Permit 4 CITY OF TIGARD" MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2004 -00580
' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/26/2004
PARCEL: 1S133CD-10700
SITE ADDRESS: 11710 SW WILTON AVE
SUBDIVISION: COTSWALD MEADOWS NO.3 ZONING: R -25
BLOCK: LOT: 139 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: 1 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace with new.
Owner: FEES
MCCOLL, LYNN R + DIANE M Description Date Amount
11710 SW WILTON AVE [MECH] Permit Fee 8/26/200 $72.50
TIGARD, OR, 97223 [TAX] 8% State Surchart 8/26/200 $5.80
Phone: Total $78.30
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED INSPECTIONS
Phone: 503 - 848 - 3838 Heating Unt Insp
Final Inspection
Reg #: LIC 43124
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:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
AUG -25 -2004 15:31 FROM:GAROKEN ENERGY CO. IN 5033569002 TO: 5035981960 P. 1
10/18/2003 • 13:57 FAX 5035981980 CITY ,0E- TrGARD lit 1002
Mechanical P,4. cation
_ �� sr Received n Mechanical
5 10 4 ate/Dy.? U 1 A Permit No.: MV (.....2 0d `l DD )�
C � Planning Approval Building
1` v g W Hall Bl d 0 Dower: Permit No.:
Tigard, Oregon 97223 lIG P lan Revtcw Other
D
S 8 t1 .1 pF AS pN _ Date/By: Permit No.:
Phone: 503 -639 -4171 Fax: 51 Post•Review Cana Use
'' „ ��; ..,i'l l :� , t�tc/9y: Case No.:
Internet: www.ci.tigard.or.us B �'
Contact
24 -hour Inspection Request: 503 - 639 -4175 - N � fit
e: ! Su See Page 2 for
l a
_ s•: (r 1 Supplemental Information. ,
, ' . . •t - '; •_ :; :<. :- "• :•:..::fC..s' ;13.' ~: ;40:44rC E +
OMMERCIALFESCHEBUI:Z
❑ New construction Demolition Mechanical permit fees' are based on the total value of the work
! ddition /alteration/replacerrwnt a Other: performed. Indicate the value (rounded to the nearest dollar) of all
f ' :, . at . : F,, r''; Y :. mechanical materials, equipment, labor, overhead and profit.
i! 1 & 2- Family dwelling II Commercial/Industrial Value: S See Pap 2 for Fee Schedule
IS Accessory Buildin: ■ Multi -Famil °'' ItESIDErarkkE0131PMENTISYSTEMS4EVSCERDELE
12 Master Builder _ IN Other: r o 1 Qty Fee(ea.) 1 Total
•Heitioe/CooUoE
'' ' :','- "t ONFaead,I:OCATIONs r'':; •': Furna add -on air conditioning" ( j 14.00
Job site address: 070 sc.J 0 /141 Ark . ' . heat pump 14.00 "
Suite #: I Bldg. /Apt. #: , Duct work 14.00
Project Name: Lye). M c-CoJI Hydronic hot water system 14.00
Cross street/Directions to job site: Residential boiler
f35'44% (for radiator or hydronic system) 14.00
/ Unit beaters (fuel, not electric)
65 Pr3 (in wall, in -duct, suspended, etc.) 14.00
,
Flue/vent (for any of above) / 10.00
Subdivision: Lot #; Repair units • 12.15
Tax reap /parcel #: Other Fuel Aepliaaees • _
Water heater 10.00
.A.%.”. "' :' ; DESCIitIVIIION:O .'A ::A :? ' Gas fireplace 10.00
K , - l Qto i' o g t^I !IV inarr-C Flue vent (water hearer /gas fireplace) 10.00
• Gel f VI O L J
Log Tighter (etas) 10.00
I Wood/Pellet stove 10.00
Wood fireplaceAnsert 10.00
% �: OPER'F !A't1EBr:,•:, - (fl N . -. Ot y/llner /tlue/vent 10.00 0.00
"•' s �"F, �N�'dy�:.�.,.�r�.�1;': "�; Other:
Name: IA V\ f,A4 Range hood/other khan ental Exliaw't•dt Ve6Watioo"
Address: w ge q tpment 10.00
11 5 e �
City /State/Zip - 7 r • �jryaa 3 Clothe aclraust lo.00
sin d uct ex
Pone: 4 - 1 733 Fax: (bathrooms, toilet compartments,
PPLICANF= 4" :t:: •• ��, i IlroNvAcrocaset utility rooms2 6.80
Name: aa,,r t) k U 'r Attie/crawl space fans 10.00
Address: �� 0 � 1 0.00 ,
City /State/Zip: «(35.40 for first s 00 each addidonal)
Phone: I Fax: 3 b' Op a . Furnace, etc. ••
Gas heat pump
E -mail: ��'oRt.v. �c . XQr�' •• •
1 . ;" ' `rCONFRAC'>FOR:; :' Wa ter heater ended/unit heater ••
Water heater � •• •
Business Name: AR n K En► ,rl R6.1.? Ln . Fireplace ••
Address: 356ri 5u) 12 Nh �E . Range as
City /State/Zip: P pt uE.g.-To Ns c1"7.00 0 BBC) ••
� C c1'7 �° Clothes drier (gas) • •
Phone:
Ste- 3R3s I Fa 35 L -c(00_ - Other: ••
CCB Lic. #: 44-g O4 Total:
Authori r — i Mechanical Pewit Rees•
Signature: Date: Subtotal: $
Minimum Permit Fcc 572.50 S 79 , �
v∎a O V e, G.� Plan Review Fee (25% of Permit Fee) ' S _
(Please print name) State Surcharge (8% of Permit Fee) $ )13
TOTAL PERMIT FEE 3 •
Notice: This permit application aspire ira permit is not obtained within *Fee methodology set by Tri •County Building Industry mice Board.
ISO days after it his been accepted as complete. **Site plan required for exterior A/C units.
: ,N.,. o.....r. cw....• .....o- �:.A— A... At /AI
r
CITY OF TIGARD /1111/ 24 - Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (5Q3) 639 -4171 MST
BUP
Received Date Requested � / 7 AM PM BU
Location // 71 D U)uC--E Suite C..&0Z00 y— 0 S
Contact Person Ph ( ) 5' (1- 173 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear y * ,
Framing • r 1 /VIA v
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Other:
Othe
Final
PASS PART FAIL %
i i i
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS FAIL
M L
Post & Beam
Rough -In
Gas Line
S • : Dampers
Vii �'
S PART FAIL
LECTRICAL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date > / l 7 / y Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL