Permit ,f.
;'- CITY OF TIGARD MECHANICAL PERMIT
IA DEVELOPMENT SERVICES PERMIT #: MEC2004 -00004
� � I I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/5/04
PARCEL: 2S1 15AD -06000
SITE ADDRESS: 10605 SW TUALATIN DR
SUBDIVISION: DOVER LANDING ZONING: R -4.5
BLOCK: LOT: 043 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas insert.
Owner: FEES
THOMPSON, DENISE P Description .Date Amount
10605 SW TUALATIN DR
TIGARD, OR 97224 [MECH] Permit Fee 1/5/04 $72.50
[TAX] 8% State 1/5/04 $5.80
Phone: 503 620 - 2504 Total $78.30
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 51469 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)246-669°.
Issued By: 't ti P ermittee Signature: I i t
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
06 %22••2001 14:43 F.-LI 5036847297 City of Tigard 0 002
0
�. _ M ec ha m c �P
_, ermitApplication . . - _-
6 .--1 ‘ � Datereceived:/ -S Perarit . 1 '0 1
, = :: Q ��J i of Tigard
,;= .�'�_ Project/appt. no Expire date:
�� � �ddress: 13125 SW Hall Blvd, Tigard, OR 97223
�fY° Date issued: By: ;+; Rccciptno.:
� �' O � �\� Phone: (503) 639.4171
, c? Fax: (503) 598 -1960 Case file no.: Payment type:
'r , i
G \ S ., Land use approval: Building permitno.: �
•+
-«d ,; _ 4 , ;, °TITEOFPERNIII x " r
r' & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family • 0 Tenant improvement
O New construction Q Addition /alteration/replacement 0 Other:
' -- _.roH:SITEI(FORIVIATTON' "''` - ' • COMMERCIAL VALUATION =SCIWIRT_ L
Job address: / 0 C 0.5 S J / 2 q / 7 0O/e, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: ( Suite no.: value of all mechanical materials. equipment. labor. overhead,
Tax manitax lot/account no.: profit Value S .
Lot 1Blocic: (Subdivision: *See checklist for important application information and
Project name: 7'L7o , .So `'7 jurisdiction's fee schedule for residential permit fee.
City/county: / /6, i cle ZIP: 9 ? ' 1. 1:.21:AMIL)t`1)1h111;1NG PERMIT .FEE_SCNEIULI:;
Description and location of work on premises: - h s i // AND COILIIEIZIC_S ANDUS RIAL EC1VIRNIE NTSCliEDLTE
7G Fee(ea.) Total
Est. date of completion/inspection: D stsipdan Qty. Res. only Res. only
Tenant improvement or change of use: uvAC:
Is existing space heated or conditioned? 0 Yes Cl NO Air handling unit CFM
space insulated? O Yes 0 No Air conditioning (site plan required)
Is existing P� Alteration of exisangTlVAC system
MEC1-I N!CAL_ CONTRACTOR, - r4. ;.; Boiler/compressors
Business nam ' - State boiler permit no.:
HP Tons BTU/H
Address: /a /,75 ,5J ASewuer . ow, Rci Fire /smokedampus/duasmoke detectors
City z tr State:0 - ZIP: - 70 t:s,5 Heat pump (site plan Jufi required) �-
PhonelpS/�p. W
LnstatUtsptacefu«a.r/btuner TU •
9 F • E Including dttexhvorlr/veot liner 0 Yes 0 No
CCB no.: - - a' _ instalUtspa ooze .eaters- suspended.
City /metro lic. no.: wall. or floor mounted I
Name (please print): te C7tzi 007 Vent for a`pliancc other than furnace
CONTACT PLIISOti _ Absorptio n units BTU1H •EllIl
Name.: s n/ ePG Kee. Chillers HP MO
HP i
Address: / -#0 Co•,.•
Environmental exhaust .. ventilation: In
City: State: ZIP: Appliancevent
Phone: Fax: E-mail: D erevhauq
hood fresuppression e up system I I . /haanat ■
Name: e ? /sc., o nn ..5c7 Exhaust fan with single duct (bath fans) III.
Mailing address: /0 e o • .54) 7 9/q 7z- 0/Q Exhaust em •., : . • ,, beau • or r�
City j /�ov2 oB Swrc:OR - Fuel pi . and . ,. on (up to 4 outlets)
Type: LPG fNG Oil 5 . D - 7v)
Phone: 69_ v - c 7,50 Fax: - Fuel piping each additional over 4 outlets
- - _ . F_ \GINEM ; - .r� 'roceas mug (schemtancrequired) • Number of oudets
�-
t , - T-- r� a . � .. or equipment:
Ad • Decorative -.lace
C • . I State: ( ZIP: allgainfr 1111•11111MM
• , one: 1 Fax: E - mail: WoodstoveJpellet stove / G-- V .9 _ ore-) .. Ora
Other.
Applicant's signature: Date: /- Other,
Name (print)c9,2,; .woe• t/C •
/
' Ka en imtsdmm� �t plc= cell ae. plc= i r mare itdmeava Permit fee _- - - -__.. S / .) .. `7 O
0 Visa O M Notice: This permit application Minimum fee $ - 7 .�. .5
Cred me / / expires if a permit is not obtained Plan review (at _ %) $
ExpyC6 within 1 SO days after it has been State surcharge (8%) .._. $ -5 ?O
t� el emieider az m card accepted as complete. $ - C )' —50 s RECEIVE' . t� t
gignaose 'JAN u b 2004 - D
CITY OF TIGARD
BUILDING DIVISION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/�
BUP
Received /5 ' p "v. Date Requested / - // 5 AM PM BUP /
Location / 7 5 7�L� L� 0 r Suite MEC �
Contact Person OClvr Ph ( L15 ) (DV' (Sag PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner � /G /' s tee- tO2.o Z V ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear C.C46 z \ G
Framing
Insulation I t 1 l 'C( 0 244t
Drywall Nailing 1 '
Firewall
Fire Sprinkler '' A j/� �
Fire Alarm C/ � /UPS i —\ " \ l Y\/\ 4- 'v r
Susp'd Ceiling II Q
Roof . r.AA , \
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line y ti
Smoke Dampers
witiof 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: III Unable to inspect — no access
Fire Supply Line \
FDA qi
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL