Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00432
� .��)'. DATE ISSUED: 7/1/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134DC-11400
SITE ADDRESS: 11490 SW GALLO AVE
SUBDIVISION: CASCADIAN PLACE ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A /C. Do not place within the required setbacks
Owner: FEES
JEFF CORDILL Description Date Amount
11490 SW GALLO AVE [MECH] Permit Fee 7/1/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 7/1/2004 $5.80
Phone: 503 267 - 0830 Total $78.30
Contractor:
SKY HEATING + AIR CONDITIONING
1637 SE NEHALEM
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 235 - 9083 Final Inspection
Reg #: LIC 50244
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: ( � -i4'/ Permittee Signature: , /' i „ /
Call (503) 634175 by 7:00 P.M. for inspections needed the next business day
4 ,6, /t � ` Sky gating & A/C 5032350454 p.2
Y w � \
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tanical Permit Application re �7��` FOR OFFICE I'SE ONLY
f Tigard \� ® r ••�p, '`� Received ��
Permit No •
.' Hall Blvd., Tigard, OR 97223 , � O� - 4,,,,,,% ' \� o *t \� Plan Review I / y r
13.639.4171 Fax: 503.598.1960 -tw I Dnu/By: Other Permit
Line: 503.639.4175 G pj q I � Date Ready/By rte' H See Page 2 for
www, ei.ti gard.or.us ` ` \�� j Notified/Method: Supplemental pplemental Informetlon
- TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
construction ddith n/altetation/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
olition Other: mechanical matenals, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
d 2 family dwelling ❑ Comm trcial/industrial ❑ Accessory building T EQUIPMENT /SYSTEMS FEES*
For special information use checklist.
[ ❑ Master builder ❑ Other:
Description Qty. 1 Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
G�
iddress: \ t L' 1 U SC. `3 C1` \° AVe, Air conditioning or heat pump
(requ plan showing placement) -QC
ires site lan showin lacement ) 1 14.00 )
C/ZIP• V1 Q l ■1 A ) C✓... ` � 17_7:--- Furnace 100,000 Err U (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
g. /apt. no.: Project name, ( . k q Gas heat pump 14 00
eet/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
ion : Lot no..
Other: 10.00
parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
i \ � ' � Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log tighter (gas) 10.00 •
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
tVPROPERTY OWNER (I ❑ TENANT Chimney /liner /flue/vent
Other: 10.00
10 00
` L
v i r \Sta Je.A- C6,r l ' Environmental exhaust and ventilation
k l 0 v C / Range hood/other kitchen
�(� I \ y) ��! / equipment 10.00
e/ZIP. o - - 2.:2--. 3 C7 j a Y-cN, Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
(3 ? t0 - 07`)-C) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
/��Q ' Other: 10.00
name:
V r 1v ( 1oe V\� Fuel piping
name: $5.40 for first four; 51.00 for each additional
Furnace, etc
Gas heat pump
te/ZIP. Wall/suspended/unit heater
Fax: ( ) Water heater
Fireplace
Range
CONT 2ACTOR Barbecue
: name: J � �l - 42/7/ Clothes dryer (gas)
-- / / Other•
Z& �� r . - MECHANICAL PERMIT FEES*
tel7.IP. /� 4 „ t ,„/ �� 9,Qj 2 — Subtotal
+3 ),. - 9 �- , J Fax: (.5:4i ) 3J _0 [f� c� Minimum permit fee ($72.50) 1z ,C30
Plan review (25% of permit fee)
Q p2 17/ i ) State surcharge (8% of permit fec) S,' 0
/�, I ^ I permit PERM FEE �`�; 30 zed signature: / `t q`� { / �� l / < 1 This peit application expires if a permit is not obtained within 160
V I IJVV f /\ days after it has been accepted as complete.
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1 Sky Heating & A/C 5032350454 p,3
HOME LAYOUT /SITE PL • \>
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\i-i90 SW Lial 10 Avg
STREET
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (50 ; 9 -4175
INSPECTION DIVISION Business Line: (50 • 9 -4171 MST
/I BUP
Received Date Requested AM 05M BUP f
Location ! 7 U Suite 4 7 00 — 0 6 4'3
Contact Person .ai Ph ( ) -3 Q 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/WP- ELC OA—IL
Footing (# 7 - O e3 6
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Ina Sheath /Shear 1n n `/ L Q 7 C/
Framing r V 1
Insulation
Drywall Nailing
Firewall Y "� v A � • . G
Fire Sprinkler � I • �
/ •
Fire Alarm � ( �■ J ��
Susp'd Ceiling
Roof AV t/
Other: T /�
Final j S �.��'� �C1 V'
PASS PART FAIL - n �� ; p
PLUMBING Y
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer \
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS T FAIL
M �L
Post & Beam
Rough -In
Gas Line ")
"do y;; ke Dampers
` PASS 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 El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA I p (f t c'
Approach /Sidewalk Date / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL