Permit w � F
CIT OF TIGARD MECHANICAL PERMIT
t �, DEVELOPMENT SERVICES PERMIT #: MEC2004 -00007
'� I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/8/04
PARCEL: 1S133DB-03800
SITE ADDRESS: 11445 SW WINTERLAKE DR
SUBDIVISION: BRITTANY SQUARE NO. 3 ZONING: R -12
BLOCK: LOT: 065 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: 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace with like kind.
Owner: ' FEES
HALL, CHRISTINE A Description Date Amount
11445 SW WINTERLAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 1/8/04 $72.50
[TAX] 8% State Surchar€ 1/8/04 $5.80
Phone: Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 72623
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 -! You ma obtain copies of these rules or direct questions to OUNC by calling
(503) • 6 -6699.
Issu - • By: ; ; f� / . Permittee Signature: )(2
Cal 03) 639 -4175 by 7:00 P.M. for inspections needed the next business day
II
Jan 06 04 10:lla Giese le Sahagon
(503) 557 -0919 p.2
4. _ a
•
non
Received FOR OFFICE USE SE OiVLY
Mechhnical P a
City of Tigard DatdBv �
fs , 4 de,� an
n Planning '- Permit No.: 'cal � c pp40 7
13125 SW Hall Blvd. JAN 0 6 20Ph. DataB s Approval Building
Tigard, Oregon 97223 Plan Review Permit No.:
Phone: 5 03 -639 -a 171 Date/E3 : Other
Internet: wwvtr,Ci.hgard.o � D Post - Review Permit No..
III DIVISION �" °/ ", i
Land No.:
s : 639 -417 c
I I Date'Bt
'
24 -hour Inspection Reque I Contact
Case No.:
Name/Method: ® See Page 2 for
•
Su . lemental Information.
TYPE OF WORK
❑ New construction COMMERCIAL
31 Addition /alteration /re. Demolition FEE* SCHEDULE USE CHECKLIST _
lacement 0 Other: performed. ln dicaa to the value (rounded to the value
earest dollar) ar) of all
rIll CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
L 1 & 2 -Fanul dwelltn • 111 Comr nerctaUIndustrial Value: ;
Accesso Buildin See Pa e 2
■ /v faster Builder r• RESIDENTIAL E • UIP g for Fee Schedule
❑ Other: ANT /SYSTEMS FEE* SCHEDULE
JOB SITE ENFO Descri don
RMAT'[ON and LOCATION t Total
Job site address: PA/ Furnace - add -on air conditionin • ••
�vi 14.00 Wang
EMPZI Pro ect Name: Bld•JA.t, �/ 14
Duct work
Cross street/Directions H dronic hot waters stem 1 ` —
c/Directions to job site: 14.00 —
Resid ential boiler III 14.00 (for radiator or h runic s stem) Unit heaters (fuel, not electric) ■
(in wall, in -duct, sus .ended, etc.)
Subdivision:
Flue/vent (for an of above 14.00
I Tax ma. /.arcel ft: Lot #: .. 10.00 —
DESCRIPTION Other Fuel A , fiances ®-
PTI OF WORK Wat h eater
....._______vresemsfa
10.00
1..
1....
' /a11111111 Lo • li • ter r
0.00 Im stove 10.00 _
Wood fire.lace/insert 10.00 _
Ii ' ROPERTY OWNER 10.00 -
r � Other: 10.00 -
�/ ��� 10.00 -
Address: Ra nge hood other kitchen equipment t - tll ado n
L� 10.00
L� q / Clothes dryer exhaust _
Phone: SaclL - ^Z) - Single duct exhaust 10.00 —
r (bathr rooms
toilet compartments,
�� CONTACT PERSON
Name: r. utili rooms
EMMEMENill Address: II • • • • . - • , ■■- • 5.s0
A : • C Other: 10.00 -
Cit /State /Zi • : OREGON CITY OR 97Q45
I o.00 Min
•• $5.40 for first 4. $1.00 each additional
Phone: PHONE:
E -mail: - A s :557 -2220 Gas heat
_
CONTRACTOR Wall/su • ended/unit hearer
•
Business Name: Tri County Temp Control
Address: •13150 S . Clackamas _�-
kamas Ri ver Drive _
�—
Cit /State /ZI•: Oregon City, OR. 97045
:t• ��
Phone: 503 - 557 - 2220 Fax: 503 - 557 - 0919 Clothes d er •as)
CCB Lie. #: 7 :23 Other:
=� -
Authorized _
Signature: 6.4e- , Total: _ -- • Date: Subtotal:
Minimum Permit Fee $72.50,'
Giesele - - gun
e
ica
permit a
p
is a tion i (Please print name)
Plan Review Fee 25 °/. of Permit Fee)
notice: Thepplx it State Surchar • a 8% of Permit Fee LIEWAIKIPAMI
o de : h i s has b ppl ca tion e x s if a ermit is not obtained within TOTAL PERMIT FEE �'
80 ' %OstsTerrnit orm s been rmitppp.doc 01/03 •Fec methodology set by e County Building Industry ' e ice :. ard.
•"Site plan required for exterior A/C units.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (50) 639 -4175 M�
INSPECTION DIVISION Business Line: (503) 639- 4171 (1'u - e
B •
Received 7-3 2 ' � Date Requested 2-/-/ PM ) :UP
Location � e / 4 / A S - ji1.. Suite GO V - 000 0 7
Contact Person YliliLC 'i G( Ph (_SZ 5 7 - Z2 PLM
Contractor 4.4 �_ _...� Ph ( SWR
BUILDING • wner r, : 4I 4U (XLe. ELC l ..(Z_
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam � 2f� _ r
Sr Anchors
Ext 7'D 4
Ext Sheath/Shear di d
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
PASS PART FAIL � % 4
PLUMBING i
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS RT FAIL
M L a�
Post & Beam
Rough -In QI�
Gas Line lY'
S • e Dampers
PART FAIL
EL TRICAL
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 Ili Approach/Sidewalk Date 0 ....tor Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL