Permit •
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00166
e 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/2/2004
MEW PARCEL: 2S 103CA -04900
SITE ADDRESS: 11550 SW TERRACE TRAILS DR
SUBDIVISION: TERRACE TRAILS ZONING: R -4.5
BLOCK: LOT: 003 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: 1 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Install gas furnace and AC, gas line existing.
Owner: FEES
BLACK, GAROLD R NANCY E Description Date Amount
11550 SW TERRACE TRAILS DR [MECH] Permit Fee 4/2/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchari 4/2/2004 $5.80
Phone: 503 639 - 0294 Total $78.30
Contractor:
HEAT RELIEF CO
1311 NE 116TH AVE.
PORTLAND, OR 97211 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 122424 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: gedrUU Permittee Signature: c - -Y1 Gt,742 it
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr 01 2004 11:59AM Heat R ief 503 - 261 -9814 p.1
1 Permit All ' 'on _ 1 1; t 1- 1(: i (Y\ 1.
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City of 'rim() `ci o
Balltlag
13125 SW Haf Blvd. .q - (Is Bt v[wr Oder
Tigard, Oregon 97223 F 0 Permit Ito.:
Phone: 503-639-4171 FSLIC 50311$1- Laud Use
[ w>ovw,cl tigatdar ns G Q\ Oise No.:
24 -boar Inspection Request 50309-4175 __1_1,1: Massa r see seat a �r
Namlld� l (� I sapv�emeacd ra18,m,
F:- ^G'i : ;_',+.; }: �.3..�= 2w:.',�SSdR� '43Y F�, .' I. ! r .1 Ci''.�i E � i �'.'��•. r ` ".: ��Li � � � � i Zr � ' I'yp .�d 7 ,.
IN • `'. ; , I N Demolition blociamical permit finis* ate based to la total value oldie weld
N :r ,,, IIIIIIIIII Other. Wormed. Infican:11te velar (rounded to Ste nearest dam of
a Ma . F ? s 4: g r 1' : _ :, ?: mechanical naturials, equipment, labor, overhead and profit.
11.1 t '= h „ 11 11 Winn $ See L - for Fee Sc •, ]1 WI - aait = 1 :' ti i A . e ; . ; V •:. l • :3_ s • �'J . I ',� 1 71
x r 1 r,.. ..
■ , ■ other, :: QV Fee(ea-) T
- ' 1, ;T u . _ y �4Q Forum - add•ansir I 14.00
... _ _Iob.site address:. • Su 3 . - .. i - r . _ - ()as bat pimp __ _ . _... _ _ _.. _.. __...14.00 -- .
Suite #: EL"-MT7MIMIIIIIIIIIM Duct work 14.00 _
.' :. Hydreadc hot water system 14.00
Gds street/Directions to job Sit= Reddened boiler
(krrad atororhydroids system) 14.00
Usk beams (fork not electrie)
On wall, Depended, .) 14.00
• Mucha* (tier any of above) 1 0.00
Subdivision; u 1215
Lot
11'.11-:: . _ : ti p;.... .
ter, ,:� - 4 ) fi Wat r• beatler 10.0
,_ '; ; . gaitit�' "rF " i i h 1 ! ',} ",,:r;1 .a ' : ON theplace 10.00
.11 . r _ Hoe vent Omer heastrAws ) 10.00
� Fl Log lighter Ws) 10.00
4 WoodlPdlet Move 1000
Wood 8replaoerin t - 10.00
,. _ x •a 10.00"
P n ' [ i. !.), - ,:lf:7: : <<,;,:L._�j a._. M L _' • F _ �..1 �
v� Othaz 10.00
Bongo bood erkitchenetparpr.eat 10.0
Address: 1 1 ,, . SW Ter- rrr ce e tTC4{ IS =' IOAD
,;I - t•:' ,.. fcl b. c /7.2 •
Phone: - - b34 ' it Fax: Slagle e
iiki71J:_ , (t.k.,.kri.• Wi . ,` _a7. F 5 -= - �� I' 6.80
Name: s - _ err 1 - Fa „ S Attloraawl apace thus 10.00
Address: J E I b'S C. - Ober: ... _ , 10.00
•: `.. - . : of :._,. . 73.7 -0 0 9 5 5A i for l ing al) addition ^
1, �[,
Phone: SZ8- 14=o-0oi7 Fax: Sla- 0- 6 ( -481 Pomace. etc.
s, .
B -m,ail: WalVazurendea►uoitheater ss
• & "e`�a Y ' — -0? ' Water beater • ..
Business Name: 14ee + ; 42_ L;e& Pngpbee ••
Address: I 1 mg /(6`ts p saw
BgQ sib ` ki.: -, . , f B oren 41 „ f: q . t !
., �T_ 1:=�!.o -ui al Fax: - .. - A 01ber. dryer (gas) '.
CCB Lic. #: / _ ,Z Total-
Authorized 0, L A
slptate e: aeZ■VC Date: i f /Of Minimum Permit twee Subtotal: 5
srlso $
s
/ha. rk De_crr+ c.0 Sc. Plan Review Fee (25% of Permit Fee) S
(Mese print mune) Sista Surebauge (8%ofPermit Foe) S
TOTAL r tT P $
Naked This prude andleatten empires if. permit b out ebd l.ed with• 'foe rnabodetog set by m -Comfy BaUatap Industry servie. Boar
150 days alter It bas beds at:aid ed as ea.o ere: "Otte plea rota dr.d for eaferior ruc .der.
i:N13stalPbratltFaonsIbieat' udtApp,daa 01103
•
Apr 02 2004 12:17PM Heat Relief 503-261-9814 p.2
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IIMAILK KEW =Milk
18756 S.W. TETON 7915 SOUTH 184th St 730 E. FIRST AVENUE