Permit CITY TIGARD MECHANICAL PERMIT
l6 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00551
- �� J II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/13/2004
PARCEL: 1S133DA-07800
SITE ADDRESS: 12636 SW SNOW BRUSH CT
SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R -7
BLOCK: LOT: 138 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of furnace & A/C.
Owner: FEES
CODD, DENNIS M AND JOAN M Description Date Amount
12636 SW SNOW BRUSH CT [MECH] Permit Fee 8/13/200 $72.50
TIGARD, OR 97223 [TAX] 8 %State Surchar€ 8/13/200 $5.80
Phone: Total $78.30
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 8897 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 -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: _s -� 1p
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b us ih ess day
FROM : ANCTIL Heating & Cooling PHONE NO. : 503 2825722 Aug. 13 2004 03:22PM P1
R
• -
Mechanical Permit Application
A . . � `/ rm i r r ro.. ' Q l
� ` 1 ' i City of Tigard RE Datereceive - f
M e ' y
411 - 'J g Projecdappl. no.: �� Pr Expire date:
Cityo,Tgard Address: 13125 SW Hall Blvd, Tigard, i � OR 9 7 23�
Phonc: (503) 639 -4171 A a (0 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Paymenttype:
Land use approval: CITY DIVISION
BUILDING Building permit no.: ; I E
TY1'l: O1: Qk ltl•11T
A .A. 2 family dwelling or accessory Cl Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction . Addition/alteration/replacement ❑ Other. -
JOB SITE INFORMATION COii%lI%I1 >It(IAL VA1.UA"fION SCHEDULE
Job address: 10 (03(e S • L SACCii- Indicate equipment quantities in boxes below. Indicate the dollar
Bldg no - I Suite no.: value of all mechanical materials, equipment, labor, overhead.
Tax map/tax lot/account no.: profit. Value $ ,
Lot Block: 'Subdivision: *See checklist for important application information and
Project name: 1 jurisdiction's fee schedule for residential permit fee.
City/county: , / j 6 .4.1/2.,1 [ZIP: ' )223 I & 2 FAMILY DWELLING PEHN FEE SCHEDULE
Descnntion and location of work on premises: -- S-4...1..%11:1-1-5 AND COM EQUIPMENTSCIIEDULE
. A1 Fee(ea.) Total
Est date of completion/inspection: Description Qty. Res.only Res.only
Tenant improvement or change of use: YT•'AC:
Is existing space heated or conditioned? Cl Yes Cl No Air handling unit CFM
Is existing space insulated? No Airconditioning (siteplanrcquircd)
$ p d? ❑Y ❑ N Alteration of existing }I VAC system
filer /compressors
Business name: 1 •: � , • —j 6 g , cap , .13G State boiler permit no.:
_ HP Tons BTU /H
Address:
4. .12z • to: ii1. l} . Fie /smoke dampers/duct smoke detectors ■
City: • g 2g■...0 State i� ZIP: - r eat pump (site plan required) -
Phone: 2.f. l ' Z
. Pax: S 2 -a7 - 'mail nsta irep acefurnace/bumer BTU/H
Including ductwork/vent liner,Yes U No t
CCB no.: gio 9 3'1fi fl Install/replace/relocate heaters-suspended,
City/metro lic. no.: I A - 6 wall, or floor mounted
Name (please print): Z — Vent fora fiance other than furnace
elrigera on:
Absorption units BTU/H
Name: K Chillers HP
Address:
Compressors HP
>�v
;� ironmental exhaust and ventilation:
City: I State: l I Appliance vent
Phone: Fax: E-mail: Dryer exhaust
oods,Type 1/ IUres. kitchen/hazmat
^ hood fire suppression system
Name: . V€ 1. }S eb , D V Exhaust fan with single duct (bath fans)
Mailing address: __ _ _ a r Exhaust stem a • : from heating or AC
i p , g .H F up to 4 outlets
City: l (, ,t L,, M3 ZIP: ri LPG NG Oil
' Phone: $ $b Fax: E-mail: • • piping each additional over • out ets ,--__-
1•:N(:!NEER 1 roeesspiping(schematicrequired) _
Name: • Number of outlets
Address: Other listed appTamee or equipment:
Decorativefireplace
City:
StakL___I ZIP: `Insert -type
Phone: I Fax: B -mail: Wooditove/pellet stovo
Other
Applicant's signature: K i Date: X -a - air
Name (print): Vg . (, ,3 6 l
Not alt ju6'6``'ees "9"'"14. cads. P can jurisdkuoo rot more iofommcia+
Permit fee $ ') a SD
Notice: This permit application Minimum fee $
0 MasterCard
e if a permit it obtained
St
o card � / / s not review (at (8 96) $
r 1 E within 180 days after it has been State surcharge (8%) .... $
ru a. oe card accepted as complete. TOTAL $ , 1 R
cardholder aiaoapne Amount 4404617 (G/DMCOM)
FROM : ANCTIL Heating & Cooling - PHONE NO. : 503 2825722 Aug. 13 2004 03:23PM P2
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20' ( +)
7 '
20' ( +)
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n I t
Denny Codd
12636 SW Snowbrush Ct.
Tigard, Ore. 97223
W/O 23755
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date ' equested AM PM B � U , P >
Location % / 3 • :��,� .� Suite a,00
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
5
BUILDING Tenan s . — 7_4) A/ U2.—/
Footing
Foundation ELC
Ftg Drain ACCeS /
Crawl Drain — — • ' - - -- � ! /I - ; ELR
_ Q. -_ _.
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation 5/,L
a ` d �° '7 2 Co /„
Drywall Nailing
Firewall ST
Fire Sprinkler 1
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 C
Post & Beam
Rough-In
Line _ r
S
• moke Dampers
Intl
- PART FAIL
ELECTRI"
rvise
Rough -In
UG/Slab
Low Voltage �� J
F' Alarm
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
FAIL
V
Please cal for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date ; � Inspecto � Ext
Other:
Final DO NOT REMOVE this Inspection record from th = ob site.
PASS PART FAIL