Permit ® `1 CITY OF TIGARD MECHANICAL PERMIT
I�1► PERMIT #: MEC2004 -00808
A I� DEVELOPMENT H BMEN9 Tigard, SERVICES 639 -4171 DATE ISSUED: 12/9/2004
PARCEL: 2S 111 AC -02500
SITE ADDRESS: 09110 SW PINEBROOK ST •
SUBDIVISION: PINEBROOK TERRACE ZONING: R -4.5
BLOCK: LOT: 066 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: 1 DOMES. INCIN:
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: Replace heat pump and furnace.
Owner: FEES
MAYER, JAMES C E J Description Date Amount
9110 SW PINE BROOK ST [MECH] Permit Fee 12/9/200' $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 12/9/2002 $5.80
Phone: 503 639 - 9594 Total $78.30
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 Heating Unt lnsp
Cooling Unt lnsp
Reg #: LIC 71878 Final Inspection
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 -01 -41 0 :h OAR 952 - 001 - 0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503 46 -6699.
Iss - d By: _ � �% ; - ,� Permittee Signat % �7 f --�- -�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
DEC - 09 -2004 08 :38 A TEMP HEATING 5035572990 P.02/03
Mechanical Permit Application r c)ti (la rlc l: i �r. MI.) City of Tigard D ECEIVE ��I '� . _ ., 'eV :�.
13125 SW Hall Blvd., Tigard, OR p� Review
Phone: 503.639.4171 Fax: 50
pec 3.598.1960 �. may; othcPermi inspection Line: 503.639.4175
DEC _ s (� `• D ote Itmdy/By: runs RI See Pace Z for
r Internet www.ci.tigerd.or.us DEC 0 200 -- Notitied/Method: Supplemental Infotmatioa
❑ New conduction I t dition/al • . on/ =.7 eeetne - ' Mechanical permit fees* are based on the value of the work
perfbnned• Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical matcri : ■ i .m labor. o • and • rofit.
Value: S
r: - and 2- family dwelling ❑ CommerciaUiadustrial ❑ Accessory building
For special information use checklist.
• ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
._, . ., l . b a h. la I .- ..,._r 1111 14.00 M
City/State/ZIP: 1 "' • . '1 02 a ' ^ Furnace I. 000+ BTU Mans/vents 17.90
SltitrlbldgJapt no.: Project name: 14.00
Cross stmet/direarons to job site: Duct work 14,00
00
Residential boiler (radiator or
h dronic) 14,00
Unit heaters (fuel- type, not electric),
/ in -wales in -duct, suspended, eta 10.00
Subdivision: Lot no.: Flue/vent for any of above
Other 10.00
Tax map /parcel no.; Other fuel appliances
;,. .
- , � ,� ,; �:: i' � •i. ,. Water heater 1000
Gas f realace
IL 1U.00
� � . O .rr Flue petit for water heater or gas _
fueplacc 10.00
• Log lighter fees) 10.00
Wood/pellet stove _ 10.00
Wood freplacelmscrt _ 10.00
uler/flue/vent
10.00
' f1� �� J , Environmental exhaust and ventilation
�' Range hood/other kitchen
Address: . a equipment 10.00
w wv ► n. e ■ • ! Clothes darer exhaust 10.00
City/State/ZIP: �-�
Single -duct exhaust (bathrooms,
Phone: ' (4, Fax: ( ) toilet comparuncnts, utility moms) 6.80
■ ; , I y , I Attic/crawtstace fans 10.00
Other 10.00
—
� ' g f.1 peel . . i . ■ :
Contact name: 55.40 for first four; 51.00 for each additional
Flunaeo, etc.
Address: I Gas heat pump
�� A WaWsuspended/unit heater
Fax:: ( ) Water heater
Fireplace
E -mail: Ranp -
B e
Clothes (gas)
Business name: 411 •re .v Other.
Address: t . 0 / ip 5t ' , i . �. 'ii
City/State/ZIPO . 4 S CAL.) .-) • L Subtotal
Minimum permit fee (572.50)
Phone: ( J) CpSQR, tO C) - • F ax: f l 19- 0 Plan review (25% of permit fee)
CCB lie.: k q• L 7 State surcharge (13% of permit fee) � ��
TOTAL PERMIT FEE I e 1
, , This permit application expires if a permit is eat obtained within t
Authorized sigrtattu e: tG//yy o1V�Q . • �� day. after It has been accepted as complete.
' Fee methodology set by Trl•Cmmty Building Industry Service Board • Print name: -� :
Iaaai.r.ap... itMF.[- PerrnitADD•doe 1210i so- min fliet171COMIWm)
DEC -14 -2004 14:27 .A TEMP HEATING 5035572990 P.02i02
ru 0 cet4
i• f
c `
A. -Temp Heating and Cooling
s i t e Plan
,.2 -9 -ay
Prepared bye , 1)a(o: { 2 r ,AA:pY
Customer Na,nc; t . Eiteepp s s eI,/1eJ
Customer Ph ione — 95f
.
PropciI I1►>rrncl;rry Line
A
4- - - --
29
�' Yo
I IcnIsc
Slrccl
TOTAL P.02
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (50 639 -4175
INSPECTION DIVISION Business Line: - .3) 639 -4171 MST
BUP
Received Date Requested / I AM PM BUP
Location a ..1_•�__ i ' Suite MECv0 R
Contact Person _ .r. • h ( ) - q5 PLM
Contractor @G na&) Ph ( ) SWR
BUILDING Tenant/Owner ELC B - 06'7 7/
Footing
Foundation ELC
Ftg Drain Access: t. ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear / ■ r G
Ina Sheath/Shear K p P4A - U A T
Framing I`
Insulation � �JV
Drywall Nailing >> xi PT— M I N 3n .
Firewall P.# 14
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: �p
Final
PASS PART FAIL
PLUMBING — FA-/ L_
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: CO
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PASS PAR
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
"rF e.Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
4 0149
Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1 L ' �/ Inspector Ext
Other:
Final DO NOT REMOVE this inspection recor - . m the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:. (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested < / a AM PM BUP
Location '7l L P,Lig iv),,, .....4/- Suite lzp a -00 gDg
Contact Person Ph ( ) . 4 PLM
Contractor Ph ( ) r SWR
BUILDING Tenant/• iee-- Male p / EL( ° C1 c 9 7 /
Footing l0 3 ! S q ! 1F ELC
Foundation Access:
Ftg Drain I -
,� t '
t-/ �7 4--;a1q4 /l c �. F � '�J
4 , / °.
Crawl Drain l V 1
Slab Inspection Notes: C- )a) ✓' SIT
Post & Beam -- ____
Shear Anchors /1 / "1 _
Ext Sheath/Shear /`�' l oL
Ina Sheath /Shear VIN t - ~ l
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL C.)
PLUMBING
Post & Beam
Under Slab
Rough -In . \ P
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PA ART FAIL
' :' rte AL
Post & Beam
Rough -In .
Gas Line
Smoke Dampers p
F' �(
PART FAIL
ELECTRICAL
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: ❑ Unable to inspect - no access
Fire Supply Line
ADA J
Approach/Sidewalk Date < 71/4 C 2.5 Inspector k• -.1--7.--- Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL