permits■MEC.P.rnotApp.doc 12/03 440. (11/02/COM/WEB)
a - d SILO B6S COS 2uTa.eaH R di70:60 170 LT daS
CITY OF TIGARD 24 -Hour
BUILDING inspection :L e:. 03) 639 -4175
INSPECTION DIVISION Business Line: 503) 639 -4171 MST
/ BUP
Received Date Requested /b — is AM ✓ PM BUP
Location 92 5s .-- 5 -- 4:1_21.41(....., Suite 06 — c 5 v 4 ' 2
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner -qco / soa
Footing
Foundation ELC
Ftg Drain Access: M�� 30'
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 I '
P,LUMBING ' `' `:`'r ,
Post & Beam
Under Slab
Rough -In t
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PAR FAIL
•
Pos • Beam .
Rough -In
Gas Line
Smoke Dampers
Yom
T FAIL
CTRIC `
Service
Rough,-In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line -
ADA /� ,
Approach/Sidewalk Date /461' / ' v Inspector - Ext
Other:
Final • • DO NOT REMOVE this inspection r rd from the job site.
PASS PART FAIL