Permit •
CITY T I GA b MECHANICAL PERMIT
4, DEVELOPMENT SERVICES PERMIT #: MEC2002 -00609
!- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/30/02
PARCEL: 2S 103AD -02000
SITE ADDRESS: 10965 SW PATHFINDER WAY
SUBDIVISION: PATHFINDER ZONING: R -4.5
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install gas insert and 1 outlet.
Owner: FEES
ALDRICH, DAVID A + BARBARA D Description Date Amount
10965 SW PATHFINDER WAY
TIGARD, OR 97223 [MECH] Permit Fee 12/30/02 $72.50
[TAX] 8% StateTax 12/30/02 $5.80
Phone: 503 780 - 8707 Total $78.30
Contractor:
EASTSIDE HEATING
7200 SW JOHNSON CREEK
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 - 774 - 3281 Gas Line Insp
Mechanical Insp
Reg #: LIC 00003258
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: ff ., C
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
12/29/2002 22:42 5037743057 EASTSIDE HEATING PAGE 02
1 C
r ..
Mechanical Permit Application 0, 111 I I ' I
Date received: J O -O .9-- Pmmh noo. to; "0 0 .14
- 1 City of Tig t ED
no.: ry
�a1+ P►�,e�t�appt. no.: Expire date:
of Tigard Address: 13125 S gar , OR 97223
Phone: (503) 639-4)71 Date issued: �� Receipt no.:
Fax: (503) 598 -1960 DEC 3 0 2002 7 Cate file no.: Payment type:
Land use approval: RD Building permit no.:
1
O 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction O Addition/alteration/replacement 0 Other:
mitt .ti1II: I \1Ol I4IIO\ (Y)11114: Ill 111. 1'1L1.1IION 5l III l)I I.1. ii
Job address: JO? 6 5 W '41h f i e - Val/ - Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: l Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: - profit. Value $
Lot: IB1ock: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county /?f. .Z//1 I ZIP: au & . 1 I I I.1 I)1 \ . ` ► i
Description a n d ; location of w o r k on pr+elnises: t \ I) (O 1 \ ► 1 k l t u . 1 1 \ n 1 .. t k 1 1 I I t ► I 1 r \ 11 \ I r 111 1)1 1.1 i }
Fee(ea.) Total
Est, date of completion/inspection: ' Bas. Rea
Tenant improvement or change of use: C'
heated or conditioned? O Yes 0 No 'fir handling wit CPM
Is existing space• Air conditioning (sits pion )
Is existing space insulated? 0 Yes 0 No ' Alteration ofexignng system _ ,
Boiler /compressors i:
State boiler permit no.:
Meet me: £ j t j 2 _ edrl j1n k ,-r 6nn) . Hp Tons BTIJa1
Address: elOO , 4., Lh n t,,,•, rte. h /u) Firelsi a duct smoke detectors
City: • N , State: Q$ ZIP: ' I t puw ace an r
Phone: E rrnv
77 J �� / Fax 77y 3�s' Including ductwork/vent liner O Yes O No
CCB no.: i 50 — 11-17 - o °j _ Install/replace/relocate heaters - suspended,
City /metro tic. no.: /a y wall, ar floor mounted ,
Name (please print): Vent for appliance other than furnace
('0\ i •1(•I I'4:iRSO\ lefrIg at
�
^ Absorption units , BTU/H It
Name: L it / I/YYLI v^ C sore H _
Address: Lu,Ironmental exhaust and vent ladon:
City: 1 State: I ZIP: Appliance vent
Phone: Fax: E -mail: pryer exhaust
()11 :\ 1 it Hoods, 'type D tl/res. kitchen/haamat
hood fire suppression system
Nettle: 0 - ift • Exhaust fan with • a duct (bath fans)
Mailing address: Exhaust system apart . hennas or AC
Fuel OpW sad . ,. to 4 outlets)
City: State: ZIP: T L PG I Oil 40
Phooe•z. v 57i) Fax: E - mail: m in . •• , a•► - o». ,..
F'\(: I \ 1•:4:1l ' . - p . no (schematic mequved)
Number of outlets 4
Name: Otherlistedapplinnee or equipment
Address: • Decorative .. -lace
City: State: ZIP: - --1:16 •
E -mail: " • . , , v , l et stove
Phone: I Fax: I tom:
Applicant's signature I Date: Other
Name (print): _,I.
Permit fee S ?0L.
NW an pakdktiocu a terc recut weds. Weise cart juAadicaon for more intaeemiion. Notice: This t Cali®
❑ visa O MEir ICard permit a Minimum fee S
Credit cacti,mmher " .._ / / expires if a permit is not obtaua re
ed plan view on %) 5
Expire& within 180 days after it has been State a h arg e ($96) . -.. S ms s- 8v
Name of cardholder ea rho.,, on ordi, urn accepted as complete.
$ TOTAL s lea 3 (,
Cardholder signature Amounu 1404617 (6/00/00M)
CITY OF TIGARD 24 -Hour
BUILDING " Inspection Line: (503) 639 -4175 - -
INSPECTION DIVISION BusinesS.Linea. (503) 639 -4171 MST
� 7 BUP
Received Date Requested - ! M PM BUP 2 �
9��
Location 4Suite MEC —2)6 6 •
Contact Person Ph ( H ) F $ Za PLM
Contractor Ph ( ") ) -2 I0 6 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation / ELC
Ftg Drain Access: e 4 / /V ' ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors n D / �
-
Ext Sheath/Shear lJ V
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
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough-In
Smoke Dampers
rn
SS PART FAIL
ELEZ. FRICAL
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 El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA 2_ 0 3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL