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9465 SW MARTHA STREET-1 IS VHIUVW MS 99V6 H a x a a cco 3 ED wCD 9465 SW MARTHA ST CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00537 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 8/10/2004 PARCEL: 2S 114AB-12700 SITE ADDRESS: 09465 SW MARTHA ST SUBDIVISION: KNEELAND ESTATES NO.2 ZONING: R-4.5 BLOCK: LOT: 120 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: 1 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: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTI I: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Ins:atlatian on new A/C unit. Owner: FEES _ KORNBERG, DOLORES E Description Date Amount 9465 SW MARTHA ST [MECH] Permit Fee 8110/200, � $72.50 TIGARD, OR 97223 1't'AX]8%State Surcharl 8/10/2001 $5.80 Phone: Total $78.30 —' Contractor: _ COLUMBIA HEATING& COOLING INC P.O. BOX 230397 TIGARD, OR 97223 REQUIRED INSPECTIONS Phone: 503-624-2704 Cooling Unt Insp Final Inspection Reg#: LIC 76359 �G H rn m This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes LU and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. �- Issued By: _ � r��,/ Permittee Signature: ne Call (503) 639.4175 by 7:00 P.M.for Inspections needed the next business day Hus 09 04 01 : 16p PHM Dfil_BY 503-598-02-0 p. 2 Mechanical I'•.rtrait Application � . OFFICE � City of Tigard Pr:�, NLY Uate Ny IV,';SW �/1 Q�� / � Fermr Nall Blvd,T:gard,OR 97223 �C f���� �_L� Phone 503 639 a i 71 Fat. 303 598.196:' Gv IPlan Review Other hrmtt : Inspection Li-e. 503 639 4175 Vale/By _ Internet wwly ci-tigard.or.es i Date Ready/rty. law 0 to Page 2 for ,.1rM�n AUG O 9 7 I Nodf ed/Method Supplemeard Information I i'' .'i'i�•I�ii�f�SJ({,j�.+�' `,'(���fCr�' � t' � ,•'�,its� ,wiF SM :��' a t }tvY •''a ': ft 'LrrBEta►`'SCMbULiE - USDCHECKLIST ❑New construction ($'Add Qj 11�g�(PI�(9N�R9NFnt Mechanical pernit roes*are based on the value of the❑ De no tUon performed.Indicate the value(-ounded:n the rear.dolls-I of at,Other mechanical materials,equipment,labor,overhead,and p-alit v. M t ;'�,rG� 1 ►!5 � 401Ht �'"re ` h►;,.a;, :�:a.� Value.S ! Xj I•and 2•farruly dweCln _- g ❑CurnmerciaUindustnal Accessory building ' ' • �F .rE0TPYJENT/SYS7'UM5 FEES* ❑Multi-faruly ❑Master builder _ For special information tie checklist ❑Other .- Dfscnpnon _ Qty Eo .;� .r( :t;''�� S -�+J(�� 3LT` If>jdtUx' �arl`I ..O('y r©I�•��rrr ,,t,.,. Heatln moll "o:e -- I lob site adCress Air conditioning or hew pump ss ���/lJ rr rarer site plac fhuwlna _PL__ 7 p Ciry/SiatelZ[P: Fuaiscc 100,000 DTU duets vena 4 90 Sa:te.'bldg.lapi.no Project name Fumace_100,000*BTI:(duetyvents) _I'Q+)-�--- � Cross sfree:idtrccUons to job siteGas heat hump 1400 . -- ----- -- �- Duct work 14 00 LHydronic hot water SVS:CMi-� 400 T I Residential boiler(radiator or hvdiomc 1400 I)nit heaters(fuel-type,not electric), in-wall,in-duct suspended,etc. 10,00 Subdivision Lo aro Flue/vent for any of shove 1000 Other _ 1000 Tax map+parcel no.: yOcher fuel appliances 4.1• cr. .L...�;, Water heats- - 000 I I Ga fireplace 100 r '�� LL' G..-- __I Flue vent for water heater or gas T fireplace _ 1000 i �- - -- '- --- - — -LU18 (gas) _ 1000 Wood/pellet stove 1000 i - Wood fire Iacehnsert1 1000 Chirtvi—.eY'/.inerinue/vent 10 JO E.e,,n t i k T. .:.�• a S .} �1:•� „ d i,' ^t" l(,h1X '. ` 11'Jt1 r'r fff — /� Other too" Name: _Environmental exhaust and ventilation _ �Address. yRange hood/other kitchenegNi�ant 1000 --- - _. Ctr-rStatrZil' Clothes dryer exhaust 1000 ~Phone _. -- - - - 5ingle--duct exnaust(badvocrus• ( �) fv�� �.. Fax. ( ) _/p t urilct compartments, -.!y roorns) 6 gG afYlp'tri ]t pat , t;1, "Ifw t. r°heti l�GR 1�• r9?l(0 Autcicraw!spece!ars _- 10.00 - --- - -- - - - - — Businessname Other: -- _ Contact name -Fuelplping ----- M 42,9,1& $5.40_ for Urst four;51.00 for each additionai Address --� Furnace,etc. IL CtrylState%ZIP Gas heat pump-_- - X _ _ _ Wall/suspended/unit heater N PhoreJ 7 ��'y ��t7 1 Fax (�0 J) J! d Water heater _ �- E-mail. - 4'�L2� Fireplace - r Ran e .- J I f?';r . 'C ' ' ?' . +.. 'CO K C V4. i rr ''_d "`::,.i "� ► ''I -- - l -- d.. -Wiz___• �3 /'fs.'-1' e. 4 ..: ;. Barbecue _m Business name: 19A M Clothes dryer(gas) } � Address. WGy% ,SlateZiP O t7 3 .3 p ---'- ._ ii ;_•• w. t` +� Ct1L'DERI�IES' -I Ti`sl•- eei. _ Subtotal — Phone: ). G Fat: j-yj) S' Oa ,,� — Minimum permit.ee($72 5C) CCB tic _ Plan review(23%o!permit Cee I74 i State surcharge(11%of permit fee; 1 TOTAL PERMIT FEE Authorized sir nature ��>-?1 �� This permit application aspires if a permit is not obtained .,then 190 days&rite It has been accepted a eomPlere. Print name � � V l bate: Fee methodology set by Tri•Cou-iiy Building Indutry Sernct bis-_ ,b4ildlneVerruntl./EC•Perryl�pp ctx 12/07 ��0.e61'T(I ire?rCO MlwPIr; HuC 09 04 01 : 18F PRM DRLHY 503-598-0270 p. 3 HEATING & C00LIHGj INC. 8900 S.W. BUl?jN'P M ROAD, SUITE E110 TIGARD, OR 97223 (503) 6242704 FAX (503)598-0270 I I a a J JOB ADDRESS:_ yL .Sk/ Old , m SITE PLAN FOR AC OUTDOOR UNIT LOCATION CITY OF TIGARD 24-Hour BUILDING 0 Inspection Line: 1503)639-4 750 MST INSPECTION DIVISION Business Lind: (503)63 71 `---- c _ BUP Received ___Date Requested____L— _ AM — PM _ BUP Location ---_C�� C � Suite --0�5 37 Contact Person - Phq PLM Contractor .__ Ph( ) __ SWR ��_ BUILDING_ Tenant/Owner ELC __ Footing ELC Foundation Access: -- Ftg Drain ELR - Grawl Drain Slab Inspection Notes: SIT _- Post&Beam Shear Anchor. - �- Ext Sheath/Shear int Sheath/Shear Framing -G+-�-�- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarmj Susp'd Ceiling Roof 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 PAJkT FAIL -'-� H L os F. Beam Rough-In Gas Line IL Smoke Dampers - - H W nPA� PART FAIL -- - ---- ELECTRICAL Service m Rough-In _- a UG/Slab W Low Voltage J Fire Alarm -ural Reinspection fee of required before next inspection. Pay at City Hall, t:+125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line ADA Deb `� G� .Cllns��cto� _Ext Approach/Sidewalk - Other: _ Finai _ DO NOT REMOVE this Inspection record from the job sits. PASS PART FAIL