Permit f _ ♦ ee
CITY TIGARD MECHANICAL PERMIT
I' DEVELOPMENT SERVICES PERMIT #: MEC2004 -00674
��'I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/7/2004
PARCEL: 1S133CD-04900
SITE ADDRESS: 13669 SW FEIRING LN
SUBDIVISION: COTSWALD MEADOWS ZONING: R -25
BLOCK: LOT: 047 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: 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace furnace and install A /C. A/C unit cannot be placed within required setbacks.
Owner: FEES
RYAN VANDUSEN Description Date Amount
13669 SW FEIRING LN [MECH] Permit Fee 10/7/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 10/7/200 $5.80
Phone: 503 524 - 9350 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 72623
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.
I ' . .
Issued By: f V r 1 Permittee Signature: OA" - 7°/'G/
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Oct 05 04 07:15p TriCounty Temp Cntrol 5035570919 p.1
Mechanical Permit Apphcatio n - FOR OFFICE USE ONLY
.:1•/A
. 'City 04 Tig 5.rd Vol Received
, Dateay: (0/6/0X 444- EC,4040 V
',,, 13125 SW Hail Blvd., Tigard, OR 972 , ,_,..c„,..-
Pln Rie
.., Phone: 503.639.4171 Fax: 503.598.10i'
a Permit No./V 7X
evw
Other Permit:
Inspection Line: 503.6394175 va eLS\_‘.M.4 DateiBy:
Date Ready/By: JUil: 1 12I See Page 2 for
Internet www.ci.tigard.orus OC Notified/Method: 776. Supplemental informabon
iJi t oli t ti .. 4424 At: 4 0. 1 * .- .S ' Llik:Dt:TDE-'-i: - ESE10EI.ECICLIST
0 New construction X AddltiOgaeration/replacement Mechanical permit fees* are based on the valt e of the work
performed. Indicate the value (rounded to the nearest dollar) of all
• 0 Demolition 0 Other:
mechanical materials, equipment, labor. overl and profit.
_
;-::1'.'.::::::•-•:CATEGORtlr,',.OF0.C.ONSTWYMOW,Ip-s.,%'.-i '.';, - ....!, • =.;?i....:7..• .7;' • , - Value. S
.. ,t,,...:j3.E.Oippl,11TAL- EQ-UIPMENT. ISYSTEMS.FEES*
XI - and 2 dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
Multi 0 Master builder 0 Other: '
Description I Qty. I Ea. 1 Total
.::...:.•:‘• Ijii4it;01.140**.1140 ,-:',. . H eutinWcoolin°
fob site address: tatzew ratirairt- Air conditioning or heat pump
(requires site plan showing placement) I I i 1 4 . 0 0
City/State/ZIP: 118 V2120
Furnace 100,000 BTU (ducts/vents; II i 14.00
Furnace 100,000+ BTU (ducts/vents) 1.7.90
Suite/bldg./apt. no.: 1 Project name: •
Gas heat purnz 14.00
i
Cross street/directions to job site:
Duct work 14.00
1-1ydronic hot water system - 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc.
_ 1 10.00
1
1 Flue/vent for any of above 1 10.00
j Subdivisiort: .
1 Lot no.:
Other: i I 10.00
Tax map/parcel no.: .
Other fuel appliances
'.:%:'.....:...' ' '..cit: ".WOK .:c ::.•;.:,!i:.: i :-:..",‘, - r -.: • ....' ' . : • ' ' Water heater
I 10.00
Gas fireplace
FtP aCt f i fa 410 Flue vent 10.00 for water heater or gas .
fireplace 10.00
. Log lighter (gas)
: 0.00
Wood/vellet stove
,
0.00
Wood fireplace/insert 0.00
Chimney/liner/flue/vent , 0.00
''.' '''AiRoitier:y:76ciisigiez...,-,....4.:,,I;,:-:-.,.,„:,.a,:.;:ty::iii:uisif.c._,:.,..................-_ Other 1 i 000
•
Name: Nan. vanzuser) Environment exhaust and ventilation
Address:
eaotii--- , Range hood/other kitchen
equipment 0.00
Clothes dryer exhaust . I
I
City/State/2W:
10.00
Single-duct exhaust (bathrooms,
Phone: OtS) 024--42;ISO Fax: ( )
toilet compartments, utility rooms) 6.80
20'.,,-A.:iii,y6kii-to4,,.:',.':!'7:•?.-,:•:.-:)::: 1-2i-'0sriciii:::4*§.(*.,--..-; ,,:,. . Attic/crawlspace fans 10.00
Other: 13.00
_Business name: TO Cocin ty Tcmp Carii-0/ .
Fuel piping
' ReYW53
Contact name:
$5.40 for first four; $1.00 for each additional
ace etc.
Address: (zoo �. ciockairas Ritirr(brWO Furn,
Gas heat pump -
City/State/ZIP: ertgen Ci -tv C1 q 7045 Wall/suspended/unit heater
.
Phone: () 557.-- 2220 I Fax: : e,a3, 557-011q Water 'neater
Firlace
E-mail:
' Range
1$
' ''' '' -""'''::"-!‘'''!''''..... tit:Af ....' .".."- -.''''17.177".":‘'''';44".*-4?:''''' 4
''''''''' Y''''- - '`':' Barbecue
7 ',..:T , : , Dri . r.-: , ::::$-- a: --- -i;•.:!;:' . :,,:9i:.=:-.::- -- i , ::L:.i:; - -7rf.CP§?., -c -4 -,,.--,':. 7:'
Business name: iri Coun Terry Cnyrtrol Clothes dryer (gas)
, Other:
. I .
Address: PASO G.Sk mos RiVci ,,,,-- : - .71 „. ...ii7:;:::%::Figi'aiiiAmitizAh-:- , iiki-:..' -
city/state/ZIP: Ortaarri ok._ (1.7C45 Subtotal,
Phone: ( 55 I Fax: (0
657 -Oct H Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.. 72te 23
1 State surcharge (8% of permit fee)
'
c TOTAL PERMIT FEE
Authorized signature: I
„67atary..._______
This permit application expires if a permit Is not obtained within 180
days after It has been accepted as comple e.
Print name: _bitzi-Le Alta,564 1 Date:114 i lie I
I • Fee methodology set by Tri-County Building Industry service Board
1:NBuilding‘Pemtas \ MEC- Pennit App. doe i 5/03
440-4617T ( I 1 / 0 2/COWWEB)
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CUSTOMER INFORMATION
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ADDRESS
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PLEASE REPAX APPLICATION WITH SITE PLAN.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested / r AM PM ! - CZ) BUP
Location . / 3&(a G - . r Suite er--.7/)6 —CO 6 7
Contact Person Ph ( ) PLM
i
Contractor Ph (. ) SW .
BUILDING Tena , • / r i3 { q - .�(o�v(. vu) c 0°66
Footing 3 i g A/36) ( �) ELC
Access:
Foundation � j n ‘r s' /o0 Ftg Drain �/A=�- + `-- � J S/ ,/" .
ELR
Crawl Drain /
Slab Inspection Notes: -_ 7 ./ ' SIT
Post & Beam - (--g--/-044-, - • .1
Shear Anchors
Ext Sheath/Shear cQ"O ( '. ' :/ V_ - 1 L � vi7 — tear /_ G � a '�
In sulation Ft) 2Z-- A 7 0> -��
Drywall Nailing
Firewall r ®� _- _ t7LL`�3C7
Fire Sprinkler f
Fire Alarm
Susp'd Ceiling
Roof k --- I/� .11 j�
" 6 /A fr1 A`� 3 e7
- Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam ' _ - ��\
Under Slab .
Rough -In ,�(7 ``
Water Service � \*
Sanitary Sewer 01111 ii
Rain Drains -
Catch Basin / Manhole
Storm Drain
Shower Pan - ___ _ .
Other: ..„
Final
PASS PART FAIL ,� � _
MECHANICAL
Post & Beam , ` ' (/ Ced
Rough-In
Line
G
a Line
Smoke Dampers
40 PART FAIL
CTRICAL
Service
Rough -In 12 .G
UG /Slab 6 r�,
Low Voltage t? \ '
Fire Alarm �
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
tom'' PART FAIL
E ❑ Please call for reinspection RE: / 0 Unable to inspect - no access
Fire Supply Line
ADA I
Approach/Sidewalk Date / g. 0 Inspector Ext
Other:
Final DO NOT REMOVE this inspection reco • ron1 the job site. /
PASS PART FAIL
/