Permit Pi' 4
A . .0 rrY OF TIGARD MECHANICAL PERMIT
1� DEVELOPMENT SERVICES
PERMIT #: MEC2003-00613
�• DATE ISSUED: 10/17/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DB 04800
SITE ADDRESS: 07185 SW SHADY CT
SUBDIVISION: SHADY DELL NO.2 ZONING: R -4.5
BLOCK: LOT: 022 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: 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:
> GAS OUTLETS:
10000 cfm:
Remarks: Install gas furnace.
Owner: FEES
PAM LINDBERG Description Date Amount
7185 SW SHADY CT
TIGARD, OR 97223 [MECH] Permit Fee 10/17/03 $72.50
[TAX] 8% StateTax 10/17/03 $5.80
Phone: 503 224 - 6460 Total $78.30
Contractor:
COMFORT MECHANICAL INC
17936 SE DIVISION STREET
PORTLAND, OR 97236 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 79558
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 -00
Issued By:0 Permittee Signature: D /9
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
,.IJct %17 03 10:29a Comfort Mechanical, Inc. 503 - 762 -5394 p. 2
FOR OFFICE USE ONLY
Mechanica Permit" R eceived Mechanical / Ai
Date/Byfil f i Q3 '7 r Permit No. ' ZOQ3 -- JO 4
City Tigard 1 7 201' Date/By: Approval Building
Cit of Ti and ate/B y: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
F TIG • R® Post Review land Use
Phone: 503 639 - 4171 Fax: 503 - � i �
G D 4 , , h ,l , Date/By: Case No.:
Internet: www.ci.tigard.or.us i u sf I I Contact ns.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 - 4175 " ` V ��� Name/Method: 716 Supplemental Information.
.. TYPE OF .WORK ' • - COMMERCIAL FEE* SCHEDULE L. USE .CHECKLIST
_ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
[. Addition/alteration/replacement III Other:
CATEGORY: F,CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
R. 1 & 2- Family dwelling (l Commercial/Industrial Value: S See Page 2 for Fee Schedule
❑ Accessory Building 111 Multi- Family RESIDENTIAL :EQUIPMENT /S.YSTEMSEEE, *..: SCHEDULE_
Description i Qty j Fee(ea.) 1 Total
n Master Builder ❑ Other: Heating/Cooling
JOB SITE 1INFORMATIO and'LOCATION . Furnace - add -on air conditioning ** 1 14.00 1'-i'-' :'
Job site address: '1 1135 Sta 5+ y, C.,'r Gas heat pump 14.00
Suite #: 1 Bldg. /Apt. #: "—1 Duct work 14.00
y Hydronic hot water system 14.00
Project Name:
‘ , 4 y � 1--t �` 1r t [ Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaterS (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: I Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OP WORK Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
r . t „ / Log lighter (gas) 10.00
`� f ;( t -4 Wood/Pellet stove 10.00
'_) Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
, R TROPERTY'OWNER . r0 TENANT.” ' ` Other: 10.00
Name: : "t� 1 Lk ( (�F� l Environmental Exhaust & Ventilation .
R ange hood/other kitchen equipment 10.00
Address: 1 kE`--.? L ;. • ,5 IY:(' L C.� ,
( Clothes dryer exhaust 10.00
City/State/Zip: y p' . �t< <�� ti c�. � L � �- Single duct exhaust
Phone: ; - : : 7 __.i r,.,,�_; Fax:
(bathrooms, toilet compartments,
'O APPLICANT •. ` "CONTACT ;PERSON. utility rooms) 6.80 _
Name: Attic /crawl space fans 10.00
Address: Other: 10.00
Fuel Piping •
City /State /Zip: *(55.40 for first 4, 51.00 each additional)
Phone: I Fax: Furnace, etc. ** _
Gas heat pump **
E -mail: Wall /suspertdeci n•,it heater **
CONTRACTOR .. • . .. Water heater **
Business Name: ClDriTf'DY+ Mt,(,i16ti4i C4'c Fireplace **
Address: r i q 3to £ E Di v i s 1 inn &1-. Range * *
C
City /State /Zip: P ea, q-72_02_ Cotthesdryer (gas) **
Phone: 1101 • i 5 Cx Fax: "iv.:} - -'-: scot Other: **
CCB Lic. #: i Ci S��S Total:
Authorized j Mechanical Permit Fees*
Signature: ( 1 r �`` Subtotal: $
gn r j(, �' ��.�/ �, / Date: (£: J [ �� Minimum Permit Fee $72.50 $ t'
1 ` '1 �`s
1 _ ,i i'[: l � iTi4 /�- Plan Review Fee (25% of Permit Fee) $
(Please print name) / State Surcharge (8% of Permit Fee) $ ••= .
TOTAL PERMIT FEE $ 1., ?�
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. •
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
CITY OF TIGARD- . ' 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION COVISION Business Line: ' - (503) 639 -4171
BUP
Received Date Requested I -'' 4 ' 3 AM PM BUP
Location r7/ c 6 vU S h N) ,/ 1- N /717 3 Suite MEC 0 7 -, -- 0 V L R
Contact Person ' 1 1 u - 'A Ph ( ) f 7 (D f - 1 S D PLM
Contractor CD N) F o'f\ M 40\ , Ph (--S 3 ) ) " is SWR
BUILDING Tenant/Owner N. 19-( 6 --- vie .,- V1 & ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: p SIT
Post & Beam , `\t \KS p, L co rktwsc ( �1�� Anch
Ext Sr ea h / Srs ( � 'c � �� ��� ml �(q
Ext Sheath/Shear �l •
Int Sheath/Shear
Framing
Insulation - l 1 t \19 \ 03 � J 0 c V \V 0 (�I )O Ot Atb 0 A l N)
Drywall Nailing
Firewall -
Fire Sprinkler - T
Fire Alarm I �� $ J t( '.; 1 �3 ► . I, • Roof d Roof 0 \Zk - S
Other:
Final
PASS PART FAIL
PLUMBING Clot -� 1 \ ji 103 1 L
Post & Beam_
i f
Under Slab .
Rough -In
Water Service
Sanitary Sewer ( N\ � y `
Rain Drains '!
Catch Basin / Manhole 0 k 1
Storm Drain -
Shower Pan
Other: (� I' l �rn ,^
Final L v�� G L_ �l 1 J)N(.w � � ip p Q, V )} V'k 5 c
PART FAIL
ANICAL)
Post-& Beam
Rough -In
Gas Line C 4-1- 12 /y /d I, 4,
Smoke Dpers
final
PASS >PART FAIL �
h y
ELECTRICAL 1 c l ` \ \ 0 L.U1�1 0 OIS ��( pk1 N ) KI . S 1-1 1 v
Service •
Rough -In ,L)\)) L 1t (1 `J : A , C •
UG /Slab
r_- Low Voltage
Fire Alarm ,
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for rei , spection RE: ❑ Unable to inspect – no access
Fire Supply Line
,„. / 1 /
ADA -c —
A roach /Sidewalk Date �� Ti►i . 7 Inspect Eut
Other: '1 3 i
Other:
Final ' DO NOT REMOVE this inspection record from the j site. •
PASS PART FAIL
•