10455 SW GRANT COURT• �. J
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CITY OF
n GA R D MECHANICAL PERMIT
^ , DEVELOPMENT SERVICES PERMIT#: MEC2002-00425
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6°9-4171 DA-,'F ISSUED: 10/2/02
PARCEL: 2S102CB-06100
SITE ADDRESS: 10455 SW GRANT CT
SUBDIVISION: WINSOME TERRACE ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: A'! T FLOOR FURN: FVAP 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:
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: AIR HANDLING UNITS CLO DRYERS:
--- OTHER UNITS:
FURN >=100K BTU: <= 10000 ctm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas line to water heater.
Owner: _ v �J FEES
ARNOLD, LOURINDA J Description ^v Date Amount
10455 SW GRANT CT —'
TIGARD, OR 97223 )MEC'III I'vinlit Fec 1012/02 $72.50
[MF UI I I I'ci nw Fee 10/2/02 $0.00
I I',1X] `; State'Tax 1012/02 $5.80
Phone: IT 1X] 8%,StateTax 10/2/02 $0.00
Contractor: F^ Total $78.30
COLUMBIA HEATING+ COOLING INC
P.O. BOX 230397
TIGARD, OR 9722.3 REQUIRED INSPECTIONS
Phone: 624-2704 Gas Line Insp
Final Inspection
Reg#: 76359
i his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approve J plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law
requires you to to4low rules adopted in the Oregon Utility Notitication Center. Those rules are set forth in OAR 952-001-00
issued By: �/ ,. � Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections neeoed the next business day
INIechanical Perinit Application
7Dateissued:
ed:10 9 1- Permit no.:
lid City of Tigard
�.dd `� a l.no: Expire date:
City ofTigard Addreft 13125 SW Hall Blvd,Ti*irij!( rmI � 1'
Phone: (503) 639-4171 BReceiptno.:
Fax; (503) 598-1960 '� Case riileno.: Payment type:
Luted use approval: Building permit no.:
1
U 1 & 2 family dwelling or accessory J Commercial/industrial O Multi-family U-fenant improvement
U New construction 144ddition/alteration/replacement U Other: _
J61-1—SITE INFORMATION
Job address -
Indicate e ui anent uanhUcs ut bt xcs bacµ. Indt.atr tete dollar
q I 9
Bldg. nu.: Suite no... value:of all mechanical materials,cquipmciti labor,overhe•td,
Tax map/tux IoUaccounl no.: _ profit, Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule fur residential permit fee.
City/county: ZIP; 97e„��3 l
Description and locali m of work on premises: _ Ir
an1 1 r Di Fee(ca.) Total
Eist.date of colnpletion/inspection: D scrirtlon Qt . Res.unl Res.unIN
Tenant improvement or change of use: nit CFM
I Is existing space heated or conditioned7 U Yes U No ----C —
Air conditioning(s�it��e'`lim requrreR -
'-
Is existing space insulated?U Yes U No terntfon.7-,x isting TVA_ sC� ysteni--
511-A-11111AINA-Al CONTRACTOR or er comprc
Business name State holler permit no. 1
AIHJI Q- � - _ HP Tuns IiTU/H
Address: 00 it smo a arnpersi uct smoke electors
City: 1 _ State: ZIP: eat .ump(sate p era dequtre )
Phone; �7Oy Fad E-mail; ,_ -fntta repace urnac -arncr..�-BTU/11
CCB no. g - Including ductwork/vent liner U Yes Q No
. (� 3 .'J' ri:;ta 'rep a�T-Tee r0ocatefeaters--suspended•
City/metrolic.no.: �1• 7 wall,or floor mounted
Name( lease tint): m� /tj p�_ / o/s enl or ap ranee other than furnace
1 1 e Geral on:
Absorption units_ _-` BTU/H
Name: ` A _ -_QA1,,r,t A.rL� Chillers _ _ HP v�
- _�M �_ /b AN ,�
Address: Com ressors Ht
City: _ State: Zlp; nv rnnsneata exhaust an vent at un:
__ A chance vent
Phone: Fax: E-mail- Drycrexhaust
1 t 4 Hoods,Type ! res, itc a hatmat
hood fire suppression system
Name: L,. Exhaust fan with sin le duct(bath fans)
Mailing address: /pf'SC �Ca I el 4a_v f ee- x gus_t s_y_s�tem a art tom cattn or.4
City: State:,o ZIP: fja 7 ut piping st ut n cup to -URCLS) -
Type: I_PG NC oil
Phone: 6 Fax E-mail: Fuelt tri�eacK a tt ona aver out ets
rocessppng(schematic required) _
Name: Number of outlets
Address: (Tier appliance or equipment:
Decorative fireplace
City: _ State: Insert-tt•oe
PhoncFax: Entail: Woods ove/pe let stove
Other:
Applicant's signature; �e Date% -U _ t ter:
Name (print): yr.� A JJf�(✓ _____ r
T
Not W jurit&ctioru occepi ctedit cmit,pteau call junviction to mote iarm%tatioa Notice: Permit fee_..................$ _
Q Visa U MasterCard expt�es if a if
permit application permit is nat obtained Minimum fee................$
Crede card number -�'
__-_-- within 180 dais after it has been Plan review(at _ %) $
Expirca State surcharge(8%) ....$
Name of cardhulder u a own on credit card accepted as complete.
_ $ TOTAL .......................$
Cudholder ai`ualum Amount
440-461' Ifr00JC01-1,