Permit s DEVELOPMENT SERVICES CITY OF TI CARD MECHANICAL PERMIT
PERMIT #: MEC2004 -00198
DEVELOPMENT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/20/2004
PARCEL: 1S135AA-01102
SITE ADDRESS: 10360 SW 90TH AVE
SUBDIVISION: TOWN OF METZGER ZONING: R -4.5
BLOCK: LOT: 019 JURISDICTION: TIG
CLASS OF WORK: ALT 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: Furnace install.
Owner: FEES
MACLAREN, ROBERT P Description Date Amount
10360 SW 90TH [MECH] Permit Fee 4/20/200 $72.50
PORTLAND, OR 97223 [TAX] 8% State Surchaq 4/20/200 $5.80
Phone: 503 245 - 3433 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 66578
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. k�
Issued By: 1,14,,, , ��G�� Permittee Signature: £
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
•
.. r Oat RcceivCd I Mechanical
e/B :
fermi N �_ • 0 —00/f 4r
City ( if Tigard • Planning 0
aai Building ding
x3:.25 S Hall Blvd. °' �/ Permit No -:
P )T
Tigard, Oregon 9722 -' V E� Other
Phone: : ;03-639-4 171 Fax: 503 - 598 - . Permit No.:
�b Pout- Revie Land Use
t
Internet: www.ci.tigard.or.us EW �` s° I �'''' '
g r o w . y Jll+ ontac Case No.:
24 -'tour : nspection Request: 503 -639-41413 -- -- - '=" 1 ---* N ® Sc Page 2 for
e/Method: >f1 Su ee Pa a Information.
310N
TYPE OF WORK COMMMERCIiAL FEE"' S
�;' New construction Demolition CI�bT3I.E' USE CF{LCKLIS
Mechanical permit fees* arc based On the total value of the work
❑ .Addi : ion/alteration / replacement Other: performed. Indicate the value (rounded to the nearest dollar) of all
_ .__:__CATEGORY OF CONSTRUCTION • • �"
chi mechanical materials, equipment, labor, overhead and profit.
ta i - Family dwellin Commercial/Znt dustrial Value: 5
See Page 2 for Yee Schedule
IN ace sory Buildin Multi-Family RESIDENTIAL EQUWPMENT /SYSTEMS FEE* SC:ki,EDuLE
❑ lviasts:r Builder Oth is Description 1 Qty I Fee(ea.) 1 Total
::O.K SITE INFORMATCON atid `LOCATION Hearin • Coolin*
e, 3 ( u SLR C' 04 Furnace - add -on air conditioning ** 14.00
Job Site address-
Suing _ Gas heat pump 14.00
• Bld /Apt
. #. Duct work
Pro N ame: 14.00
l dronic hot water system 14.00
Cross strcet/Directions to job site: Residential boiler
(For radiator or h dronic s tem) 14.00
Unit heaters (fuel, not electric)
_(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) �_ I 10.00
)n: Repair _ � Lot #: p r units i 2.15 '
Su bdivisi
Tax ttm%� parcel #; Other Fuel A. fiances
_. .. - DESCRIPTION OF WORK .— Water heater_ 10.00
Gas fireplace 10.00
,` Flue vent (water heater/gas tireplaeG) 10,00
�- ��� ■ . - _ Lot; li (as . .
10.00
Wood/Pellet stout 10.00
Wood firc•lace/insert 10.00
I PROP OWNER Oter: Chimney/liner/flue/vent 10.00
� " r ANT Ocher:
Name:
Environmental Exhaust & Ventilation
0.00 ,
Range hood/other kitchen equipment j 10,00
Adar:ss: 5.-- .9.--..
Cit /;date /Zi Clothes dryer exlmu.% 10.00
Phont: aLt — ay 33 Fax:
—
Single duct exhaust
• APYL)IC, tNT (bathrooms, toilet compartments, `
d'C ONTACT PERSON'. ;':'• uti lity rooms)
Name: 6.80
Attic/crawl s.ace fans 10.00
Address: Other:
l o.00
C.iry /��tatc� Zip: Fuel Pi .in
Phone : - `_(55.40 for first 4. S1,00 each additional)
F ax: Furnace, etc.
E-mail: Gas heat pump ,,,
CViV1'RACTOR Walhsuapcnded / unit heater .,
Business IN aIrir3: Water heater «,
S �` C..� - +�C ,•f - y Fireplace «s
Address: j'(„ C I �.-
City /State / ri f Range R«
I s. l S t cv --,-e, . t i- • l CBQ _ 1 .«
Phone - C L L ).- Fax: __'! Clothes dryer (gas)
L 1- 53 Other: I «.
(� ta: s -
CC$ I,ie. h:
Authorized - --- Tonal:
Signatures: C l �� t� 4-'—.... t (� Mechanical Permit Fees*
Da[e; V� (0'1 _ Subtotal: TS
�1 F,3L'' -, _ 1 i e—, Minimum Permit Fee $72,50 I S
Plan Review Fee 25% of Permit Fee) S
(Please print name) State Surcharge (3% of Permit Feel S
TOTAL I'ERM1 Ft*E j a U
No This per nth application expires it a permit is not obtained within 1 ' r 3 vice Board.
130 days after it has been accepted as complete. `Fee methodology set by Tri County Building Industry Ser
i :\Dsts\Pennit Foi ma\MecPermitApp doc 01/03 "Site plan required for exterior A/C units.
2 • d BTLO BSS EOS uizeaH �aietoadS dEStZO 470 6T ,add
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MS
BUP
Received 17 q Date Requested = 5-1 q AM PM BUP
Location /0 / () �� A-r) Suite MEC ) CO
Contact Person Ph ( ) PLM
Contractor , r • Ph ( ) SWR
BUILDING Tenan 41140 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 ---- f re.e �.�� —�
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
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 PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Fi
RT FAIL
L CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: 111 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