Permit A - CITY OF TIGARD MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2004 -00760
- � � 11 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/18/2004
PARCEL: 1S125DB-04700
SITE ADDRESS: 07175 SW SHADY CT
SUBDIVISION: SHADY DELL NO.2 ZONING: R -4.5
BLOCK: LOT: 021 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:
LPG 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: Installation of furnace and A/C unit. A/C unit cannot be placed in the required setbacks.
Owner: FEES
HAMILTON, RICHARD F + JUDY E Description Date Amount
7175 SW SHADY CT [MECH] Permit Fee 11/18/20( $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 11/18/20( $5.80
Phone: Total $78.30
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503 - 234 - 7331 Mechanical Insp
Final Inspection
Reg #: LIC 1441
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: or
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
FROM : TaeobsHeat i ng FAX NO. : Nov. 18 2004 01: 46PM P2
• •
$ Mechanical 'Permit AuPligetiv Et)
City of Tigard ph. aevieu Reeeived
batein // / e) , ••• Pe . t \T VVE - C - si&D f/ 76; 0
13125 SW Hall Alvd_, Tigard, OR 9722
Phone: 503.639,4171 Fax; 503.598.1960 „Ahli
2 8 (1(1 . \ Date/ar Other Permit:
Inspection Line: 503.6394175 14 1 Pete Rcady/B y: /twit: I Fil Soc Pao 2 for
Internet: www.ci.tigard.or.us . - Notified/Method! 77— 6 Supplemental Informat1011
CO OF TIGA P -....=............ .........- ,................
8
.. •,. • , . ,
7.".010Vy'VT;iiRVIIII.W'jiM'tinit:RigfEALIW 7. rol” ■.t.'4,..ii!f*
I nioi
4 k:4 ., -. i rit
.1.1;_dtriteirt.rsT
If.Avi„4Aski14..., , :,4444'?ii.- tWis'i'.Ek :(1'.i .. tat n• ' '-' . • .:R „IX; 71 :,:th 6^ ' ,,,,, ' ' i. ,. i' . '' ... , ,...-,,,,j, ' • '-''''. " ... ' • ' ;..a .; o • • '...• ' • '
Mechanical permit fees* are based on the value of the work
0 Now construction 0 Addition/alteratinn/repleeemcnt
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. .._ ..
4y..1.-L: , , ,, y4 , ; , ;„,''V t rii..i:;;%.ii , ';Itli . 4:U;',4 1 1 .3 2Li. 'V . : . tk 67 4. 4 0$1;"(;' : ;:: T. -$' ,r o , . . Vail.= $
,
1 I-A,11.'0.% flAaattifidn,r1;.,2. 4.12 '‘....,001. • ■. 1 :' ' . • " '''7.•■••:S. ' '''''''. ' J.' J "Z . ' i,. . •,'%4,61Aititiapkaifiallisekri Y s'
E 74 .s•yi•ms FEES
. *
74 and 2-family dwelling 0 Commercial/industrial 0 Accessory building Iii',•ike , .•. ....., ,;;„ „, z•,. • ,•• • ,•.17'n."'”•'
• Multi-family 0 Master builder 0 Other: For special information ttoe
Description Qt31 Ea. I Total
•, -.1., .
); r i
‘: ril" r ,` I I0',P F rr' r t 7,L4.P wen, :;•, "';',::';14!,-,1, ..:ir 1. .: .. --•
ViantaditteC .,6'a R. , • Velit . a Ualaidaz..1,1*,.*.wit,.. .i...,...., :',..,1.,,..: Heating/P.
Air conditioning or heat pump
Job site address: p.m
(requires site plan showing placement__ 14.00
City/State/ZIP: 1 07 Willi • . I.
Furnace 100,000 DTU (duets/vents) 1 14.00
I Furnace 100,000-1- BTU (duets/vents) 11%
Suite/bldg./apt. no.: Project name: a •
Gas heat pump 14.00
_ . Gas
Cross streot/directiatts to job site: Duct work 14,00
- —
11Ydrottie hot water system 14.00
Residential boiler (radiator or
--... -. -...„.. _
hydronic) I 4.00_
,_ Unit heaters (fuel-type, not electric),
in in suspended, etc. 10.00
_____ . .._
Floe/vent for any of above 10.00
Subdivision: lot no,:
_._ . . Other: 10.00 {
Tax map/parcel tto.:
Other Aid appliances
' • . - ' .' ' • Water heater
gl„.,Ni,Virrlf,a ;NSW", 'TMO•tr; . l irrrekilWit ''. 4.: . 06;164.11,',.,; . :;;1 , 0,:• , .iit.i 111.to
1 .,• , .„„,,, vd0,2 .......1...2 . • ..• .... • , .......• ... :41tt :34122:!!Lk.:'' •. — "••:,...k.S chr (1_1_ 10.00
, •
I ' ' ----
--441A1611/1--Ck.0/ .
_. a ""1"“..-.' -- Flue vent for water heater or gee
fireplace _
Loglighterk ait)
AtOve ,
. ,..,. -
10.00
Wood/pellet 10.00 10.00
. ___
' Wood fireplace/insert 10.00
„..
...,
I 0.00
mown,. ,..,„,,,, .„.,:. r „,, :. Alf ...,.., ... • Ir , to" , 4 : .4:, ,,, ......r:! ;,, Chimney/liner/flue/vent
tiviArt ; g . T ,,qi...0- '.1,i • Si L - ' 4 l' '11;T:1°
- ki , ,a,i4)li, .1l..' ..:6• ', . i., •,■••.! 1, . .• .,„,..' I •: ,,': „ i •• 74 I . •'. ' I.• I 1;: ' „,',.a. (met: ,_10.00
Name: _ „,,Ttreki J a A . Environmental exhaust and ventila ion
- •
. ,...
Range hod/other-kitchen
— Addr -- ess:
.00
equierrievt .
i 0
--
City/StateMP• ■ r i , II - WO
- Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) ••....4., Pax: ( ) "=”. toilet eompernnents, util4y_loomo _ _ 6,80
..:.. - ' '-' '.: . ' 'I Attic/crawls acc fans
c!/.. ..iii-:. if iA;14:.:tzgi;:iiiii,;, , t -. . •yorf p .., ... 10.00 •
{, , - r•, 4: :• • .,:. ...py..t;.,,, , L ,r,„.... 7,.......,• -.:,....,- .,..f. , ;. .. ,... j . , , •:..,. , . , O ther; 10.00
Business nem : • ,..1
— ' - Fi!OPJP101i..
. W •
Contact name: . .. $5.40 for first four; S1.00 for each addItional
. .. - .........._
„„._
, Fumaco, etc,
Address: 1 tA 1( Q t
_.t ., Oas heat pump
CitY/State/ZEP: -.. 4 d 06 GV) .2 0 2- _WalyauspandedAmit heater _,
, . . ,
Phone: 20 Da.ri .- 7 .. ,3, I Fax: : (
) 51,q7i:S-g'--. - Water heater
Fireplace
E _..,
,,.-...m..1,1•,.,,,r„s3:1,,,, Range _
i y,■,*- re,., i;=,FLI ,qptollN 1!4. ',' omi, If1 4,7:6 ' ( W 7-v
..4 plc... q:
Bsuar-A ...4is. .,,,, , Barbecue _
Clothes dryer (gas) .
Business name: • --
'•'• . , Other:
Address I 4; 0, • '‘',N''‘4t • ' • ' . :41i,EiSlir •
..11.1::.' .• ..; :'' '..■.' •"'w ' ;.• ‘ . .. • .., .. • • • .
..---...,... ...... —
City/State/ZIP: Subtotal st o_
__._..,.. -
- -- rrni I Me ($72 50)
Fn x: ( ) __ . Mmottom pn -
Phan review (25% of permit fee)
5.1
.._
CCB lie.:
State surcharge (8% permit fee)
__.„
t
TOTAL PERMIT FEE
- 1{4/ 0 q ... --.
This Perini( application ' Ir n permit Is nut niti;;ine 1 . in 1 8A Authorized signatur. I
• i . 4: worm i , , - dive •fter It hoe been accepted as complete.
Awl / / 1 I Date: dology t b Tr-County °nth:ling Industry Service Brood
Print name: ' (-, ET2Aial. D • Fee metho
. ..., „..._
iAllnilrang1Pttnt100113C-ponnitApp.dnc 12/03 440-461 Tr (1 I /07./COIWW2a) 81 ' 0
.FROM : Ja bob sHeating FAX NO. : Nov. 18 2004 01:46PM P3
r r �
i
! SITE PLAN
A
i;
vo
DIRECTION
4
r' r HOUSE
4
0-
A FRONT
s i b
•
Job Name I L. 'i
Address
g7 2.Z 3
Model # • t - 36 I
Make 12)) ..
•
JACOBS HEATING & AC
4474 SE Milwaukle Avc.
Portland, OR 97202
(503) 234 -7331 •
. . (503) 813 -9257 fax
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: ' (5037639-4171 MST
BU
Received Date Re• nested 1 ' 3- AM / � � PM BUP
Location _ _ Suite MECA O 6 - DO 7 MoD
Contact Person �r.��'l J Ph ( ) � 3 - 7331 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear �
Int Sheath/Shear
F
raming' ' c--°"1:/2
Insulation
Drywall Nailing
Firewall
giA ftwrigz , —
Fire Sprinkler 1P 5c S 7 ��
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam )2 V-5 /(,
Under Slab
Rough -In
( K) Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
16;fr°9*---
PA--S FAIL
Post & Beam
Rough -In
Gas Line
Smoke 1 mpe•-
pm FAIL
• R AL
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 fl Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA / 6 Approach/Sidewalk Date Inspector �-�` Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL