Permit 1 /
I Y OF IGARD MECHANIC PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00491
may- .. DATE ISSUED: 8/13/03
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
� �
PARCEL: 1S133CD-02200
SITE ADDRESS: 11786 SW SWENDON LP
SUBDIVISION: COTSWALD MEADOWS ZONING: R -25
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A/C unit. Do not install within the required setbacks. 8/18/03, addition of furnace.
Owner: FEES
LUSK, JANICE L Description Date Amount
11786 SW SWENDON LOOP [MECH] Permit Fee 8/13/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 8/13/03 $5.80
Phone: 503 - 524 - 9686 Total $78.30
Contractor:
COMFORT MECHANICAL INC
17936 SE DIVISION STREET
PORTLAND, OR 97236 REQUIRED INSPECTIONS
Phone: 503 761 - 1500 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 ■ . ' - Center: Those rules are set forth in OAR 952 - 001 -0010 through OAR
95 101 -0100. Y.. may obtain copies of these rules or direct questions to OUNC by calling
(5 63)246-6699. / /
Ise • d By: /' /! „ I , 1 i Permittee Signature: Qp /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next • usiness day
Rue 12 03 02:28p Comfort Mechanical, Inc. 503- 762 -5394 p.2
0
.r Mechanical Permit VED FOR OFFICE USE ONLY
R e c e iv ed Mechanical � ``
Date/By: Permit No.l�(s asta3 - oD 4 /I
City of Tigard AUG 12 Planning Approval
Date Building
By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 - '. s OF T ARD Post - Review Land Use
B 1N <'r t : , a „i I '' Date/By: Case No.:
www.ci.tigard.or.us _a
Internet: t-'.4 I Contact Juris.: ® See Page 2 for
24 - hour Inspection Request: 503 - 639 -4175
P 4 Name/Method: Supplemental Information.
TYPE'OF WbRK: COMMERCIAL 1?EE' SCHEDI = .USE• ,
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
[ 9 -Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
' CAThRYOF CONSTRUCTION: .. .... • mechanical materials, equipment, labor, overhead and profit.
® 1 & 2- Family dwelling ❑ Cotnmercial/Industrial Value: $ _ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDEN`X'>IAIGQUIP. 7i T /SYST EMS FEE';SC :On IDLE-
Description Qty Fee(ea.)
El Master Builder ❑ Other: Headng/
Cooling 1 Total
JOB SITE7IVFORMATIO T :audtOCATYON :'. . Furnace - add -on air conditioning** ( 14.00 14
Job site address: t l -l. `r (v 5, ; 5�t.: e r ,r - 1,001 Gas heat pump . 14.00
Suite #: I Bldg. /Apt. #: I Duct work 14.00
Project Name: c Hydronic hot water system 14.00
Pro
1�en ►ce Lo
Residential boiler
Cross street/Directions to job site:
(for radiator or hydronic system) 14.00
b55 J .. 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 Fad Appliances
Tax map /parcel #:
Water heater 10.00
: ' `R OF. WORK'' Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
1 Y Li A-I.L Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent iner /flue/vent 10.00
;ROPERTV. ' :`.: 1 ::❑. M13'- ' :':.'- ::r;,: 1
. , .:,:..,. Other: 10.00
Name: \J (R,fl Lee L t` Environmental Exhaust & Ventilation
Address: Range hood/other kitchen equipment 10.00
t (O '' l ��''e ��� LCx Clothes dryer exhaust 10.00
-1
City/State /Zip: k 4C eel '2 . 5 •
Single duct exhaust
Phone: 5 2-t - Fax: (bathrooms, toilet compartments,
:, IR APPLICANT •:.: ... :: , ::..: ;13CONTACT;EERSQN.. • : :_;■ utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Address: Other 10.00
Fuel Piping •
City/State /Zip: ••($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: I Fax: Gas heat pump **
E -mail: *,
.: .... • ,.. , .,. .. cfnr
a s»spe ' t heater '
COI�TTRACI'UR', Water heater **
Business Name: ( n - Mu,has, iCOQ Fireplace •*
Address: t 1C 3t.a sE Dl si all Si-. Range ••
Cit City/State/Zip: CBQ •*
Y p= Qa�`hluti.�. � ell 2.02- Clothes dryer (gas) *+
Phone: - 7 (DI - I5 Co [Fax: Other: **
CCB Lic. #: 14 SS% Total:
Authorized Mechanical Permit Fees*
Signature: d l Subtot al: $ IH °
Si gn G�rLt�t% Date: 1 2 G_3
Minimum Permit Fee $72.50 $ •'i 1.50
Ll ` I ill a.VI el Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ Pi_ SO . TOTAL PERMIT FEE $ -- 30
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 Fotms\MeePermitApp.doc 01/03
i
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LOT LINE:
FIRST NAME: JANICE LAST NAME: LUSK
ADDRESS: 11786 SW SWENDON LOOP CITY: TIGARD STATE: OR ZIP: 97223
INSTALLATION ADDRESS: 11786 SW SWENDON LOOP CITY: TIGARD STATE: OR
PROPERTY LINE
FT:
`
FRONT
S FT:
PROPERTY LINE
Sbatiii- - n/ L
X = OUTSIDE UNIT
•
CITY OF TIGARD i specfioriLlne' (503) 639 -4175
BUILDING MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / 0 — / AM PM BUP
Location / /7 SI0J{.Yt cle LO Op Suite CS, 3 — Oo 149 /
Contact Person 1 V q Ph ( ) 7 Co / — I SO 0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC N &v•--
Footing
Foundation ( ELC
Access:
Ftg Drain VVV _ � M � ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam (--7 rAliJ6
Shear Anchors \ ?�, fit, _4' t �
Ext Sheath/Shear °>�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
Post & Beam `� ! k \ 1 ] � f rls , (6 „, 0
Rough -In v)(/‘." I
Gas Line
Smoke Dampers
t 'ART FAIL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
ma Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
W PART FAIL
SI ❑ Please call for reinspection R • ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date c� b " ' Inspe o Ext
Other:
Final DO NOT REMOVE this Inspection racer from t ob site.
PASS PART FAIL