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9730 SW ELROSE STREET i ca V w n m r O m r f i 1 i I I 1 1 19730 SW ELROSE ST CITY ®F T I GA R® _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00671 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/24/03 PARCEL: 2S111 BA-05200 SITE ADDRESS: 09730 SW ELROSE ST SUBDIVISION: SOLARCREST ZONING: R-4.5 BLOCK: LOT: 004 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: I_PG 3 - 15 HP: COMM'_. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: OD GAS PRESSURE: 50 + HP: C FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: R UNITS: 1 FURN >=100K BTU: <= 10x300 cfm: > 10000 cfm: GAASS OUTLETS: 1 Remarks: Inslall;inon cif ga.s fireplace and gas piI in Owner: F EES BILL MARTIN Description Date Amount 9730 SW ELROSE ------- TIGARD, OR 97224 1MI:c llI Permit FCC 11/24103 $72.50 jMF'('PLNj Pian Re. 11/24/03 $5.80 Phone: 503.968-2298 1 Total $78.30 Contractor: R &D INSTALLATIONS 5246 SE 62ND PORTLAND, OR 97206 REQUIRED INSPECTIONS Phone: 503-774-7142 Gas Line Insp Mechanical Insp Reg#: LIC 95236 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 follai: rules adopted in the Oregon Utility Notification Center. Those riles are skit fore;; in OAR 952-001-00 Issd By: Permittee Signature: jr- C. ;I (503) 6 4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application keceived MechanlLal Data'B .. Permit No.: ie,2$0-j nwe7 Cit Of Tigard Planning Ap oval Building City g r Dat"Y: Pertnit No.: 13125 SW Hall Blvd. Plan Review Other -- Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 Post-Review land Use Date/By: Case No.: Internet: www.ci.tigard.or.us contact luris.: 0 See Page!—for - 24-hour for24-hour Inspection Request: 503-639-4175 Name/Method: Suittileviental Information. TYPE OF WORK COMMERCIAL FEE*SCNEDULF-USF CHECKLIST New CottStruction _Demolition Mechanical permit fees*are based on the total value of the work Addition/alterationire lacement Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. I &2-Family dwelling Commercial/Industrial value: S See Page 2 for Fee Schedule Accessory Building Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE Master Builder Other: Description Qty Fee(ea.) Total JOB SITE IPIFORMATION and LOCATION _conditHeating/ioning" ling Furnace-add-on air conditionin 14.00 Job site address: �- SI-1 /vo,Je ST Cas heat pump 14.00 �( Suite#: Bld ./A t.#_ Duct work 14.00 11� Project Name: H dronic hot waters s:em 14.00 Residential boiler Cross street/Dircetions to job site: for radiator or h dronic system) 14.00 Unit heaters(fuel,not electric) q in wall,in-duct,suspended,etc. 14.00 Flue/vent for any of above) 10.00 _ Subdivision: Lot#: Repair units 12.15 -- _ Other Fuel AppGances Tax map/parcel #: _ _ Water heat.-r 10.00 DESCRIPTION OF WORK Gas fireplace - 10.00 Flue vent(water heater gas fire taccl _ 10.00 Q� Lo li hter as _ 10.00 —� r� /tom, /Y P lG C P Wood/Pellet stove _ 10.00 I'$-,Sryr C�. Y s'-' 9 G C // `1 Wood frreplace/insert _` 10.00 Chimne /liner/flue_/vent 10.00 PROPERTY OWNER ICITENANT Other: 10.00 ,,Name: / ��G, r j/ Environmental Exhaust&Ventilation JAddress: 7 3 0 $-•./ rl r o Range hood/other kitchen equipment 10.00 Clothes dryer exhaust 11).00 Cit /State/Zi �/�' G rr� .:aft S'%,1� y Single duct exhaust Phone:s;3 " ' -.9 Fax: APPLICANT CONTACT PERSON utility lity o ms)flet compartments. 6,80 ame: Attic/crawl space_fans 10. 0 Address: `J` S•cam S' ��.p Others 10.00 J City/State/Zip: first 4. 1.00 _ _ ••S5.40 for first 4,$1.00 a telt additional Phone: 5p �'� J).� Fax: Furnace,etc. — •• Gas heat pump _ •• E-mail: r r I WalVsus nded/unit heater •O _ _ CONTRACTOR Water heater •• Business Name: a►- Tj ; H ST c-t // Fire lace •• Address: - Range " EEL] City/State/Zip: BB �' Clothes dryer(gas) •• Phone: t-oj ) y-7l y Fax: otter: - _ - •� CCB Lic. #: 3 Total: Authon,ed ) Mechanical Permit Fees• _ 1i Signature; V� .. � Date: v7 5 _ Subtotal: S Minimum Permit Fee 572.50 $ �• / 0 V, / _ Plan Review Fee 25%of Permit Fee) S (Please print name) State Surcharge(8%of Permit Fee) S W. TOTAL PERMIT FEE S 71.il� Notice: Thls permit application expires If a permit iv not obtained within 'Fee methodology set by Tri-(bunt Building Industry Service Board. 180 days after it ha been accepted as complete. **Site plan reu.uired for exterior A/C units. i Dsts�Permit FormsMecPerrnrtApp doc 01'03 1leclianic,.d Permit application - Ciiv of Tigard P,ige 2 - Supplerr.ental Information Commercial Fee Schedule: TOTAL VALUATION: PERMIT FEE:_ $1.00 to$2,000.00 Minimum fee$72.50 $2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction thereof,to and including$5,000.00. $5,001.00 to$10,000.00 $141.50 for the first$5,000 00 and$1.80 for each additional$100.00 or fraction thereof,to and including$10 000.00. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and$1.35 for each additional$100.00 or fraction thereof,to and including$50,000,00. _ $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and$1.25 for each a6ditional $100.00 or fraction thereof,to and including$100,000.00. $100,001.00 and up $1,396.50 for the first$l 00,000.000 and $1.10 for each additional$100.00 or fraction thereof. All New Commet-,hl Buildings require 2 sets of plans. i 18uddinglPermit Forr ivMecPermitAppPg2 09-01-03 doc CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50j)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 O MST 01 � BUP Received �O _Date Requested �� PM BUP — Location _ 1 h7 Suitgge�� ME — Contact Person " II_ Ph( j _� ' z PLM Contractor !� _( �I(.�yv) lr � SWR BUILDING _ Tenant/Owner — ELC footing Foundation ELC Ftg DrainR Crawl Drain PAW- Slab Inspection Notes: S Q SIT Post&Beam _ - R_Jz Shear Anchors --- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing __— Firewall Fire Sprinkler ---- -— Fire Alarm SL-,. -Ailing ---- --------— -- Roo, Other: — Final - - - PASS PART FAIL PLUMBING Post&Beam Under Slab -- Rough-In Water Service ----- - Sanitary Sewer Rain Drains ---— Catch Basin/Manhole Storm Drain — -- - — Shower Pan Other: ---------- - Final - - PASS PART FAIL_ - - — MECHANICAL Post&Beam — ----- - -- Gas Lins ilk Smo Dampers -- ----- ------- Fi 1 AS PART FAIL_ ---- — ----- _It-0-TRICAL Service --- ---� -- -- ------ Rough-In UG/Slab - Low Voltage ----_-� — -- -----_— Fire Alarm Final r] Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SIT_F — Please call for reinspection RC [� Unable to inspect-no access Firo ctupply Line ADA7 Approach/Sidewalk Datil ' 0!Ispedor Other: Final D OT REMOVE thls Inspection record from the job site. PASS PART FAIL