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10620, 10630, 10640, 10650, & 10660
SW DEL-MONTE DRIVE
CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00622
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/27/03
PARCEL: 2S 110AD-07000
SITE ADDRESS: 10660 SW DEI- MONTE DR
SUBDIVISION: LANG HILL NO 2 ZONING: R-12
BLOCK: LOT: 062 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: 5F UNIT I EATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/CC'MPRESSORS _ 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: 504 HP:
CI-0 DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
F1.!RN >=100K BTU: GAS O'0000 cfm: — ASOTHUNITS:
OLUTLETS:
> 10000 cfm:
Remarks: Itclilace existing gas furnace.
Owndr: FEES
GLUHR, SETSUKO TRUSTEE Description Date Amount
10660 SW DEL MONTE DR
TIGARD, OR 97224 N1EC'I I] i'crmit Fee 10/27/03 $72.50
j'rAX] 9%State Surchari 10!2710'; 15.80
Phone:
Total a $78.30
-••
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 2;0397
8900 SW BURNHAM#E1110 REQUIREDINSPECTIONS _ _
TIGARD, OF? 97223
one: 503-624-2704 Heating Unt Insp
^,'.
F'ial Inspection
Pea #: LIC 76359
This permit is issued subiect to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty bodes
and all other applicable laws. All work will be done in acmrdanc, Al)approved plans. This permit will expire f work is
not started within 180 days of issuance, or if work is suspended or i.i ,re 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 952-001-00
Issued By: ` -= l/�� -� Permittee Signature->r,-
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
FOR hFVICF
NLY
Mechanical Permit Applicatic:n Received USE
Eilg
Date/By: 4/p 7 �% Permit No. /` ! 1 Cr�r �L.�
City of Tigard Planning Approval Building
Date/By: Permit No.:
13125 SW Hall Blvd, Plan Review Other
"Tigard,Oregon 97222 .-Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review (and Use
InI. net• www.ci.tigard.or.us Date/By: Case No:
Contact
24-hour inspection Request. 503.639- 0, 1 See Page 2 for
175 Name/Method: Supplemental Information.
TYPE OF WORK CU.,NMIERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction _ Demolition Mechanical permit fees'are based on the total value of the work
Addition/alteration/re lacement I L Other: performed. Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mecha.,.cal materials,equipment,labor,overhead and profit.
1 & 2-Family dwelling Commercial/Industrial Value: S See Page 2 for Fee Schedule
�Accessoty Building Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE
Master BuilderOther: Descri dun tv Fee ea. Total
Hertln Coolin
JOB SITE INFORMATION and LOCATION Pum add-on air conditionm •' 14.00
Job site address: Ie ('0 ' as heat pump 14.00
Suite #: Bld ./Apt.#: Duct work _ _ 14.00
Project Name: h dronic hot water system 1400
Cross street/Direcoons to job site: Residential bailer
for radiator o;h dronic_system) 14.00
Unit heaters(fuel,not electric)
in wall,in-duct,suspended,etc,) 14.00 _
_ Flue/vent for an of above I O.UU
Subdivision: _ Lot#: Repair units 12.15
Tax ma i,-P arcel #: Other Fuel Appliances
Waterheater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Flue vent(water heater/ as fireplace) 10.00
Log lighter as 1000
-- Wood/Pellet stove _ _ 10.00
-- Wood fireplace/insert IOAU
Chi mne /liner/flue/vent 10.00
{{,`.jj[PROPERTY OWNER TENANT Other: IU.00
1Va1!le; X Environmental Exhaust&Ventllatlon
Range hood/other kitchen equipment 10.00
AddrAss:
Clothes dryer exhaust 1000
City/slate/zip:
Phone, (, Fax: Single duct zxheust
APPLICANT (bathrooms,toilet compartments,
CONTACT PERSON utilit morns _ 6.80
Namesj0&ff Attidcrawl space fans 1000
A'dress: — other: 10.00
--�- -- -- Fuel Piping
city/state/Zip: ••($5.40 for first 4,St.00 each additional
Phone: ,�H spa/ I Faxae3��'�Po,� Furnace,ecc. �•
Gas heat pump ••
E-mail: Wall/suspended/unit heater ••
CONTRACTOR Water heater ••
Business Name: CD/ . 1, Fireplace ••
Address_ P6 Range
Ran a ••
Cicy;scate/Zig_ / 09 974-4-1 .__ BBQ ••
Clothes dryer as) ••
Phone: p ��y�t7'o Fax: o X" D 0 other: ..
CCB Lic. #: 74 _ Total:
Authorized Mechanical Permit Fees'_ _
Signature _ Date:�p,3 Subtotal. S
_ Minimum Permit Fee 572.50 S
Plan Review Fee(25%of Permit Fee) S
I Please print name) State Surcharge 8910 of Permit Fee) S
_
TOTAL PERMIT FEE $
Notice: This permit application expire if a permit is not obtained within •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 Dsts\Permt Forma MecPermitApp d,)c 01103
CITY OF TIGAPD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
IIJSPEC.TION DIVISION Business Line: (503) 639-4171
BLIP
Received _Le E)e _ Date Requested— AM _ ____— PM_ -_ BLIP
Location l d�� �— -11
-Suite_ MEC 3
Contact PersonPGCtiv'L. ",L — Ph PLM - ---- __.
