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18876 SW EDGEWOOD ST
CITYOF T I G A R D MECHANICAL PERM',T
DEVELGPMENT SERVICES PERMIT 9: MEC2003-00659
13125 SW Hall blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/19/03
PARCEL: 2S 102DD-01600
SITE ADDRESS: 08876 SW ELGEWOOD ST
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: 007 jURISCICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VE NT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT .';YSTEMS.
STORIES: BOIL ERS/COMPRESSORS HOODS:
FUEL- TYPES 0 3 HP: 1 DOMES. INC!N:
LPG 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UWTS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES.
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K RTU: 1 _ All? HANDLING_ UNITS _ OTHER UNITS:
FURN -100K BTU. <= 10000 cfrn: — GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas furnace wuh like kinLi, mSUrll nc�% ;
Owner_ -- r-- - _ FEES ----�
1 NNiN, ROBERT O ELAINE M Description ArTwUnt
8876 SW EDGEWOOD STREET —
TIGARD, OR 97223 I FAXJ X"„~late Surchart 11/19/03 $5.80
1\Il (1111'emmFee 11/19/03 $72.50
Phone: I
Total $78.30
Contractor:
COLUMBIA HEATING+ COOLING INC
P.O. BOX 230397
8900 SW BURNHAM#E1110 REQUIRED INSPECTIONS
TIGARD, OR 972^? -- -
Phone: 503-( . r•-2704 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 76359 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
SpE�cialty Codes and all other applicable laws. All work will be done in accordance with approved
H:qr E. This permit will expire ;f 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
952-00 100.__you may obtain copies, cl these rule:; nr direct gljF stions to OUNC by calling
(503) 46-1 99.
Issue By: +_ Permittee `.signature:Ar
Call 03) 639-4175 by 7:00 P.M. for inspections needed the next business day
FOR OFFICE (ISE ONLY
Mechanical Permit Application Rea;ved Mechanical
Permit No.: (' p4J-,,w 5
City of Tigard Planning A proval Bu+lding
-Date/By: Permit N,i
13125 SW Hall Blvd. \ Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Internet: www.ci.tigard.or.us Date/By: Case No.:
Contacts See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Medrod "r^ SupplementalPageInformation.
TYPE OF WORK _ COMMERCIAL FEE"SCHEDULE-USE CHECKLIST
New construction LJ Demolition Mechanical permit fees'are based on the total value of the work
Addition/alteration/replacement I.,Lj Other: performed. Indicate the value(rounded to the nearest dollar)of al;
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
_ 1 & 2-Family dwelling Commercial/Indus.rial Value: S _ See Page 2 for Fee Schedule
Accessory Building Multi-Family v RESIDENTIAL E UIPhIENT/SYSTirMS FEE•SCHEDULE
ISSter
Description
Other: _Qty Fee ea. ote_,
Ifestln Coolln
_ JOB SITE INFORMATION and LOCATION Furnace-a 14.00
Job site address: Gas heat pump 14.00
Suite #: _ Bldg./Apt. : Duct work 14.00
Project Name: — W dronic hot waters stem 14.00
Cross street/Directions to job site: Residential boiler
Cor radiator or h dronic stem) 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 W
--
Tax map/parcel #: Wdter heater Other Fuel Appliances 10.00
DESCRIPTION OF WORK Gas fireplace _ 10.00
Flue vent(water heater/gas fireplace) _ 10.00
Log lighter(gas) 1000
—'—� Wood/Pellet stove 10.00
-- - Wood fire lace/insert 10.00 _
_ Chimney/liner/flue/vent 10.00
OPERTY OWNER TENANT Other: 10.00
anle: _ �dC Environmental Exhaust&Ventilation _
Address: 8'P7` `eik) f laud&�o Range hood'other kitchen equipment 10.00
City/State/Zip: `— Clothes dryer exhaust 10.00
D — — --- Single duct exhaust
Phone: 2_0r;? 7D 1 Fax:
(bathrooms,toilet compartments,
APPLICANT —_ CONTACT PERSON utility morns) 6 50
Name: Attieic•rawl spat e fans 1000
Address. - Other:. - 10.00
Fuel PI Ing
City/State/Zip: "(S5.40 for first 4,51.00 each additional
Phone: Fax: Q Furnace,etc. +•
�9p 0. 70 Gas heat pump ••
E-mail: Wall1sus ended/unit heater ••
CONTRACTOR Water heater ••
Business Name: CD%f�� i( l'ireplace ••
Address: P6 8_X_ a 0 3 q_� R,tn e "
••
Cityi$tate'Zip: �� Qom_ ,7� 8B2
Clothes dryer as) _ ••
Phone:S4,3 L��[ �! Fax: Other_.--- ••
CCB Lic. #: Ile.,�s _ Total:
Authorized Mechanical Permit Fees*
Signature 65a& ��4t_ Date IR -- Subtotal. S
Minimum Permit Fee 572.50 S
_14 fel Plan Review Fee(25%of Permit Fee S
(Please print name) State Surcharge(89;of Pemut Fee) S
TOTAL PERMIT FEE S
Notice: This permit application expires if a permit is not obtained�%ithin *Fee 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.
i MstsTzrrnit Forms\MecPerrmtApp doe 01/03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST _ —
INSt • CTION DIVISION Business Line: (503) 639-4171
_ BUP
Received 14 _ K Date R ested. 2 AM- PM BUP
' .
Location � Suite EC
ZL.Contact Person _ Ph( 0 2 7y P_ —
Contractor ' e Ph( ) SWR
BUILDING TenanVOwner _ ELC
Footing ELC - - -- -
Foundation Access:
Ftg Drain ELF!
Craw! Drain -- - —
Slau Inspection Notes: SIT
Post& Beam ----- -- - -
Shear Anchors
Ext Sheath/Shear - - - - —
Int Sheath/Shear
7raming - - - - --
1,isulation
Drywall Nailing - - - --- --
Firewall
I Fire Sprinkler —
Fire Alarm
Susp'd Ceiling
Root
Other: — --------- -- -
Final
PASS PART FAIL i
PLUMBING
Post&Beam
Under Slab -- ____ --------
Rough-in
Water Service --- —
Sanitary Sewer
Rain Drains ----- —
Catch Basin/Manhole
Storm Dram - - - - ---- -
Shower Pan
Other. -- —
Final
PASS PART FAIL
MECHANICAL --
Post&Beam
Rough.In - —_
Gas Line
_PARTFAIL - -- -
CTRICAL_-- ---- - — ---
Service
Rough-In - ---
UG/Slab
Low Voltage --
Fire Alarm
Final l J Reinspection fee of$. _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
_PASS PARI FAIL
SITE - 0 Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Data C 1 Inspector Fxt -
Other:
Final I DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUI'T'E E1 '.0
TIGARD, OR 97223
(503) 624-2704
FAX (503) 598-0270
� o �
JOB ADDRESS:
SITE PLAN FOR AC OUTDOOR UNIT LOCATION