Permit A y i,. CITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2004 -00771
Aj_ Ali 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/29/2004
PARCEL: 2S114AB-13900
SITE ADDRESS: 09355 SW JULIA PL
SUBDIVISION: KNEELAND ESTATES NO.2 ZONING: R -4.5
BLOCK: LOT: 108 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:
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: Gas furnace changeout.
Owner: FEES
BRENT PEDERSON Description Date Amount
9355 SW JULIA PLACE [MECH] Permit Fee 11/29/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 11/29/20( $5.80
Phone: 503 624 - 1827 Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 14008
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)24 69'.
Issu d By: � ', /� Permittee Signaturh�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ext business day
04/17/2000 03:51 15032632513 ROTH MECHANICAL PAGE 02
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City of Tigard 1 III — i 1 Am Received ` • armit NO.:
13125 SW Halt Blvd„ Tigard, OR 97223 0 Date/LtY: � !'� "�' � ' • �� �
Phone: 503.639.4171 Fax: 503.598.1960 F TIGA. <� P1an Review
Y � 7 t , rr , ri�il:i!' y : � � +� AateBi•: Other Permit;
Inspection Line: 503.639.4175 GIT tit ��� 41.41. • --- 1 bate Ready/13y: aur! ' ® See Page 2 for
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Internet ww.ci.tiganior.us * 9 i f t pj G l. v ".,•- "' Nodfied/Mothod -7 / • Supplemental Information
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❑ Now construction L lddition /alteration /replacement Mechanical permit fees” arc based on the value of the work
/ performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit,
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and 2-family dwelling
Master w ustri ' , ... • " • .
y g ❑ ❑ Accessory bu ilding
For special trl {ormatlon use checklist,
Mutti- family ❑ Master build ❑ Other:
•
Description QV I Ea. Total
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Job site address: • 3 55 S w A 1 & ••1 Air conditioning or heat pump
(requin:s sitgplan showing placement) 14.00
City /State/ZIP: 1/4'7-' 7 e9 7 2 (f Furnace l00,000 BTU (ducta/vents) ,` 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site; Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
ltydt'onie) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duet, suspended, etc. 10,00
Flue/vent for any of above 10,00
Subdivision: ` Lot no. :er 10.00
Tax map/parcel no.: Other fuel appliances
, 1 1 1 , 111' 5 ,1 i s 3Vijig' ;, 0 t1V 0 RI N.' @� t,4 1,'Ctli
, , �.'.�'� , t � ,V? .�4F�'.� � �,� '' ++�� }.' ; . 1 i � �,�1 I �9 I�,'1�1:'q�i"lt,'�.I�sl?a' Water heater 10.00
Gas fireplace I0.00
Flue vent for water heater or gas
Q
bO P n ` L 1— r V~ � •�4 Log lighter (Ras) 10.00
. Wood/pellet stove ] 10.00 •
Wood fireplace//insert 10.00
al mncy/liuer /flue/vcn
t MO11 ; O *Wri w;S l ngi dpi i`i .ia; .. .:. xl is"� I t
t.
.. . , ether• 0.
Name: `0_01,0A-0 01-) Environmental exhaust and ventilation
Address: Range hood/other kitchen
t3 equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
P Single -duct exhaust (bathrooms,
Phone: ( ) k0 2 4- — ` g �I F ax: ( ) toilet compartments, utility moms) 6,80
Ii i', i8V " `' ,,1, "`: t L” '1PRal 1 rt lOt . ',( Attic /crawlrrpace na 10.00
0,Ytt : uii r , ,„1, . , .1 ' +f4 1 , . ; ' , _;1I.. , :lx f ;r a , i. . o
r . `�
Other: 10.00
Business name:
Feel piping
Contact name: $5.40 for first four, $1,00 for each addltlona
Address: Furnace, etc.
Gas' heat pump
City /State /ZIP: Wall/suseended/unitheater _
Phone: ( ) i Fax:: ( ) Water heater
E-mail: Fireplace
t, ;:''A. ,. 4 � 7 r 6 ' may , .1�;;,� 1 .iN�k'!i' I? r'.t dxh � }1 N r� M. i �a;'�3'�r. �I Range
y r,�, O P , '7a i” .: ' 1 '..�,, 40 l3► q { , }, ,','t} ql' ,I�qj; v �` r, li:. 'NI iUl ''1�4
'a "r 6i33L+Uik �. �+� � Gy4t �, - +: r?`i�.. �Nd.. r �1�,'�.. . ��ii 1 y {Ai��i'�i�;i,ll T {:5i�1�� .', a r:�i�,,l � ?LY. , .a 1� 1 )�arbdGtlC
• (gas)
Business name: A Clothes dryer / ` Other: •
Address: °b / ,50;ingFitglAli.),404 i ' '.,1 , , I I t r .• o�ir;�,yy a � tis' t a d� ' 3g
City/State/ZIP:
7 0/1
P.,/,/ � ,� � .. Subtotal
(503) Z L,G� — ( 2 4) (55 ) 2"l /O . i / ' (� lvltnrmtunpetmit ($72.so� ,�G
Phone: Fax:
,/ Plan review (25% of permit fee)
CCB lie.: / Lit Qi State surcharge (8% of per
I TOTAL PERMIT FEE -- f
Authorized signature; _ ` 1J.1 This permit application expires if a permit In not obtained l in 1a11
days after It has been accepted an complete.
Print name_ ' ' Al Date: , " Fee methodology set by I'd-County Building Industry Scrvice Board
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639 -4171 v
UP
Received Date Requested / ' i °� AM� I
BUP
Location 73 .ss Suite e D' -DD J? 7/
Contact Person 61-de2-riPh ( ) 2&6. / a L PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation Q 4-1).-1-/'.3 , 0 1 6 \ Drywall Nailing L
Firewall
Fire Sprinkler ±Iti- f 1 , r Fire Alarm & V� C N/ v( C./ - ��/t C a i - ' .,—, , --e - o l f , L
Susp'd Ceiling
Roof C _0 0/(.A .
Other: _ `"� ;�
Final
PASS PART FAIL ( I
PLUMBING'k ` - , �2� , � �'- - �!/Y , _ . , K - 6,- (jk
Post & Beam � ;j 1
Under Slab `-� � �w1 % G �\
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm'Drain . .
Shower Pan
Other:
Final -
PASS- PART FAIL Q�
EC CAL. _ ,i. - i _
Pos r& Beam i'
Rough -In
Gas Line /
Smoke Dampers
/' SSA PART FAIL `
tEECTRICAL:_ ° ,.
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ requir.' •afore next inspection. Pay at City Hall, 13125.SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line V q
ADA Date ' 2 / 0 (
Inspector v Lit _
Approach/Sidewalk p Ed
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL