Permit A CITY OF TIGARD MECHANICAL PERMIT
ern DEVELOPMENT SERVICES PERMIT #: MEC2004 -00226
..I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/29/04
PARCEL: 2S 115AA -09000
SITE ADDRESS: 10727 SW TITAN LN
SUBDIVISION: BERKLEY ESTATES 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: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace
Owner: FEES
COOK, WILLIAM B JR + ALICE E Description Date Amount
10727 SW TITAN LN
TIGARD, OR 97224 [MECH] Permit Fee 4/29/04 $72.50
[TAX] 8% State Surchart 4/29/04 $5.80
Phone: 503 639 - 4130 Total $78.30
Contractor:
SUNSET FUEL CO
PO BOX 42287
2944 SE POWELL BLVD REQUIRED INSPECTIONS
PORTLAND, OR 97242
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 2374 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 -00
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next .0 iness day
04/27/2004 1 2: 42 0000000 ABAB:AAAAAA AA PAGE 02/02
I 1 ' � •. 1.00 Ot IA( :'1: Ii11. ONI.I'
Vethanical Permit o L : tt on Received Mechanical
ti I L U Date/B . Permit No. id ± " I -' 1 2 2 (o
City of Tigard APR Dat)D .Approval Building
A ?0 )1111k
Date./11 • Permit No.:
13125 SW Hall Blvd. C/T Plan Review Other •
Tigard, Oregon 97223 BUILDhu )F T I GA 1a : • Permit No.:
Phone: 503- 639 -4171 Fax: 503-59g-196d/ VI Post- Review Land Use
Internet: www.ci.ti ard.oY-us I
Case No.:
$ s Contact luris. : -i See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 - Name/Method: Se . lemental Information.
aSa9 .. 4.i- 1V`.-MItW 5k• , :;. - 'Q i t `rtJYv"S$',�� � a aciN ,• . 'yk:,;.,i's.
l• New construction IU Demolition Mechanical permit fees' are based bn'the total value of the work
I�
tz Addition/alteration/ .lacement • Other; performed. Indicate the value (rounded to the nearest dollar) of all
labor, overhead and pro
T� v T •r r.
, ., equipment fit.
''= w�dii °n. %�F'��.�:ZY ^ n:_:L�`����ex �. :Ill "',�k'�� :. �a�i���� mechanical materials, equipmen
In & 2 -Famil dwellin: III Commercial/Industrial Value: $ _^ See Page 2 for Fee Schedule
• Accesso Buildin: IU Multi -Famil "'� • ' °^1�. :;; r _8 `� ifi ` "';-;;, i:r� ri;a ,
111 Master Builder IN Other: Description Qty lree(e _, Total
q Heatiwr/Cooling • . ....
:,�!t�1� :. �!�;..• ,`
�';r.��1�.'.�.�.sl�_�.,. 7.[ : k;;,.1.I. :, .(a,_71::.,, . :K. .S1 Put 'trace - add -onaar wnditiot+iug•• 1 14.00 1y.0D
Job site address: p St.J T loo I - L etyma. Gas heat pump 14.00
Suite #: Bld l ./ • .t.#; Duct work 14.00
Pro'ect Name: p OK- Hydronic hot water system 14.00
Residential street/Directions to job site: (for radiator boiler
(for 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: Lot #: Repair units _ 12.15
--- .; -:, ' Ottie 'Phel'AZI i1lances ..
Tax ma . / • arcel #: Water heater 10.00
e TIIn E { l' I . r I w .)..k.:i' w f:li �.
a.9 _ 1 Gas fireplace 10.00
V V Flue vent (water heater /gas fireplace) 10.00
■ Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /tlue/vent 10.00
P.Ilk '}rf01 } F i1 !..;;::;:',Kr I. .'i7 :! ∎,t+.) - ' ■ E r,l - P r, 1 { :• :1 1 ..1 .■;'1.' t , "' Other : 10.00
Name: ..., l i • _ . SitilionmertfaTraliatial ' &Vent tan ', :.:. ., . ,
Address: Cl/ j r A_!. Range hood/other kitchen equipment 10.00
Clothes dryer exhaust 10.00
IREMEEMMET • Single duct exhaust
Phone: , - 011111 (bathrooms, toilet compartments,
!SF / . 1, 1 : t k' ii. 1' r",;',''1,',' 6 5 ms s(i,, + 1,.:Ii o-CA) } ( . II i : ' i r(I ; utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Other:
Address: , > . , 4 ?;. 10.00
r "($5.40 for first 4, $1.00 each additional)
Phone: Fax: Furnace, etc. ••
Gas heat pump as
E-mail: . _ I _ _ Wall/suspended/unit heater •`
. . $� .� ' " . +' Ir0 5t, '. I T:AS.: _{' i. : w Water heater is -- '
Business Name: S2-t- • I Fireplace **
Address: ' / 4 4 '1 1 Range _ ••
Cif /State/Zi.: ° e 1,2.'1 I
Clothes dryer (gas) "*
Phone';,, 23 A - • 1 Fax: 23 • y 0 Other: ••
CCB L1C. #: Total: Mechanical Permit Fees*
Authorized 423 l0 y Subtotal: $ ly -Do
Signature: �� Date: 1 Minimum Permit Fee $72.50 $ '7aa S
<arit.tt.►'1G� I) J}- b 14)SIt■-, Plan Review Fee % of Permit Fee $
(Please print name) State Surchar:e 8% of Permit Fee S .t►
TOTAL PERMIT FEE $ ' , ::)
Notice: This permit application expires if a permit Is not obtained within *Pee 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.
is\ Dots "Permit FormaWtecPemdtApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
// BUP
Received Date Requested S" AM PM BUP 2-405 2-405 Location X0 27 / /`��� o -- ._ � Suite MEC // uP
_ 0G2
Contact Person -� =� CL l-c Ph (5
" lJ 3) 2-3 / -b / I PLM
Contractor Ph ( ) ( 3 / SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain O \&\ 4V%in 0 10 ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation .,,
Drywall Nailing Di
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING APT
Post &
Under Slab VA IL �" �j / 1 4 14 S
Rough -In V
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
.Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S .•.- ' -ropers
FAIL
e
Rough -In
UG/Slab r
Low Voltage 1 V
• Iarm
11111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please cal for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA AM,
Approach/Sidewalk Date Inspecto - Ext
Other:
Final DO NOT REMOVE this inspection record rom the Jo ' site.
PASS PART FAIL