Permit CITY OF TIGARD
MECHANICAL PERMIT
I't DEVELOPMENT SERVICES PERMIT #: MEC2004 -00359
t•��1- DATE ISSUED: 6/10/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136CA -90581
SITE ADDRESS: 10900 SW 76TH PL 58
SUBDIVISION: TIGARD WOODS A CONDO COMM ZONING: R -25
BLOCK: LOT: 058 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SFA 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 BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
• Remarks: Installation of a/c unit.
Owner: FEES
JEANNE ARBOW Description Date Amount
10900 SW 76TH AVE #58 [MECH] Permit Fee 6/10/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 6/10/200 $5.80
Phone: 503 - 968 - 9191 Total $78.30
Contractor:
ALL TEMP PROFESSIONAL
8230 SE 72ND ST
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
Final Inspection
Reg #: LIC 58513
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 -66 • •
Issued = / / , _ Permittee Signature: gat— t e
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
JUN - 07 - 2004 MON 10:20 AM P. 001 /003
ONLY
r =� OFFICE USE -
e'chanica1 Permit A Lcation Received
FOR R. R EU L u Dat IB ; II •
r �:. �a
Planning Approval Building
City o#'Tigard
Date/By: PerrnitNo.:
13125 SW Hall Blvd. JUG" 7 2004 Plan Review - Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 -639 -4171 Fat 321-§8ZigeOR0 Poit- Review Land Use
Internet: www.ci,tigard.or BUILDING DIVISIO /�''n..i'ili�'�t'�ilibt Deta /ey: Case No.:
r t j. r:• Contact Jul El Bee Page 2 for
24 -hour Inspection Request: 503 -639- 4175 Names/Method: (1 sh Supplemental Information.
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�ri''� iy- ,,
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New construction Demolition ddition/alteration/replace permit foes' are based on the total value of the work
nnent Other' petformcd: Indicate the value (rounded to the nearest dollar) of all
,; �E1,!', t` l +'eJ:,j?!.G,;O.I!1S�`,�',Iij'CT ,•`�' mechanical materials, equipment, Tabor, overhead and profit,
& 2- Family dwelling L,] Commercial/Industrial value; $, See Page 2 for Fee Schedule
• Accessory }3Ulldlri Multi Family , ' ;, $11 ` E0 T.'M /S'.P;r�gSirt J !SCHFIAl ;E';:.:• .
Description Qty 1 Fce(ea.) 1 Total
0 Master Builder , Other: Meeting/Cooling -
''' 'M 1011'.Si tEINFO aikl )<011 LO CATION Furnace - add -on air conditioning ** 14.00 /4.//
Yob site address: ./09 7. tf' / 1 Oas heat pump 14.00
Suite #: jB , ldg. /Apt. #: Duct work 14.00 -
Project Name: _IL Ironic hot water system 14.00
Residential boiler
Cross street/Directions to job site:
(for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent for an of above 10,00
Subdivision Lot #: R - 'air unit 12.15
Other Fue1;Appliances
Tax map /parcel # y : : ,,,��yy F�.y Water heater 10.00
r" '�tfi ei'tl 1'�R!a'.`>�fw� 31S,t tI N'Oyy� lligr ^ y,i�� :� .'r�i :i0: ,;;I:∎ i Gas fireplace 10.00
j` ,4 1P4r � A/ f , Fine vent (water heater/ ,as fireplace) 10.00
Log lighter gas) 10.00
Wood/Pellet stove . 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue/vent 10.00
iPAI O'!.M.a4 :NEE R oli V °r:c'" r / :V 1!S .' ?�t! Other: 10.00
J •
ante: �E •�1A17 Enviipnment l i at :VeAS l� tti ;;,, .
�� � Range hood/other kitchen equipment 10.00
AddCes - . Clothes dryer exhaust 1 0.00
City /State /Zip: i. - Az_ 9)22, " Single duct exhaust , .
Pho --', `;. '- ° ' - Fax: i (bathrooms, toilet compartments,
, ',:lt'.: a .- . ,4 :.,. !N;.®@NEKM 't '`='K ,1° N1 :: utility rooms) 6.80
Name: '
ame: ' y ,�/ / 7iec_, Attic/crawl space fans 10.00
Address:: - . Se 7 *.e7x-re--- Other: 10.00
: d dl
City/ . �� * 5.40 !br first 4� $1.00 eacadditional) Phone
*r
,4 'ZZG r '*, Furnace, etc. •
;J � � Fax: Gae h eat putnp
E -mail: ,s T /� �/ry Wall /suspended /unftheater
tyD s�r. sl � : ;z:: „1 t'4�6 k, ,rat _ **
.�:Stli�t -01i,i., i 4�,d,t: 1'.�: .,. 'VII 1 ��,:-1:' �. d k% •i ..r �. �� S.�i!+,r Water heater
Business Name: _ Fireplace Ili*
Address: B e Q ss -
City /State✓Zip : Clothes dryer (gas) .1.*
Phone: Fax: Other:
CCB Lie. #: $7/ Total:
Mechantealrermit.Fee•s i . •
Authorized . - / : ,' Subtotal: $
Signature: /.� !:' / Date Minimum Permit Fee $72.50 $ .50
/ 4 Plan Review Fee (25% of Permit Fee) $
(Please print erne) Stat Surcharge (8% of Permit Fee) $ _
• TOTAL PERMIT FEE $ 9,5".. a
Notice: This permit application expires Ka permit Is not obtained within *Nee methodology set by Tri- County Building Industry Service Board.
180 days after it hos been accepted as complete. **Site plan required for exterior A/C units.
i:\Dats\Permit PormsWteePermitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested -3 AM PM BUP
Location / TOO 7 �a 1P Suite ST MEC 4:=Q670 (435
U<
Contact Person Ph ( ) <o �5� f _ 1 1" l PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner `�� 0.45 Ytj%O ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation 4 1 , ' "` 4 r
Drywall Nailing - -
Fi rewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Er
•
Roof •
Other: regralr 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
Rough -In
Gas Line
• • • - Dampers
- •ASS PART FAIL 41
Service
- ICAL _ r
;1 Rough In I ► ni �� ����I
UG /Slab ., W ( W ralp '��" MeV
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: E Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
JUN - 07 - 2004 MON 10:20 AM P. 003/003
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