Permit CITY TIGARD MECHANICAL PERMIT
• DEVELOPMENT SERVICES DATE PERMIT #: 4 -00345
ISSUED: 6/4/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S114BB -16700
SITE ADDRESS: 16312 SW 103RD AVE
SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7
BLOCK: LOT: 013 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC install.
Owner: FEES
ARTHUR, MIKE Description Date Amount
16312 SW 103RD. AVE. [MECH] Permit Fee 6/4/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 6/4/2004 $5.80
Phone: 503 696 - 9916 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Cooling 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.
Issued By: �_ / !� Permittee Signature: / �•/ /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
M ckl!Ileum Permit 4pp1ica Received FOR OFFICE USE ONLY
}
/ , Mechanical A/��� j
�✓ V Date./A 7 / Prrmit No • u __ ., �d !601:3 /"r
e 1>1 O "CI and rG, Planning pp .vat Building
l � iv Date/By: Permit No.:
13125 SW I Ia11 Blvd. ., t Plan Review Other
Tigard, Ore;;on 97223 Date/Jaw,: Permit No,
Phone: 503.639 - 4171 Fax: 503 - 5981 . _ * Post - Review Land the - -
. Datc/B 1 Case No.:
Internet w vw.ci.tigard.or.us OF ■ _t t '_\! li Contact Juris,: e See Page 2 for
24 hotr Inspection Request: 503 639€111V3 NameMfethod: 'C Supplemental information.
TYPE OF WORK COMMERCIAL FEE* SCIEDULE - USE CFIECKLIST • .
n New cc nstruction ❑ Demolition Mechanical permit fees* arc based on the total value of the work
ri A /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
'CATEGORY OF CONSTRUCTION :.' . mechanical materials, cquipmcnt, labor, overhead and profit.
❑ 1 & 2 -f amily dwellii ❑ Commercial/industrial Value: S See Page 2 for Fee Schedule
MI Accessi iry Building LJMulti- Family RESIDENTIA,L.EQUIPMENT /SYSTEMS FEE* SCHEDULE -
❑ Master Builder ❑Other: Description 1 Qty Fee(en.) Total
�--.. Cooling
JO B SITE INFORMATION and'LOCATION • • - . Furnace - aton air conditioning)* { 14.00
Job site acct tress: Z S z,..1 I 0 ? Gas heat ou — 14.00
Suite Bid 7./A t. #: Duct work 14.00
Pro t'C i Nlt) nt : Hydronic hot water system 14.00 .
L- -- °--- -" Residential boiler
Cross Stree:/Direetions 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 any OF ahnvc) 10 00
Repair units I 12.15
tlbdi .tstoe 1: ^�
S Lot #: Other Fuel Appllauces
Tax map /p; cruel #: Water hearer I 10.00
DESCRIPTION OF WORK , • Gas fireplace ! 10.00
Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) l 10.00
� Wuud/Pellet ]LUVC 1 10.00
Wood fireplace/insert I 10.00
Chimney/liner /flue/vent I 1 0.00 • PROPER ry OWNER I 0 TENANT '. .. .. Other: I 10.00
Name : Environmental Exhaust Si Ventilation
- °--^ - Range hood /other kitchen cquipmcnt 10.00
Address:
Cit /State,'Zip: Clothes dryer exhaust j 10.00
Phone: ���; Single duct exhaust
(bathrooms, toilet compartments,
• APPLIC. LNT ' • . • f CONTACT:PERSON. ' utility rooms) 6.80 _
Name: I i Kt. ...,,,,-- Attic/crawl space fans I 10,00 _
Address: Other: ! 10.00
Cli f�itilte. Zi Fuel 1 . 1 1 0 e
� p; ""155.4U tor �irst 4, slaw each a ctitional)
Phone: Iv .1 - ° 1't ( 1, Fax: Furnace, etc. I **
Gas heat pump *"
E- mail: . wall/suspended'unit heater I •`
_ CONTRACTOR :.., • :.. _ Water heater **
Business Name: S to` L (c_t t -t� i c.. - H l r\e, Fireplace � **
Address: 1 t S�_ i v Q- r ' -� E J Range ` BBQ I .*
C1 /5i tatt;,'Zip: I #1 i ( s I � C '- ( 0 1 h 2-T Clothe d ( G ag) i ^•
Phone:: _ -j o , S C } Fax: 147&' I - O M 5 13 Other: ..
I CC__B Lic -'#: (`, j' - Total: I
Authorized M echanical Permit Fees`
Signature: r t' -• •'�-� � C ' 1 ' _ Da te: / z l ' a CI Subtotal: _I S
Minimum Permit Fee 572.50 i S . SU
I L I-...._' L I c e.. — , Plan Review Fee (25% of Permit Fee) I S
(Please print name) State Surcharge (8% of Perini[ Fee) ! S . Y . °
TOTAL p_ peMIT FEE_ LS '�-Q(. 3 _
Notice: This permit application expires if a permit is not obtained within 'Fee methodology set by Tri- County Building Industry Service Board.
1110 day; after it has been accepted as complete_ '*Situ plan required for exterior A/C units.
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Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
E'd BILO 86S EOS ZuizeaH 6ziezoadS e60 :L0 Iwo 60 unf
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ( ` AMJ4 BUP
Location I — 0 - 3 �1.4 U
Suite MEC — �
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR /
BUILDING Tenant/ ELC c b . — k.S3
Footing 63 6 9 ELC
Foundation Access:
Ftg Drain A\ C. ELR
Crawl Drain V'
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear Y1 � sLi
Framing f `"
Insulation ki 1,4 6-19
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
P T FAIL
AAE
Post & Beam
Rough -In
Gas Line
oke Dampers
PART FAIL
Service
Rough -In /
UG/Slab
Low Voltage
Fire Alarm
ina El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
E Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line 1 / ///
ADA Approach/Sidewalk Date 7// 7" Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL