Permit e
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00282
..�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/14/2004
PARCEL: 2S 110AB -06200
SITE ADDRESS: 14340 SW 114TH AVE
SUBDIVISION: HELLER PARTITION /MLP2003 -00007 ZONING: R -4.5
BLOCK: LOT: 002 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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 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 with duct work for range, dryer and bathroom exhaust.
Owner: FEES
HENRY, DIANNA Description Date Amount
14340 SW 114TH AVE. [MECH] Permit Fee 5/14/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 5/14/200 $5.80
Phone: 503 849 - 6465 Total $78.30
Contractor:
KENTEC HEATING CONTRACTOR
PO BOX 233
WOODBURN, OR 97071 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 63621 Heating Unt Insp
Duct Inspection
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.
ZS
Issued By: %oh- Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application ► ( )R O1 ► ►( ► ► s► t )\ ►.\
Cit of Tigard Receives
13125 SW Han Blvd, Tigard, OR 97223 Date/BY - i T / ! I Permit No. J .� �. J/,.- — 00 •
Phone: 503.639.4171 Fax: 503.598.1960 Plat
» Date/By: Other Permit:
1 Inspection Line: 503.639.4175 - s ,� J� Due Ready My: a See Page 2 for
Internet www.ci.tigard.or.us .4. - Notified/Method: ' Supplemental Information
.c 9
p pmt fees* are based the value of the work
U New construction El Addition/alteration/replacement
Other
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition mechanical materials, equipment, labor, overhead, and profit.
Value: S
®.1 and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building t i
I] Multi- family
For special information use checklist.
❑ Master builder ❑ Other: Description, I Qty. I Ea. I Total
a' ; Hatirlp/cooling
Job site address: l"! l `l d s HA 4 V (requites site conditioning n g showing Placement) _ 14.00
City/StaterEP: —6- r,,i G /Z 9' 7 (;)-a4 Furnace 100,000 BTU (ducts/vents) / 14.00 jy• et)
/ Furnace 100,000+ BTU (ducts/vents) 17.90
SuiWbldgJapt. no.: I Project name: /e r y Gas heat pump 14.00
Cross st eet/directioos to job site: ' // t fh S tkie.Qy) , // �,/p�,h�, Duct work 14.00
p Hydronic hot water system 14.00
a4,, C 6a ,4 Residential boiler (radiator or
• hydronic) 14.00 _
Unit heaters (fuel -type, not electric),
. in -wall, in-duct, suspended, etc. 10.00
•
Subdivision Lot �.: Flue/vent for any of above 1 00
Other: 10.00
T . mat./parcel no.: Other fuel appliances
` Water heater 10.00
/ / / Gas fireplace 10.00
H S �ct-7/ . c' Q S /art./ r ` t a ee lit e- td a PC1 J / Flue vent for water heater or gas
C C. / G t. - 6a-5 /".g._ J J .-1,---e...-e- fire ) 10.00
Log lighter (gas) 10.00
• Wood/pellet stove 10.00
Wood fireplace/insert -. 10.00
•
1 Chimney/liner/flue/vent 10.00
` Other: 10.00
Name: Q / ek_nn „- f r Environmental exhaust and ventilation
Add ss: / 4 (v S G✓ /‘t/6.1 V e , other kitchen I . 30.00 IC .00
City/State/ZIP: "7"; ` A.ve) / d '7 7a21 Clothes dryer exhaust I 10.00 10 .0° °
Single-duct exhaust (bathrooms,
Phone: (So3) ¶ - , q65-- Fax: ( ) toilet compartments, utility � rooms) d- 6.80 ! 3 �0
. :/t Attic/crawlspace fans 10.00
Business name: I /6 4 , „jQ C p ,` lo.00
- r ` Fuel piping
Contact name: /4 �,L . freita v $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc. i 5, N
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phony ( 6 ) 2 j0 - 9 7 — Fax:: ( ) Water heater
Fireplace
,maxi: .. Range
// �[ Barbecue
Business name: / I c-- Heidi ,� J i Y C d (gas)
Address: /). /aX )333
City/State/ZIP: ti)004€b (A_ r l�t Q/ 2. / /0 77 Subtotal 52 .0(3
I Minimum permit fee ($72.50) _ 5 - '0
Phone: (sue) ?g a - 4 . 7 0 0 - I F a x : (S03) ` 7 8' P — 6 . ) - ? z , Plan review (25% of permit fee)
CCB lie.: 36 2. / State surcharge (8% of permit fee) S' , �O
TOTAL PERMIT FEE 7 S,' 20
This f.U@L rued signature: -01 - -01 is p ermit applicstiea expires if a permit is not obtained within 130
days after k has been accepted u sampkte.
Print name: /� ( t f f I Date: cr. I (/ - • Fee methodology sot by Tri- County Building Indust, Service Board
CITY OF TIGARD". - 24- Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
1 BUP
/
Received & i I 0 Date Requested I 0 LI AM PM BUP
Location ` 1' y1 � � t —� l Suite MEC
Contact Person k I & i' -) Ph ( ) b 7 (' ' 1 c LM
Contractor Ph ( ) -5-57) =� "� � ` WR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Ii SIT
Post & Beam l J
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear � ,� C 1 / •
Framing �g (7 Y
Insulation yyt
Drywall Nailing ' -� r � I •
Fire wall i � ,
Sprinkler Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 45640/104 641 ./J . i /-(,703 - 00OCq
PASS PART FAIL CS � � 2 � � �
PLUMBING J
Post & Beam
Under Slab
Rough -In EL5 2
c GT71 CA- /AA- 0 ( 4� L . tom !4 7 4 c
�s
Water Service g"
Sanitary Sewer
Rain Drains
Catch Basin / Manhole a �� �< <� S t ,�-St = Z4 �• L F S�
Storm Drain
Shower Pan Gf C2/11« *.- 4 q 411 7
Other:
Final
PASS PART FAIL
MECHANICAL rp
Post & Beam ��
Ro
Smoke Dampe
Final
PART FAIL
ELECTRICAL
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 fl Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date o�— c * Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL