Permit tITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00689
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/15/2004
PARCEL: 2S1 148 B -20900
SITE ADDRESS: 10257 SW KENT CT
SUBDIVISION: RIVERVIEW ESTATES NO. 2 ZONING: R -7
BLOCK: LOT: 053 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: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Push Pull gas furnace.
Owner: FEES
COSTELLO, RONALD E + Description Date Amount
LUNDBERG, KAREN A
10257 SW KENT CT [MECH] Permit Fee 10/15/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 10/15/20( $5.80
Phone: Total $78.30
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 71878
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: � I� A� Permittee Signature: Q
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next buslnss day
OCT-14-2004 16 24 A TEMP HEATING 5035572990 P. 02/02
Mechanical Permit A l 1 -t . )It on-i . is t 1` (,)`∎I•`
Received
�+
City iii Tigard - `• ' a ECE `@q nate<sy: j !l Iv Permit D , a 1i 9
'13125 SW Hall Blvd -, Tigard, OR 97223 plan Review
other Permit:
Phone: 503.639.4171 Fax; 503 - 598.1960 Date/By:
Inspection Line: 503.639.4175 . - a . lf l
�� I --, Data ReadyBY: NM la see Page 2 for •
Internet www,ci.tigard.or.us '- Notified/Method: Supplemental Information
CITY OF TIGARD • - -
❑ New construction ddition/alteration/ • ac I. : Mechanical permit fees' 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
...... ........_ Value; $
G . r.,.n: 1•:,J!:_ ter
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist,
0 Multi- family ❑ Master builder ❑ Other: Description _ IQty j E. I Total •
;; + „, ; •:, ' " ' ..., 'r conditioning r heat ump
At conditi n g o p
Job site address: Q ••• $ ' - (requires site plan showing placement) 14.00
Q--a Furnace 100,000 BTU (ducts/vents) 1 14.00 1 t '(i'
City/State/ZiP: '`
� , t ,
Furnace 100,000+ BTU (deculveots) 17. _
SuilrJbldg. /apt. no.: 4 Project name: OAS heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system r 14,00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel - type, not electric),
in -wall, itt-duct, suspended, etc. 10-00
Flue/vcnt for any of above 10.00
Subdivision: Lot no.: Oth 10.00
Tax map /parcel no.: Other fuel a2plianees
Gas fireplace Water heater 10.00
10.00
QA_ t° uAJC2, 4 ■ * . P ' t Flue vent for water heater or gas
II b fireplace 10.00
Log_3ighter (itasi 10.00
Wood/pellet stove I0.00
Wood tireplacelinsert 10.00
10.00
:.•... u vent
Ch
Aincr/
:
10.00
Name: - Or/ Environmental exhaust and ventilation
0.211. Range hood/other kitchen
Address: ( D_ ''"1 S (A) ,N snze nt 10.00
Clothes dryer exhaust 10.00 ,
City/State/ZIP ` t, : �• Single - duct exhaust (bathrooms,
Phone: () C - P- 7 7 I q p : ,:, fans utility rooms) .
-...
r ,_,__,. .. _....... ,,. cc ens
,
i
tJ ri
,
..•. . . ;'.,. .. 10.0
r, 0
Business name: = —. Q,{/ ak..i.D 1 - tl —(--ONJ3 Fuel .1 t in:
Contact name: $5.40 for first four; 51,00 for each additional
Furnace, etc,
Address: / Gas heat pomp _ ,
City /State/ZIP: 11 !�� + ��f� Wall/suspended/unit heater
- Water heater _ - 111111111 Phone: ( ) Fax:: ( ) Fireplace
E -mail: Range .
Bar ecu
Clothes dryer
ta,.•..:;• .; '. : - ,::..'... r , . ". ' -.. .:. .. -.. _.. � ,1
Business name: ,. , . 1 .y Other e
. .. ...........: :.. •
Address. +:'; •
� ® Subtotal � - ,
City/Stat&ZlPG �s r j ) 0 t� -- 1 '1 — _ Minimum permit fee (572,50)
Phone (3 ) -.(p Q (4 D a"' - - - - - Fa x: G0- rl , ' Plan review (25% of permit fan)
y
CCB lie.: (, q "I. f State surcharge (8% of permit tbc) 5 - °-
TOTAL PERMIT FEE . r] f� • 0
i , This permit application Caplets if a penult is not obtained within 180
Authorized sign ' fA - • - • - days after it has been aeeepted as complete.
Print Hari] ' _ `n o ! t Date: ItIngralEY • Fee methodoloay set by Tri -County Building Industry Service Board
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
- BuP
fi �.
Received Date Requested / 1 J AM; - - =- `' 1 PM BUP
• Location / D-7- Suite
Contact Person ) t O�J Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING' Tenant/Owner k' ��� -fit C,81- ELC
Footing � s 8/ •
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain . . .
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear \ �1 L _ , �� ' J c
Framing Y v `
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
Post & Beam
Under Slab
Rough -In
04 6/ 9 ( : //), 4)0
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other:
Final
PASS PART FAIL
MECHANICAL.: :°
Post & Beam
Rough -In l_ r e�
Gas Line �(V��
Smoke Dampers
PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before nett inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE " ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Date 1 ✓ c /t) inspector Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL