Permit 1 0 - e — - i . k E \ lT H C -C',- -
t ITYOFTIGARD MECHANICAL - PER IT
PERMIT #: MEC2002 -26010
u DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: 9/30/02
PARCEL: 1 S 133AD -07700
SITE ADDRESS: 10775 SW SUMMER LAKE DR
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 121 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of a gas furnace.
Owner: FEES
STEVE SCHRADER Description Date Amount
10775 SW SUMMER LAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 9/27/02 $72.50
[MECH] Permit Fee 9/30/02 $0.00
[TAX] 8% StateTax 9/27/02 $5.80
Phone: [TAX] 8% StateTax 9/30/02 $0.00
Contractor: Total $78.30
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503 - 266 - 1249 Gas Line Insp
Mechanical Insp
Reg #: 14009 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 - 66
Issued By: , e,pt`' Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Sent by: ROTH HEAT4 O & A/C 503 266 3478; 09/24/02 1:24PM;JetFjx #376;Page 2/2
-. - - -- ,, , ,,., 1 l ie:arrm; 50 59916160 -> ROTH HEATIN4 & A /C; Page 2
09,47/2001 eN, 5035881960 CITY OF TIGARD 14002
rte%'' .
•
Mechanical Permit Applicatio
A .
Datarcccivcd: ? Ly Pt rIPU no. 0
,!,61- 'II, City of Tigard o M 2t- 010
Flgj t:WApp1. no.: Expire date;
CCry onigard Address: 13125 SW Hail Blvd, Tigard, OR 9723
Phone: (503) 639-4171 Dateissad $y:_ / I Receiptno.:
Fa: (503) 598 -1960 t Lic r V E sofileno.: Payment typo:
Land use approval: ■• uildillgpermit no.:
• A II
] PI :' OI. I'L I
4 1 & 2 family dwelling or a Q coesaory 1111' a�/ 1ndiis t riel l ; - t
Q Mniti-family CI Tenant improvement
Q New construction Uiiiticdala�ratiorl 0 Oth.. -
lull TIT 1 \I.lili l I1(IN 11). \i%II 1.■ 1 ll. \ \1.1! \'I IO.\ ti( 111 1)I r 1
. Job address: J?J 4 �"� WITara Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials. equipment, labor. overhead,
Tax ;ttap/tax lot/account no.: profit, Value $
Lot. Block 3ubdivi5io0: *See checklist for important application information and
Pre ea name: • jurisdiction's fee schedule for residential permit fee.
C it y / c o u p : j t f ' � i / a l l i n Z I P : . t a n ■ ,c ' i N \ 1)11 1 111. \G 1'110111 1I:I I' III ,MI (.I
Descrip- oa - dl•trationof • on premises: , f�Lra i reo7'/ \\ Ir P\ I\ II J I(\ I/ I. NI(' II( I \1 >;1
�
.e i Ail 4 _ • /L- 4 , i
• t.M.r) of co I f etionl'i' %ectiot7: _._ i r
Te , ' impm 'enter 7 - : e of Brea: ,' A ..
Is existing space heated or conditioned? 'Ares 0 No handlln unit CFM 11.1 11
existing space insulated? O Yes 0 N co -ono .: • n ySt
A �.� . on o c • : . n : >;i . eyerettt ,
\1L( II\ \I('\l ('U \J1(1(IO1( -o caalpte55gts
Business name: av `j�►A 7x Slaw boila pacmitnm:
Address: MIL A - - Tons 8TUlli
acs; %:1r �___�� �__ ZI i 0 JC►T,1�4 ,, w• • ,
- • _ ��'f . i. (T71 - 1 _owe . ,
. •urner A !1T
CCl3 no.: :' � I i � Incladin , ducavork/veat Une D es 0 No
F - comic - :!ere- Nuapen• •
Ci /metro lie. no.: ,� wall or Boar mounted
Name (please .:. ); la % r r i f ' ' OM • r •:J. once • • • an • ace MIIMIIMMIIIIIIIIIIIII
Name: ((1 r/� " onaura H /H
r r,
AddreS1: CO '
stand varttlatton:
City: State: ZIP: Appliance vent , •
Phone: Fax: R- rzaail: Dryer exhaust
1111' \I It floods. Type 1/ U/res. ate, • aznaet
r
hood s- iresuppression system
o S
Name: if g •e 1 4 Exhaust fan with sin' lc duct (bath fans)
Meiling a d d r e s s ! d • r ' 1 I/ u _ e Izthaust system ' art .. bea • a , or A �
i/ State:: / ""'a • " • - • • . button up to 4 • -to
11271 122F1 LPG NO Olt
e . . n • ea -r • •n• over4•Qu eta
I NI, 1ti: \ I . ( ,Process • ping - , .. ; c required
N om; Number of outlets
•
Address;
Decorative fire lace
City: State: ZIP: Bert- • -
iiiiaMMill Fax: E-mail; , oodatov- . - Ictatove
other
A. •Jkaufs signature: . > _//% >5ate: g �ji�—. , - _ �—
Name • dP,MitrAWITOVAMIIIMMI
"Nor 48 lwia tIelieoa accept audit cards, pl a+■ =al iuriatiaion tar maio lafa®adon. Notice: Thin permit application Pull* l'00 $ •" "
D Visa CI MasterCard
Minimum fee $ '1 5 D
•
Credit cam maw; • , ` expires it a permit is not obtained Plavlaw (ac ^ %) s
t plan r � e �nart>n 180 days after It has been State surcharge (8%) .... $
Wm" or combo — )gar as shows o. wadi) card s •accepted as complete- TOTAL $
?7
e�dtrol r e m atma A.+ew,r ,
440.4617 ppootc0M)
CITY OF TIGARD 24 -Hou
BUILDING Insp ine: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
`v // BUP
Received — 7Dcate Requested AM PM BUP - �� d
Location 1 D 7 �'' &uite MEC /
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/! ,i ELC
Footing 6 ga - ,5 1 ELC
Foundation Access:
Ftg Drain .Z I 5 / ( ere-f�0, • 9l 3 ELR
Crawl Drain 'T/ U cn
Slab Inspection Notes: SIT
Post & Beam
Y ' Ext Sr Sheath/ors
ea Anch
th / Srs Shear O / y M /� �� e
Ext eah/ �v �
Int Sheath/Shear
Framing
Insulation Gi
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
/
Susp'd Ceiling
Roof 1
Other:
Final
PASS PART FAIL
PLUMBING I
Post & Beam ` /
Under Slab ,.
Rough -In
/ NI ,
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan r'
Other:
Final
PASS PART FAIL
VP E NICAl-
am
Rough -In i/0
6 Ca b t
Gas Line
Smoke Dampers
siliilj I°
PART FAIL
TRICAL
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 Li Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line / /
Approach/Sidewalk Date () / I V / 0 Inspector /(2 I -1. __ IExt
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL