Permit r r .
C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2004 -00350
�l� DEVELOPMENT SERVICES DATE ISSUED: 6/8/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BD -02100
SITE ADDRESS: 09740 SW RIVERWOOD LN
SUBDIVISION: COPPER CREEK STAGE 2 ZONING: R -4.5
BLOCK: LOT: 038 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: 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:
> GAS OUTLETS:
10000 cfm:
Remarks: Install furnace and A/C. A/C unit cannot be placed within required setbacks.
Owner:. FEES
MARSHA REED Description Date Amount
9740 SW RIVERWOOD LN [MECH] Permit Fee 6/8/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 6/8/2004 $5.80
Phone: 503 670 - 7132 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 - 453 - 4822 Mechanical Insp
Final Inspection
Reg #: LIC 62196
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: &/� /370,4 C6 7ON
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Jun 03 04 12:09p climate control 503 968 7224 p.1
I _ .
Mechanic_ali- Permit Application
FOR OFFICE t151 ONLY
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 � Date/BY: jP /p y Permit N y t �ECo ✓ O09 - /j 0 / ,�,5'Q
Phone: 503.639.4171 Fax: 503.598.1960 �/ Plan Revi "� U
Inspection Line: 503.639.4175 0� /40/,, Date/By: Other Permit: •
Internet: www.ci,tigard.or.us �� .�' 1 ,. Date Ready/By:
aso See Page 2 for
Internet:
::r:::, I:3 Notified/Method: pp m Pag et Informalrua
:
❑New construction 1E14 ddlti0 It tl' \placement Mechanical permit fees* are based on the value of the work �'
\�� �Q� perforated. Indicate the value (rounded to the nearest dollar) of all
❑Demolition 0 Other:
building
:i ;::;(;.;, ; w r ;. ; s; r „: - :., .....:..:.:::::...:: ... _<:.:.... ........,. .. mechanical materials, equipment labor, overhead a nd profit. . p ofit
•
: .. -.. T GOIi ; ... .,._:....,.. ogijott :
and 2- family dwelling Co Accessory - 1iF15IDE r ' Value $ '
g ❑ Commercial/industrial {-•:=:.- 0 � '1>0 7�1t1 i *'' °'
❑ Multi -famil ❑ .. -. �`)C�lC1mS. c � � .._..
Multi-family El builder ❑ Other: or special information use checklist.
.:.:........:...... . ..
Q
• . ...,.. ; ,:;,..::- : .:u;.
:::,,,.;�_. : �.. ,..... , Description Qty. Ea. � Total
G / � � � Hea ti ng/cool fog
� � U
Job site address: RA(wood_ Air conditioning or heat pump
Lou” - (requires site plan showing placement) 14.00 i P
City /State/Z1P: - 1 - 1` 3 �� ' () C l\ Gi'7 2 U ce 100,000 BTU (ducts/vents) Furna 100,0
v _ I 14A0 14
Suite/bldg. /apt. no.: I Project name: ' Li 1 3 i Furnace 100,000+ BTU (ducts/vents) 17,90
Cross street/directions to job site: - Gas heat pump 14.00
Duct work 14.00
1-1ydronic 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
Subdivision: Lot no.: - . Flue /vent for any of above 10.00
T map /parcel no.: Other: 10.00
Tax
Other fuel appliances
a
.-....,: i:."si D,,, +_...Cl . ...QN'_o ". wQJ K: r'•, • : heater
:•......_.........:....:,:.:. - : Water
10.0
( � t I � $ i1 / Gas fireplace 10.00
( Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) f 10.00
Wood/pellet stove 10.00
Wood fireplace/insert -
"3 : ...:::: y r ,:::._.... 4:0: `O1: I ER ':i:a "`.,; 3i?; C`r .`ai:'` , ; �.:;v,:...: Chimney/liner/flue/vent 10.00
.......:.,:�:.... ,, Other:
(( [n�_ 10.00
Name:
QV\ In .t.,/ 1Y) 0.Y 5V Ci.. Ro_P 0 Environmental exhaust and ventilation
Address: G '7 4_o w R J � r� Cb -n J l_ ^ S�. equipment 10.00
City/State/Z1P: �i G a 1 C) fq 1� `I
■
aD. 1 _ Clothes dryer exhaust 10.00
Phone: ( 5 J 69 -7132 / � Fax: ( ) Single duct exhaust (bathrooms,
.....
toilet compartments, am
tents u l
... -• ; .
,...:
;:. .: E ;
r AP1 TieANT : i ::.:::: .: """: ,.,'
-- -•- : :. - :.;-�� - :CONTACT` PERSON Altic/ciawlspace fans 10.00
rooms)
Business name: Other: 10.00
Contact name:
Fuel piping
55.40 for first four; $1.00 for each additional
Address: Furnace, etc.
City /State/ZIP: Gas heat pump
Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) water heater
E -mail: Fireplace
s's:....::: Range • ,.,,:.:.::.� .. ,:.:. .:: • Barbecue
Business name: C(f � I� ' Clothes dryer (gas)
Address: (( ) �) � � Z� � CQ � U /� Other:
rty /State/ZlP: C� ±(CU'1 ...:.::. .:.:::. j „;•r:l:;,:,;y:_'!i!I'i;
I. 7 i2 i Subtotal S 1 ' .6u . :_ .
`i J3- q 6'2:2 I Fax: (533) ' (o8 - —72:2.44 Minimum permit fee ($72.5 -� 2�•
Phone: (5d 3)
CCB tic.: ( Z 1 C
Plan review (25% of permit fee)
State surcharge (8% of permit fee) ' %)
I �� TOTAL PERMIT FEE �
Authorized SignatufE: (� ”' This permit application expires if a permit is not obtained within 1(i0
/� days after it has been accepted as complete.
• 1- 1 1-
Print name: -t'V) (' �� -
1 D a t e: C -0 y, • Fee methodology set by Tri -County Building Industry Service Board
i: Ulu i !di ngU'ennitsVNEC -Penn p.doc -17103 4404617T(II/0:/CUM/WE81
Jun 03 04 12:09p climate control 503 968 7224
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Home Layout
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• • Z5
tro
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Windows Windows ' Doors
• Walls Roof Floors
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: A593) 639 -4171
Received / r ,/� Date Requested 1- AM / / PM BUP
Location i ll 4o K-t` t1 � -e-t..( t Suite 42 _ 4"
Contact Person - N k. Ph ( ) ` 55.5— PLM f
Contractor Ph ( ) ' ate- SWR
BUILDING Tenant/Owner 0 N
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors .
Ext Sheath /Shear � j
Int Sheath/Shear (
Framing .....,_____J___
Insulation
• Drywall Nailing -� A CJ �
Fire wall 1 f � I c L /�
Fire Sprinkler
Fire Alarm J1/� (fix 134 Td .6
Susp'd Ceiling r ` `�`
Roof — N - 5 6i(/1/1 -1® r -
Other:
Final \ fix. G--, - 1 0 Q --4-1 S J .
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In j
Water Service `\
Sanitary Sewer ;,...9..
Rain Drains r
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P T FAIL
E
CA ( 0 . zy -.'
S
1 L
eam
Rough -In
Gas Line i(
Smoke Dampers
' in -.►-
• PART FAIL
0 R ICAL
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 0 Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line W 1A ADA
Approach/Sidewalk Date I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL