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Permit CITY OF TIGARD MECHANICAL PERMIT A, DEVELOPMENT SERVICES PERMIT #: MEC2004 -00777 *ONO A SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/1/2004 PARCEL: 2S112CA-08800 SITE ADDRESS: 07546 SW ASHFORD ST SUBDIVISION: RENAISSANCE WOODS ZONING: R -7 BLOCK: LOT: 014 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: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Gas line to range. Owner: FEES VALENTINE, DARNELL Description Date Amount 7546 SW ASHFORD ST [MECH] Permit Fee 12/1/200 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchar€ 12/1/200 $5.80 Phone: Total $78.30 Contractor: COLUMBIA HEATING & COOLING INC P.O. BOX 230397 TIGARD, OR 97281 REQUIRED INSPECTIONS Phone: 503 624 - 2704 Gas Line Final Inspection Reg #: LIC 76359 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: . ��Z� Permittee Signature: S P � % Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Dec 01 04 10:24a PAM DFILBY _ --- • • - 503-598-0270 p . 2 Vlechariica11Permit A licatio vdTigard, OR 97223 FOR OFFICE USE ONLY Hall — ------- ---- -- - _ C ity of Tigard 1111+. 4 11 REG Received ,. 7 i _ Dateil3y: i All Peri 6 '......, goy-, 077 131 SW Bl, _ / Plan Review Phone: 503.639.4171 Fa: 503.598.19 Da & Other Permit: te/By: Inspection Line: 503.639.4175 tEC 01 1 ‘941411qit Date Ready/By: In El See Page 2 for 4,44. .....a Internet: vn.,--w . .ci.tigard.or.us NotifiedNethod: Supplementat 1 nformatio n ,,,,,, ... . a liGirap , ',,,, ':' A".'-':',•.!.F0i.!1'jt''-,.;:-Ei7...1• ' ...!i;:,•54.:•il'.,-'::,*,,,I.,.;:lA ., ': "eg.,V; '.,,.. .41014;:si,. :,,,,,;i:;4;,S..!‘:,::-.';iVl;T.::,.til,4'. :tc:-'61sowp.crALL...TW ,SOFIEDULE. — IJSFiCHECKLIST , Mechanical permit fees* are based on the value of the work _ 0 New construction 10- Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) a; all 0 Demolition 0 Other: mechanical materials, e•ui. rnent, labor, overhead, and profit Value: $ ,!61ft64"1g,'416Witi614#01(*. ::::.:Cc! i il '..f.'.;;■: .;:.1,1V'.'''' '::::::...::: ::',': , . , • . ' ,... ' ......'.', ' , ' . . ' . .: .. . ' ' • . . • • . : SY STEMS ' FEES. TSJPAI.CPg.g/,•Ec2,14PNEEN.T. / k5:1 and /-family dwelling El Commercial/industrial 0 Accessory building For special information use checklist. \ E Multi-family 0 Master builder 0 Other: Description Q. Ea. Total • - .. --..:.,.', :.:,:-.. ;.- •,::.i.I.Icjii•-.§10W*.404•0iii*):::464tif, C40.5:iI,.6: •', .,yi..I...../._,7,:.! Heatin t coolin Air conditioning or heat pump Job site address: 5 • / / =-•'-‘). 5 re•uires site .lan showint •lacemeno 14.00 • City/State/ZIP: Furnace 100,000 BTU (ducts/vents) l 4.00 I ' Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bIdg.lapt. no.: Project name: . . 14.00 i Cross street/directions to job site: Duct work 14.00 I i . 1-I dronic hot water system 14.00 Residential boiler (radiator or I Is dronic 14.00 Unit heaters (fuel not electric), 1 • in-wall, in-duct, su •ended, etc. 10.00 Flue/vent for any of above NO 10.00 Other: 10.00 Subdivision: Lot no.: Tax map/parcel no.: Other fuel ices t _.• ;;•.- ,..e ..' : ".......11:1:0'&1:,;;;,' . ";4*'27'!"-:-:74-MO.kii.145-t•r;** V W-catit4t,y.f,; . . .4:::A..,-k 10.00 •'• IEMEIIIIIIIIIIIIIIIIMIIINIII 10.00 _ 0 Flue vent for water heater or gas I fire .lace 10.00 • Lo: )ithter :as) MI 10,00 I wood/•ellet stove 10.00 riogiiiiiisinion 10.00 IIIII 10.00 ! .,,,, ,, ,,,,,,,...,„ .- . r , ,.:.,,_;,,,.,,,,,„ , . - , ; :::,„.c;+ ‘:i i,..: :'";,%• "i- ...:,:..',,Ai-)4i.•,,F !,,,Y,I=0.1.R.':,..C).-;,,,''.1'2:V.,.,.. :;'... ?,.,,,N.t.';,;f=?1,-w-!,..-:?:,:77.:1:,-i:-...........:•.--:,=.'.4-4, tIA,-.:'..; Other: 10.00 Environmental exhaust and ventilation AI 4 i Range hood/other kitchen Address - t• -d -I - 4t --- 0,-7 -5-1; e.ui.rnent i 10.00 City/StateiZTP: Clothes dryer exhaust . 10.00 .. . Single-duct exhaust (bathrooms, I Phone: (i 6 ,2 v 1 7. - q , toilet corn.artments utilit rooms 6.80 10.00 :.'..'''.P.•`k ;.i.,;','''',!:;Efita;aiii'CUi 1 ":.:;X ' 4:;:. ' S'... ' ,",% : ;',:i . : 1;g1X+ . e:04.0E. . 1i . 6 10.00 Other. 1 Fuel shin! Business name: Contact name: i /+/ 0/9-/I, $5.40 for first four; $1.00 for each additional Furnace, etc. Address: City/State/ZIP: Wallisus.e-iiiiimumil Pho ( ) ,- • Fax: : ( . 0 )3 ) 5 ( 0 :- / lliallW Ili i..i ;-li Al:f...,:rgi7t5/.:..t.:,:„' Barbecue Clothes d er :- s) Business name: C i. , ."..f ,e, bek,,, 74-e._,C)-7-7p.JC„, •-•,-- (...,0 e* 4. i Other: Address 0 0 0 •R 3 3 .7-7 . . . iVig6iviracAL . Cit.),,'/State/ZIP: -• Subtotal / .2 ' /I Oa-. 4......1. 4 Minimum permit fee (S72.50) „.2.:) Phone: 4, ) (.„, , 0 ) - :" 6o/ '? Plan rev es — Fax: ( , iew (25% of permit fee) CCB lic.: 7 (... - State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within I Authorized signature: 4.-27--.-e.0----P--- 62 days after it has been accepted as complete. Print name: ' Ad c _... 4. ,0PW 6 Date: / Z..--- cy" * Fee methodology set by Tri-County Building Industry Service Boar , A.,;Idina \PcrmitS \KEC-PerrnaApp.doc 12103 440-46177 (11/02/ CO NYWEB ) 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 w' ,:. Suite (Iii 41-607 7 7 Contact Person ( cti✓Vl , Ph ( ) ' 2 q -D-7041 PLM Contractor Ph ( ) SWR • BUILDING Tenant/Owner 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 64 i� —,�iLr i "I ©iV 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 Other: Pan Other: Final PASS PART FAIL MECHANICAL ) 11 1../)1 )1 %% Post& Beam Rou•h -In 9 r. ©ii )1. Smoke Dampers • Fin - PART FAIL EL 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 ❑ Please call for reinspection RE: Ei Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date /Z '^ 3 ' G Inspector Ext Other: Final . DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL