Permit C ITY OF TIGARD MECHANICAL PERMIT
�r� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00248
,.� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/7/2004
PARCEL: 2S115AA-07800
SITE ADDRESS: 10544 SW TITAN LN
SUBDIVISION: BERKLEY ESTATES ZONING: R -4.5
BLOCK: LOT: 010 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:
ELE 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC install.
Owner: FEES
BELAIR, GREG Description Date Amount
10544 SW TITAN LN [MECH] Permit Fee 5/7/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 5/7/2004 $5.80
Phone: 503 620 - 0716 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
Final Inspection
Reg #: LIC 66578
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: pyj Q C %eli ✓-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
' . -IVtiec .anica1 [Ci 'M ii, Tr cation FOR OFFICE USE ONLY
j Received Mechanical •
Detc/0 : / ' Permit No.: 14 Cd 2O#
Ciy of Tigard MAY 5 2004 Planning ' •prov.l Building
13125 SA Hall BIvd
Date/8 Permit No.:
CITY OF TIGARD Plan Review Other •
Tigvd, Oi cgon 97223 .....: Permit No.:
Phone: 5( 639 - 4171 B lr /i MPN Post Review Land Use
v"� `` ; >'�l? Date/B :
Interact: Irww- ci.tigard.or.us -` 1 e CaseNo.:
NM
24 - hniir 'Inspection Request; 503- 639 -4175 y Contact C E ) Dnse Z for
Namc/Method: Su. demental Information.
_ TYPE OF WORK • COM1v1ERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New c onstruction Demolition Mechanical permit fees• are based on the total value of the work
❑ A.dditi on/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION •.: . • • • mechanical materials, equipment, labor, overhead and profit.
• 1 & 2. Family dwelling ❑ CommercialJIndustrial Value: S See Page 2 for Fee Schedule
[71 A.cces ;pry Building Multi- Family , RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
• Iv[3str;' Builder 111 Other:
Description Q I'ee(ce.) I Total
Jt )B SITE INFORL�IATCON and LOCATION � in: Coolin
+ Furnace •add - air conditioning "• 14.00
Job site ai:dress: 0S So.) T- t' 4 -11 Ley ' Gas heat oumo 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Pro •ect N Hvdronic hot water system 1 14.00
Cross: stye :t/Directions to job site: Residential boiler
(for radiator or hydronic system) 14.00
Unit hcaters (fuel, not electric)
(in wall, in-duct. suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subd: visic n. fLot #: - Repair units 13.15
Tax n arcel #: Other Fuel ,lpplianees
10.00
DESCRIPTION OF WORK Water heater j
Gas fireplace 10.00
Flue vent (water heater /gas fireplace) I 10.00
(t_ i; f Log lig hter ) I 10.00
Vood/Pellcr stove I 10.00
Wood fireplace/insert f 10.00
Chimney /liner /flue/vent I 10.00
P.# • RI PF.F TY OWNER I TENANT Other: 10.00
Name: 7 1 4. ,,' .- Environmental Exhaust St Ventilation
Address: Range hood/other kitchen equipment 10.00
Cii / State 'Zip: Clothes dryer exhaust 10.00
I 2 p — 0 } t o Single duct exhaust
Phone: ��11 i Fax: (bathrooms, toilet compartments r APJ'LIC. NT n CONTACT PERSON utility rooms) 6.80
Name,: Attic /crawl space fans _
Address: Other: 10.00
c� Fuel Plnion
Clty /„tr1tc, Z1p: * *(S5.40 for first 4.51.00 each additional)
Phone:: I F ax: Furnace, etc. 1
E -mail: Gas heat pump .*
Wall /suspended/unit heater r.
• CONTRACTOR : • •• • • Water heater ..
Business Name: S : t c,ri. ' -1-z c- l • r Fireplace .,
Address: 1 (,, C) I CC g i v•z r e -c(. Range ..
+1 • d (S i cti� . 'e . c1 f-1 Z.7 BBQ •*
•City /S tate/ Zip: I Clothes dryer (gas) r.
Phone:
I�tio - S'L- t� l Fax: lvls�1- O — 3 _Other: *.
CCB Lac. it: W �, C 2.y Total:
Authori. :ed W Mechanical Permit Fees
Signature: f l "' e1-C Sl Si O�
`� Date :� Subtotal: S
r - l• •� i ,` (.1) I ��,� Minimum Permit t•'ec 372.50 S ' „_ .' l)
Plan Review Fee (25% of Permit Fee) S
(Please print name) _State Surcharge (8% of Perm Fee) S • �- is
TOTAL PERMIT FEE 5
Notice: This pt rmit application expires if a permit is not obtained within •Fce methodology set by Tri -County Building Industry Service Bo
180 days after is has been accepted as complete. **Site plan required for exterior A/C units.
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SITE PLAN
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5 727 72 ,41 2 4
STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
C' SILO BSS COS 2uizeaH RzietoadS dBI :TO b0 SO ReW
CITY OF TIGARD 24 -Hour
BUILDING.. Inspection Li : 503) 639 -4175
INSPECTION DIVISION Business 7 •-,te'639 -4171 MST
BUP
Received 61 1(‘ Date Re uested k M 5y VPM BUP
Location jOS> 7 ��//l) � YJ LK/ Suite ae-Oc4 - F
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC (-
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: p SIT
Post & Beam <���
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing •
Insulation V ` n _ Q
�`''_°`-i iCJ
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm lt/� a \2-NrifiCU--CL.,.—
Susp'd Ceiling
Roof n Vi'
Other:
Final \ l \ S C.-0v\ r. 3 t� (JL 'P 5
PASS PART FAIL _
PLUMBING V\/\”/ CL-1,e- 4( .< L. 7 o
Post & Beam `
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: /
Final
PAS RT FAIL I •
ME ANIC L
Pos Beam
Rough -In 14
Gas Line U +`
Awe ampers
PART FAIL
RICAL
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 0 Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA �// -- C
Approach/Sidewalk Date (COY ` Inspector V l.� ' \ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL