Permit CITY TIGARD MECHANICAL PERMIT
,,,i4' DEVELOPMENT SERVICES PERMIT #: MEC2004 -00690
� I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/18/2004
PARCEL: 2S111 CD -10600
SITE ADDRESS: 15795 SW 98TH AVE
SUBDIVISION: KEVINGTON ZONING: R -4.5
BLOCK: LOT: 007 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: 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Remove & replace gas furnace.
Owner: FEES
KROUTH, DENNIS A + NANCY H Description Date Amount
15795 SW 98TH AVE [MECH] Permit Fee 10/18/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 10/18/20( $5.80
Phone: Total $78.30
Contractor:
WESTERN HEATING + A/C
14314 SW ALLEN BLVD
STE 220 REQUIRED INSPECTIONS
BEAVERTON, OR 97005 Heating Unt Insp
Phone: 647 - 5808 Final Inspection
Reg #: LIC 76978
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: ,7 , � r Permittee Signature: e Ca
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b day
FROM : WESTERN HEATING & COOLING INC. FAX NO. : 5036259478 Oct. 15 2004 10:17AM P2
MechapicalTermit Application FOR OFFICE USE ONLY
City of Tigard Dates i5 / / X Permit No r/D y eib i 4 JO
13125 SW Hall Blvd., Tigard, OR 9721 i `'' t _ Plan Review
Phone: 503.639.4171 Fax: 503.598,19 0 7.6 : . 1 i I , Date /ay: Other Permit
Inspection Line_ 503.639.4175 '1 �j . _ Date Ready/By: Jurist 123 See Page 2 for
Internet; www.cl.t1$ard.gr.us l• . 3 Notified/lvletlad r )� Supplemental Information
`. . ice : k"-,� ` �d y 0 11-4` „a ' `T �7 f i i`,'. > sr .. 5 ` rY it . •r ¢, ., � r• " , CEE1),11I1E E - 'VWelEfE €'KEAST � °•�i ...�� r. J.., -,� . r. , •- ;1. . ":-.. VY "n .......- .,:k•: a �. � �. �7 , �'! ` - ...
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❑ New construction Addition /altcratiof/replacetttetlt Mechanical permit fees are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, c•ui•ment labor, overhead, and •rofit.
- n°r'.: » • 1 �: r,'�nc� mr r.••A rti ; J : � c:
w1 r .'.i'"t ' •F � ,'. It. ` � yr`�k' r.''.' ,•S a �yi i• -•. '�: u S
a 4 „ ... 'ilr,.,ra rA F n,..: • r, .rv d._• r ; Val i, ^ .a::.¢, .�l�E>S`
L 1- and 2- family dwelling ❑ Cornmercial/industrisl ❑ Accessory building s: • ":1' a .!..::1::4t1 e ,, j g)` :f $, E 'S�
Far special information toe checklist.
❑ Multi- family 0 Master builder ❑ Other: Description Qty. Ea. Total
air;� y • r� �e 'ti h4 , . °i ' ,... "8p
+ Ig8 e i E y� r. - - it " S .; eP "::. -
, ��/!���'s t � �.,7, ! 1�, p��) � � �`; 'i^' EEeatin• rnolin•
4', : • >„,, �'..1 �' " �:aa s � �4td:�3Y .�n'al::i� ".a . .d ...r. 5,�
e Air conditioning or heat pump
Job site address: /S S A s i , re• uirei site .Ian ahmv',, • , lacement 14.00
City /State/ZXP: - .. 0 1 , y Furnace 100,000 BTU ducts/vents) ,M 14.00
Furnace 100,0001 BTU deeu/venrs 17.90
Suite /bldg- /apt. no.: Project name: Gas heat . um. 14.00 ® .
- Ctogs 'sireetrdittathrns to-job-site; - Duet work=:-'..- ... - - 14.00 NINE - -
H sonic hot water S stem _ 14.00 am
Residential boiler (radiator or
h ., tmic III 14.00 i l
Unit heaters (fuel -type, not electric),
in - wall, in - duct, s • ded, etc. 10.00
Subdivision: ( Lot no.: ther:
O ent for an of above 10.00
Other:
Tax map /parcel no -: Other fuel a • • Lances
nrp ' ;7 •"'' ?4' -^ Water heater 10.00 —
� ,i�4"`' air -°'+ to • Y , a I Y 07 7`�= R 1i'� ar , H 5 �S,<,, ,f` 1 i• ' , 4 - .',y, . a' :
.t. �ti7' r..iKi.A�i .t'•'m�, k• , . �,r"2.:'B"ti �M„�,N RN,Ywi n,'!'�' - �..1,7e k><3ucl *�C'L 10.00
?t 7 7/ r ,Q X F 7 Flue vent for water heater or gas
r ` i�' 4' fir •lace 10.00
Lo • li titer _ : ' IIIIIII 10.00
W • • • llet stove ' _ 10.00
_ Wood fir • lace/insert 10.00
t,, �'..^�,�j , , Chimne /liner /flue/vent _ 10.00 —
, , ,j 'r t ' l i '' ...,1 I �• i r {�F ,• ;1�zs 7.: "9 : 1 ,, ,t � A` ,E.: .. A ...... . •Irt�. ` . f ., t! Other: 10.00
Name: • if / ` 0 .7".-s - Environmental exhaust and ventilation „
Pm Range hood/other kitchen
Address; `-' T .. ' - inte • u .merit 10.00
City/State/ZIP: ./71 - 0 IL Single -duct exhaust (bathrooms,
Phone: ( ) 5- ' 'Q 9 Fax: ( ) toilet corn.:rtments, utili rooms 6,80
Y "�� r�, "` " " t'1`5i`- rs " Wig'"- , I a '� - y,�'" • ts` Attic /crawls• ace fans _ 10.00
Business name: f i,„:aSr /7, M
Contact name: ,1 9 c it / l s-e), " /
$5.40 for first four, $1.00 for each additional
Y 3J L _ Furnace, etc.
Addre55: , //_._ E . , .,.
City/State/ZIP: i A i L a. Wall/su •ended/ unit heater lor
Phone: ( ) ' / —,� P i Fax: : ( ) - r
E -mail: _ �
ran " .� a ttt���,",� ca " , �r rK'j� `r 71 '' , ..1 �+{ 4, ~• ! 1 . k4%14 i Barbecue
e• 'J..q 1 .�hwk.7• ]FDAy:•. •XJm1^Fa� "ISS!i' y l i ,,Y,.l:. 4, ... ,_. . . t.'i.0
Clothes dryer :as
Business name: --7 O t h er:
Address: - A
s.ba
Subtotal
City /State /ZIP: - Minimum permit fee (572.50)
Phone: ( ) Pax: ( ) Plan review (25% of permit fee)
CCE lie.: /
' 7,2 State surcharge (8% of permit fcc)
sC� TOTAL PERMIT FEE 166,4E-Zi
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: ' P - - , .4 Date: (2... / • Fee methodology set by Tri -County Building Industry Service Board
5!
. ,...i,._�n_:ua.rcr .,..+.AAA IN(19 440-4617T(tl/02/COM / wEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
d BUP
Received Date Requested 1/ — /O AM PM BUP
Location /5 7 9 Suite d y-666,
9d
Contact Person Ph ( ) � 0 7 7 's8`a? PLM
Contractor Ph ( ) SWR
BUILDING Tenant K ELC N �'
Footing vv
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear / 41I ./A1 / 2> 9 r �56 oZ
Int Sheath/Shear v /
Framing /(
Insulation — r
Drywall Nailing
Firewall __
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL - y
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P S_ PART FAIL
ECH AL 4 LA
Po Beam
Rough -In
Gas Line
S.. •- a Dampers
PA = PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final j Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA ! J /
Approach/Sidewalk
Other: Date L / / � l Inspector (� Ext
//(
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL