Permit C ITY OF TIGARD MECHANICAL PERMIT
; ,, + 1 �i , DEVELOPMENT SERVICES PERMIT #: MEC2004 -00123
..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/17/04
PARCEL: 1 S125DB -01200
SITE ADDRESS: 09085 SW 70TH AVE
SUBDIVISION: SHADY DELL ZONING: R -4.5
BLOCK: LOT: 012 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replace furnace, install fireplace insert and exterior A/C unit. Do not place A/C within required setback
Owner: FEES
ROB SNYDER Description Date Amount
9085 SW 70TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 3/17/04 $72.50
[TAX] 8% State Surchar€ 3/17/04 $5.80
Phone: 503 624 - 2704 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
8900 SW BURNHAM #E1110 REQUIRED INSPECTIONS
TIGARD, OR 97223
Phone: 503 624 - 2704 Gas Line Insp
Mechanical Insp
Reg #: LIC 76359 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 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: / ' • '. Permittee Signature: ,/�
Call (50 ) 639 -4175 by 7:00 P.M. for inspections needed the ne b siness day
Mar 16 04 08:55a PAM DALBY• 503 - 598 -0270 p.2
- Mechanical Permit A�ion
Receive m ,� Mechanical
6■C O � Date/BY ' ' vPermi t No.: a� y—� �oZ3
City of Tigard rl� Planning Approval Building
13125 SW Hall Blvd. r � C p Date/By:
Plan Review PermitNo.:
Q 1 Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 50.3 -598 -1 6k Q Post - Review Land Use
Internet: www.ci.tigard.or.us G \` .•'A'1,1`llj Date/By: Case No.:
_ - Contact g Se Page? e f
24 - hour Inspection Request: 503 - 41�� \�' Name/Method: . ju Supplemental Information.
• TYPE OF WORK .. '.' <COMMERCIATiFEE :SCHEDULEUSECHECKLIST •
0 New construction Ei Demolition Mechanical permit fees* are based on the total value of the work
[ 'A ddition/alteration/replacement E Other: performed. Indicate the value (rounded to the nearest dollar) of all ,
• • • • , CATEGORY OF CONSTRUCTION: •. :': mechanical materials, equipment, labor, overhead and profit.
. 1 & 2- Family dwelling [] Commercial/Industrial Value: $ See Page 2 for Fee Schedule
Accessory Building Multi- Family • ;.•.•I SENT .EQUIpI►D NT /SYSLIEKTEEE*...SCHEDULE
Master Builder Other: Description 1 Qty I Fee(ea.) 1 Total
Heating/Cooling
JOB SITE INFORMATION:and •LOCATION ` Furnace - add -on air conditioning ** - 14.00 141.
Job site address: ?O/ ( 5'•) 9°f' Gas heat pump 14.00
Suite #: I r. Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Cross street/Directions to job site: Residential boiler
(for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
• Flue /vent (for any of above) 10.00
Subdivision: 1 Lot #: Repair units. 12.15 _
Tax map parcel #: Other Fuel Appllaoces
Water heater 10.00
DESCRIPTION OF WORK ' • Gas fireplace 10.00 /Q, 07)
/A + e 9at„o Flue vent (water heater /gas fireplace) 1 0.00
/.1../..r-Aga. // L Log lighter (Ras) ] 0.00
Wood/Pellet stove 10.00
/g/ f f e 9.011.0 . 41. #C' — Wood fireplace/insert 10.00
Chimney/liner /flue/vent / 10.00 /b. o
a'ROPERTY OWNER . - )• D TENANT_ Other: 10.00
a me: ,f SN Q / = A� Eavlivomeatal Exhaust & Veaulatioa
Address: y ti Range hood/other kitchen equipment 10.00
9 s7 �`� _ Si-) Clothes dryer exhaust 10,00
City /State /Zip:
T` �4t.A.sli Single duct exhaust
Phone: 0, / //0 Fax: (bathrooms, toilet compartments,
'' E] APPLICANT : Q:CONTACT: PERSON... - '' utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Address: Other: 10.00
Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Phone: 1 Fax: Furnace, etc. **
Gas heat pump **
E-mail: WalUsuspended/unit heater • **
CONTRACTOR Water heater ••
Business Name: Fireplace / •• S; 40
Address: P O 10)C 3 94-i Range .•
City/State/Zip: BBQ ••
Cit
Y p: / /G 6 .Q 9 a Clothes dryer (gas) •*
Phone:s,3 G ay an e ax: • S43Spp 0.7.7 Other: **
CCB Lic. #: Total:
Authorized ? Mechanical Permit Fees*
Signature: ��j /� Date: 0 — Subtotal: S '7? S�
/ Minimum Permit Fee $72.50 S
PA ,tie /,q A 12A fJ, Plan Review Fee (25% of Permit Fee) S
(Please print name) State Surcharge (8% of Permit Fee) S • r j . Fe)
TOTAL PERMIT FEE $ 7 Q. 3 U
Notice: This permit application expires if a permit Is not obtained within 'Pee 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\Permit Forms V lecPcrmitApp.doc 01/03
Mar 16 04 08:55a PAM DALBY 503 - 598 -0270 p.3
eaewits•TA
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUITE E110
TIGARD, OR 97223
(503) 624 -2704
FAX (503) 598 -0270
JOB ADDRESS: 90 f5 (. 5'A) '7D
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection . Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Q / / BUP
Received Date Requested AM PM v BUP
Location 9 � 7 d Suite MEC cOP 7 6 / 3
Contact Person Ph ( ),2 WS /1/ C PLM
Contractor Ph ( ) S? 0 - 7 / .I SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear
Framing
Insulation ;
Drywall Nailing !� ' - CLA- i a I''
Firewall
Fire Sprinkler
f
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
1417
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final /)A _' S ,f E'� 2 // 99
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In \ K\ ---
moke Dampers
2riT
Agn PART FAIL
"'
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please cal for reinspection RE: Unable to inspect – no access
Fire Supply Line 1M
ADA /
Approach/Sidewalk Date • jO Inspec Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL