Permit — - - „ALL-
C ITY OF TI GA , MECHANPERM
4, DEVELOPMENT SERVICES PERMIT #: MEC2004 -00011
` � fll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/12/04
PARCEL: 25111 CC -13300
SITE ADDRESS: 10285 SW HIGHLAND DR
SUBDIVISION: SUMMERFIELD NO.4 ZONING: R -
BLOCK: LOT: 184 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:
LPG 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: 1
Remarks: Replace furnace with like kind. 1/13/04, furnace replacement is actually a conversion from electric to gas. Adding
gas piping & venting to permit.
Owner: FEES
JOE DYAR Description Date Amount
10285 SW HIGHLAND DR [MECH] Permit Fee 1/12/04 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchaq 1/12/04 $5.80
Phone: 503- 968 -9902 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503- 453 -4822 Gas Line Insp
Heating Lint Insp
Reg #: LIC 62196 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 -0s -i • i. may obtain copies of these rules or direct questions to OUNC by calling
(55 - 246 -6699.
Is . ued By: . • : , / Permittee Signature: , 0_,�1/
Call (503 : 9 -4175 by 7:00 P.M. for inspections needed the nex business day
Ja t_ _________ _ y 04: 53p climate centre 1 503 968 7224 P. 1
Mechanical I rmYt A -
AAlica�loii OFFICE USE ONLY .
Date received:
,6,L 'IJE City of Tigard 1
���� + Permit no.: e
Alk
City oiTignrd Address: 13125 SW Hall Blvd, Tiga d, R PrQiect/appl, no.: ! i
Phone; (503) 63SW Hall 97223 Expire date:
Fax: (503) 598 -1960 ,aN 12 2 0p4 , Date issued:
OM Receipt no.:
Land use a Case file no Payment type:
pproval: OFTIGA 0 Building permit no.:
•
I & 2 famil dwelling TYPE OF PERR T
Y dwelling or accessory ❑Co mmercial/industrial I
0 Multi family ❑Tenant improvement
0 New construction
❑ Additio n / alteraeion / replacem
0 Other:
JOB SITE INFORMATION
Job address: 1 COMMERCIAL VALUATION SC
Bldg• �� S(�- �� �1( I equipment e III DI)LE
no.: q pment quantities in boxes below. Indicate the dollar
fax map /tax Ior/account no.: tte no • valte of all mechanical materials, equipment, labor, overhead,
Lot: Block: profit. Value $
Project name: Subdivision: •
$(, ��� _ a� *See. checklist for important application information and
City /county: jurisdiction's fee schedule for residential permit fee.
Description and I catio of work on premises'
I t • 2 FAMILY DUELLING PERMIT FEE SCHEDULE s'
AND COMMERICAL/INDUSTRIAL E QUI 1 MENTSCITED '
tA S i � CV r1a C 1L,
Est. date of com pletion /inspection: i1IE
Tenant improvement or change of use: t t 3 •�� ® Fee(es.) Total
Description
Is existing HVAC; Res. only Res. only
g space heated or conditioned? 0 Yes ❑ No
Air handling unit IMMO
Is existing space insulated? 0 Yes ❑ No - -- -CFM _
Air conditioning (site plan r equ i red) -
MECHANICAL CONTRACTOR Alteration of existing HVA system —_
Business name: t\, v R COYdi7u i Boiler /compressors - --
Address: 1 1p State boiler permit no.:
City: � F ( g 1 � c% _ HP III g7U /H IIIII
State:p>� Fire /smoke dampers /duct smoke detectors
• ax: 9(08 eat pimp (site plan required) ==
CCB no.: („9_1 I �� E-mail: eplace furnacelburncr +
ductwork/vent liner B I No
City /metro lie. no.: l y j �l I nstal l /replace/rclocatc heaters -- usp
sended, ®
Name (please print): .. ")- 1 . 1 wall, or floor mounted ■�-
.c. . Vent for appliance other than furnace
CONTACT PERSON Refrigeration: —_
Absorption units _1__ BTU/I-1 ■-
Chillers
Compressors — HP --
® Environmental exhaust and ventilation: 1111111111111111.1111 Phone: Dryer exhaust
111111111111111 R Dryer exhaust -__
owNB
Hoods, Type I/ 11 /res. kitchen /hazmat ■_
NName: $ t� �cQ D hood firs suu ppression system -
Mailing address: �3 Stv � . Exhaust . "an with sin.le duct (bath fans) 111 1 ..._ 11111 1111 m ..1.11111 City: Ti tt . ° �ti� �� • Exhaust :system apart from heating or AC —
tate :OR ZIP: Fuel piping and distribuf'• tp . 4 outlets) _
'�,! _1aa� T e:
YP _ LPG NG Oil G^ c�O IMI
Phone:�3 `ifp6
ENGINEER Fuel piping each additions outlets
Name: Process piping (schematic required) MN Number cf outlets - =—
Address: ii then tiered appliance or equipment:
Decorative: fireplace ■-
Phone: ZIP: Insert – type
inallinill
Woods[ov: pe et stove
= -
-�
Name L W . Date: ! -1a.G3 Other: ■
(print): a Other:
Not all jurisdictions accept sir cards, please call jurisdiction for more information. .
Applicant's signature: O. _
Vtsa ❑ MasterCard Notice: This pern Permit fee
Credit card number:
ut application
nn $ ""'( a ' C ' � _ —
/ / within 180 days after it has been
expires if a permit is act obtained Minimum fee $ '
Expircs — 1- ----I-----
Plan review (at _ %) $
Name of cardholder as shown nn credit crud
accepted as complete.
TOTAL surehar�e (8 %) ._ -. $
Cardholder signature - -------- - L _____S.) —
Amount $ a �
440 - 4017 (MX) /COM)
CITY OF TIGARD 24 -Hour
BUIL'iING Inspection L`in1�:, (S03) 639 -4175 :
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 1 4 3 ! – f ' Date Requested — A PM BUP
Location • _ ! / L „/ .0 4 . uite MEC ' _ — : 11 14 I/
-
Contact Person Adaliffe Ph ( 5 03) 4'S 3 " 2e_ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain `Access:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
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 `►�` 6 F \ \
Rain Drains V 1 \ v 1
Catch Basin I Manhole 1
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
/
• eam
Rough -In
Gas Line
F 0• - •� Dampers
ART FAIL
ELECTRICAL
' Service
Rough -In
UG /Slab y, ,
Low Voltage Q c_. C EP
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
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL