Permit i? - /g/o i / c7 3' - i'r :- ' - ` ±- ri' -'(-).... .
4 CITY T OARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00783
Ai DATE ISSUED: 12/2/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102AB -00204
SITE ADDRESS: 09430 SW CENTER ST
SUBDIVISION: MARIELL ZONING: R -4.5
BLOCK: LOT: 004 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: 0 DOMES. INCIN:
3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replacement of A/C & furnace. 12/8/04, REVISED TO REMOVE A/C FROM SCOPE OF WORK.
Owner: FEES
KEMP, MICHAEL L + CATHY J Description Date Amount
9430 SW CENTER ST [MECH] Permit Fee 12/2/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 12/2/200
$5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 66578 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By
G
Permittee Signatur- T .'- ,_�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b 'ness day
08/21/2000 1 :39 FAX a002/003
r.
•
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Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received , 2 DV ��
13125 SW Hall Blvd., Tigard, OR 97223 1 '' Datday PormleNO „' - / I
Phone: 503,639.4171 Fax; 503.598.1960
��, , Plan Review �� / � 7 �
Inspection Line: 503.639,4175 �� ^I Duto/Hy OtherPen:rtit:
Intemet: www.ci,agard.or.us
_A �i • ` ! Date Ready/By; See Pape Z For
DEC 0 2 21 1- Notified/lvtedele:
NM
Supplemental reformation
• .:115: e . , r ', � �'i y ^ . j M s c. s, , �.�• m• ,s' � Y
..1 It,�. A ' . :;; ,i;� Pnisitlk 19 �"vI,WI '„ , ;t .*'..W , ,, �Pi .r 4 k 'commm
y rt:.;ti5 ' I„ I,T r , . iCii1]< , FEE* SC)IEDUL•,E - 'I1SE:'C}I CI¢,IST
❑ New construction ❑ Addi1V$WlQNrlt Mechanical permit fees* are based on the value of the work
❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
'
�a ;, mechanical materials, eq p fit.
,- : �� G, " � , � I,. � ^^ •I �+�y, . , �. , equipment, labor, over head, and profit.
ii, , ' iliF.1,0;'it 4 t00,t1. ,Q ,#6TION MII "I s, . I' iii; :; ;.,'.` :'iJ' l Valuer
! ?4 1 and 2 dwelling 0 ��
y Commercial/industrial ❑ Accessory bui ldin g x>�szD i TT EQUIEiV1ENT / SYS PEMS P1ElES"
❑ Multi family ❑ Master builder ❑ Other: For special lnjormatlon use checklist,
-
./6 it,a�1111L�,Y , .I'..�h. �t! C 1 ��I�y.�, + , r, {ry,� ,. Description Qy. Ea. l Total
+' Cis' , ,,d J " A l: ,:iii5 ;J'.'1 !iici tt% f..: -T4'r ,,,1 LOCA'fTOI!fi;, „ . '; I!. , °�;I_''' " ": Iieeting/cooling
Job site address: u 7 c) _c -) /` n ,,,$n Air conditioning or heat pump r
tC`� l �^ �^- ' (requires site plan inewin�placematio 1 14.00
City/State/ZIP: C' •}-__2 5 Furnace 100,000 BTU (ducts/vents) / 14.00
no - J Fumacc 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt.
J Project name:
Gas heat pump 14,00
Cross street/direccion9 to job site: Duct work - 14,00
ldydronic hot water system 1a,00
Residential boiler (radiator or
hydronic) 14
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc, 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax trap /parcel no.:
Other fuel appliances
; i t „,i v'' v: \ 1-17:./`G'i;n ",feDi. . ;jCTI .,, •O :\ 1{ 1 . . - ? - � S , ':�' " Water heater 10 00
Gas fireplace 10.00
t CI Flue vent for water heater or gas
1 i ti s p tA.C..4"71.-C41.1- fireplace 10.00
Log l hter�as) 10.00
Wood /pellet stove 10.00
s � � Wood fireplace /insert 10.00
eitr w� `�' . , Fl ? : o;.,., < i I' y ;'n Via ,', . .� 1�: Clllmne /flue/vnt
e 10.00
:,, 1. . 1
- . . C ';t�p!�Nr �1
i
L ,q i• .•� A ir• .b. � ii� .. ,i; _i .' u " iI ,
G 'Y � il.;� : �r � Other: 10,00
Name: (/V 1� /1 Environmental exhaust and ventilation
Address: f —`- J 1 �
Runge hood /other kitchen
equipment 10,00
City /State/ZIP: Cloches dryer exhaust 10.00
Phone: ( ) / 1g t,( �3 Pax: ( ) toilet exhaust (uathro
�t �4�� 'I toilet com.artimenrs, utility rooms 6,80
1 ;' ' '''• '.i" �l:i';i; N;:'�:'J, - 1;fp ':71 17ttP1,: v, ,'�'. ; ®. G ONr' I I I�' t!d :� A ttic /crewl8 ace fens 0,
, ((7]'- '-'"�r �t,'• a • , aU,,,�}�57A - ,IA�' 1 , p I 00
Business Warne: Other: 10.00 -
+ G L -C t' C. r Fart I lII,
Contact name: S 4, i S ` lA. fry, r'''' 12 S5.40 for first four 51.00 for each additional
Address: /4 �-L }-t e'-- `. i ( e -t- Furnace, etc.
Gas heat pump
City/State/ZIP: 1 I i CI, / `,. �.6 l .y. L r' . C1 'I- / O s ....
Wall /suspended /unit heater
Phone: (SD S ) l •ectricS f C �- + Fax :: ( 92? ) r e f i - G' ct I Water heater
E -mail: Range
tJ ,' I : ,` ,.3 . '.' ” r1 ' j, tU y t :Y �. 1 ., I li Same
. _Y � ,l� -�`�.i ,� •i L at , jp � v ,� }i : :, ,t} ,b �" , ^ '! ''i; Ii ` . li., I' Her
Business name: Clothes dryerr gas)
Address: - Other:
iy l,'1.1 hii'; ' ' h7,E,CHA.NIC I'ElthlIT PEE$!*'
City /State/ZIP: _ Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72,50) Q, hr
CCE lie.; 4 3 Plan review (25% of permit fee)
State surcharge (5% of permit fee) S ,f'0
TOTAL PERMIT FEE ii(, ) '
Authorized signature: �. r1� 4 -=��. t 1% - ice-'
Thiel permit Application e.<ptres Ira parmle le not obtained within LBO
/ drys after It has been accepted as complete.
Print name: l j et 4 ..-,' T,, ' r ' f-. -L. Date: • Fee methodology let by In- County Building industry Servico Hoard
isk >, PernrissllEC- Permimpp.dee 1743 4404517T(11/021cow/ real
08121/2000 15:40 FAX Z003/003
•
•
SITE PLAN
PL
1
PL
Pr-
STREET
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
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: • , ) 639 -4175
INSPECTION DIVISION Business Line: • 03) 639 -4171 MST
BUP
Received Date Requested a- —/ AM PM BUP
Location d -'`L `�- ! N Suite AE X y - - col 6
Contact Person ( ) ( ctD 3c'0 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC ('I
Footing
ELC
Foundation Access: 55 t.. lei ---
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: _ — SIT
Post & Beam
Shear Anchors b ---
Ext Sheath/Shear '
Int Sheath/Shear
Framing —
Insulation ` Y i n , \ � �` i 0--- — 5 2 4 /z?
Drywall Nailing U V V V
Firewall S 0
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: FD
Final
PASS PART FAIL
mgrs 3 ICAL
Post & Bea �L"
Rough -In
Gas Line 1 •
Smoke Dampers
PART FAIL
i
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El 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: El Unable to inspect — no access
Fire Supply Line r
ADA Z-/S-
- OS
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record fro ei______.
. Job site.
PASS PART FAIL