Contractor 0,fr ,jLr4 WV1 r,_. Ph -7G' SWR
BUILDING Tenant/Owner — ___-.___--_____._____-__ CLC
Footing ELC
Foundation Access:
Ftg Drain ELR - --_--- --- -_--
Crawl Drain -�.—
Slab Inspection Notes: ,,,I^ []�� SIT _
Post&Beam -_-_-_ ---- ► 1 U-h'1-L' � 44- AM
Shear Anchors
Ext Sheath/Sheur --_ --_ -
Int Sheath/Shear
Framing _ ------ - -
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler ---- - -"--
Fire Alarm
Susp'd Ceiling -
Roof
Other: -
Final _
PASS PART FAIL r '
PLUMBING
Post&Beam
Under Slab -- — -<-- -
Rough-In
Water Service - - - --- -- -
Sanitary Sewer
Rain Drains ------ - --
Catch Basin/Manhole
Storm Drain ---�--T__ - - -- -
Shower Pan
Other: —-- - -- _ ----
Final
_PASS_ PART FAIL ---------_ _ __-
MECHANICAL
Post&Beam
Rough-In -- --_ -- - - - — -
oas Line
ralampers ------- - - - ----- -
1PART FAIL - - --------
_ CTRICAL
Service --
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final IJ Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - F-] Please call for reinspection RE: _ E] Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dab - Inspector_2 - -_ _ -(Ext
Other: _
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone. 6394171
Date Requested: J — --y-y-� (M. -�__ I'M _— MST: --- -
Location: �Lil G'J _-- AUP: _ _
Tenant: _ Suite: 131dg: NEC:
Contractor: 6- 'f,Q
_— � - -- Phone: ��y-3 35 64 1 PLM:
Owner: Phone:
-------- -- --- — ELR:-- --
_ SIT: _
BUILDING BLDG(con't) PLUMBINGECHANICAG ELECTRICAL SITE
Site Post/Beam Post/Beam PosU13eam Cover/Service Sewet/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/Duct Reconnect Vault
Bsmt Damp Drywall Stonn Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C Uta Slab
Shear/Sheath Fire Spklr/Alm Crawl,'Found Dr I lent Piunp Low Volt
Approved Approved Apl,tove( Approved Approved -
Appr/Sdwlk Not Approved Not Approved oved Not Approved Not Approved
FINAL FINAL FINAL ? FINAL FINAL
.t
O Call for reinspect Reinspection fee of S _required before next inspection 0 Unable to inspect
Page
Inspector. --- Date: —°f -
CITY OF TIGARD MFCHAN I CAL.
DEVELOPMENT SERVICES PERMIT
PERMIT #. . . . . . . : MEC98-0075
13125 SW Hall Blvd., Tigard,OR 27223 (503)639.4171 UATF" I SSUE::D: 02/j'7/'38
GA RCE.I. : 2S 1 1 OAD-0681 O
111TE ADDRESS. . . . I oFslr0 SW DEL 1*,1014TE UR
)LJ`r1I?TV19TON., . . . : L.ANC; 111t..l.- 1\10. ZONING: R-- 1.c:'
BL.00K. . . . . . . . . . . L-OT. . . . . . . . . . . . . :(SOG JI_JR T SD T CT I ON: T I f-
OF WORK. . :()L_T r.L..C;OR FJQN. „ . . r, 0 E'VAP f.'f101_ER :: 0
1"YFIF nF LISE. . . . :SF HNTT WATERS— : 0 VENT FANS. . . : 0
f)CCUPANCY 0R-P. . : R 3 VENTS W/O AF'PL-: 0 VI RIT SYSTE:MC.;: P
'.)TORIES. . . . . . . . : 0 SOIL_E:RS/CCIMF-IRESSCIRS HOODS. . . . . . . : m
0 HP. „ : 0 DOMES. 1 NC I N: 0
(;A5 --1.f, HP. . . . : 0 COMML.. I NC I N: 0
MAX INPIJT: 0 D-f IJ 1`5--30 HP. . . .. : 0 REPAIR UNITS: 0
1' I RF_. DAMGE:RS9. . : ?0•-50 HP.. . . . . 0 WOODSTOVE'S. . : 0
9tal.; PRF SCURF. . . : Fii7f+ HP. . . . : 0 0._0 DRYERS. . : 0
'Vn. nF' LINT TS--___.._._... ___ ATR HANnLINr; UNITS) OTHE=R UNTTS. : 0
"I.1RN ( IOOK STLJ: 1 (- 10000 Cfm : 0 GAS OUTLETS. : t
-1IRN ) =1OOl( PTI.). 0 > 1001710 c-fm : 171
remarks : Installing furnace and gas piping
Owner: —________._.__._.__..____._._- .._._._..___..._._._._..__..__._.__.___._._._.__....__...__..._. ._.__-- I. LES
"P GAXF type amot_1nL by dote recpt
10r-,40 SW TTI. MONTE DR PRMT P5. 00 P OF:.'/,'7 ')A
f Ion RD rip g7c:,:'a cr-CT I . 11713 S OCa/27/')A 91.3 10?17,7'
r-,hone #:
0fitrac^tor:
ROSBEN 9 SONS HEAT T ILII;
-=`300 SF 7TH AVE
1, 0 SOX 14OW 26. TOTAI.-.
PORTLAND OR 97214
`"'hone #: 233-.5841
001884
-- _--- RF011I RED T W-)r1ECT T.0Nc, _....___. .
is peralt is issued subject to the regulations contained in the (ic15 Line Insp
Tigard Municipal Code. State of pre. Specialty Codos and all other Misr. Insppct i on
applicable laws, All work will be done in accordance with Fl i n a 1 T n s pe c•' ion
approved plans. This perait will expire if work is not started
within 180 days cf issuance, or if work is suspended for tore
than 180 days. ATTENTION: Oregon law requires you to follow rule:
adepterl by the Oregon Utility Notification Center. Those rules arp
set forth in OAA 952401-0010 through OAR 952-0014080. You way
obtain copies of these rules or direct nuestiont to OUNC by calling
'rm7)246.9187.
T.5s!_1e LAy : w--. _.._. �� Pe -mi +tee Signatl.lr ? :
++4-++-+++4-1 +-+4-+.+..+'+++4-++-f"+-+.-++++.+_F4..1-.-1.i•-F++4.i-++.1^+...4..}.1..1-.F.1^. 4..1^++4..+..F+-+++++ ++++q--.1-+
CP 1 ' r7^ 417!5 by 7:00 n. m. fn)- in,oe+rtions nr+ecipd tha next riiv
+++4 ++ }l ++++++++4+++++++++-+4-++++4•+++....+}+t+++,l-++++ -++++,+4...++-t-+4+++++++++4 t '
Plan Che 0
CITY OF TiGARD Mechanical Permit Application Recd By D
13125 SW HALL BLVD. Commercial and Residential Date Recd_ " i
TIGARD, OR 9722.3 Date to P E.
(503) 639-4171, x304 Date to DST
Print or Type Permit# ►('C'" - 17
_ Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code CITY PRICE AMT
Job Street
Add r ss s� A) Penna Fee 0 0• 10.00
Address
Bldg# 1 Cttri to zip 1.) Furnace M 100,000 BTU 6.00
including ducts&vents _
Name for TZI business) 2.) Furnace 100,000 BTU+ 7.50
Owner including ducts&vents
Mailing Ad ress - 3.) Floor Furnace - - 6.00
including vent
-t tate2-� Zlp Phyn 4.) Suspended heater,wall heater 6.00
or floor_mounted heater
Namfoottr name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boder or comp,heat pump,air Gond. 6.00
__ to 3 HP;absorb unit to 100K HUT"'
City/Stale zip Phone 7.) Boder or camp,heat pump,air Gond. 1
"
1.w
�7� 3-15 HP,absorb unit to 500K BTU
Contractor Narrtff' (� 8) Boder or comp,heat pump,air tend. 15.00
nc _' 15-30 HP;absorb unit.5-1 -il PT'J"
Prior to permit M ng Add res y+ 9) Boder or comp,heat pump, air cond. 22.50
issuance,a copy / 30-50 HP,absorb unit 1.1.7t nit BTU**
of all licenses C to tate - Zip �PPhone r� 10.) Boiler c,t wmp,heat pump,at cond. 37 50
are required if 1� - _. �" �J � >50 HP.absorb unit 1.75 mil BTU**
expired in COT Oregon Const oar ,c# Ex to 11.) Air handling unit to 10,000 CF M 4.50
database ��
Architect Name 13) Non-portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a srrgle dud 3.00
Engineer cnyistate ZipPhon
-'e 15.) Ventilation system not included in 450
appliance permit _
Describe work New O Addition O Alteration O Repair O 16.) Hood served by mechanical exhaust _ 4,50
to be done Residential O Non-residential O
Additional Description of work 17) Domestir inrinerntnm - '50
18.) Commercial or industrial type 30.00
_ _ Incinerator
Existing use of - 19) Repair units 4.50
budding or property
20.) Wood`-stove'_______'_ 4 50
Proposed use of 21 ) Clothes dryer etc 450
building or property
7.1 1 Other units 450
Type of fuel-oil O natural gas O LPG O electric O 23) Gas piping one to four outlets / 200
I hereby acknowledge that I have read this application,that the 24) More than 4-per ontle!s(each) 50
information given is coned,that I am the owner „r authorized agent of
the owner,that plebs s mined are In compliance with Oregon State QTY SUPTOT4L
laws._
Signature of owneN t Date 'SUBTOTAL.
' 5%SURCHARGE
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
i D/t%G /�. o { /� f:II/ TOTAL I i
i\me::hpmt.doc (rev 9 Minimum permit fee is$25+5%surcharge
"Residenhat AIC requires site plan showing placement of unit
s