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Permit CITY t MECHANICAL PERMIT 44\ DEVELOPMENT SERVICES PERMIT #: MEC2004 -00680 .44 �' I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/12/2004 PARCEL: 2S 111 CB -01705 SITE ADDRESS: 10275 SW HOODVIEW DR SUBDIVISION: HOOD VIEW ZONING: R -3.5 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: 1 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: 1 Remarks: Install gas insert, extend gas line, direct vent. Owner: FEES WESTBY, RICHARD & DENISE Description Date Amount 10275 SW HOODVIEW DR [MECH] Permit Fee 10/12/20( $72.50 TIGARD, OR 97224 [TAX] 8% State Surchart 10/12/20( $5.80 Phone: 503 624 - 0553 Total $78.30 Contractor: BELL HEATING 15550 SE PIAZZA AVE CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone: 503 Gas Line Insp Heating Unt Insp Reg #: LIC 447 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 )) Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day hapical Permit Appl 1 FOR OFFICE USE ONLY City f Tigard �� - . Received ` ty g , _ /� .: .e 13125 SW Hall Blvd., T igard, Date/By:iv 1;2=6/ 6 i�l PermitNo C 6 Phone: 503.639.4171 Fax: 5 . 598 196 04 Plan Review ' Other Permit: Inspection Line: 503.639.4175 \ ' 2� : " i • I $ Date Ready/By: ! '' I Date Ready/By: 7 ® See Page 2 for Internet: www.ci.tigard.or.us / f GA �© Notified/Method: 6= Supplemental Information •f • b a d + ` ' ' ` ,"_' - t _ ° e r � '�' " r ' ° Y ,∎ 4 ` a ) a 3iA.£`^ "- l 01 _ LEtKLIST New construction C Additio eration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. iN r r 17:1 :°0 3 7:;', i' P r Ziz6" : 3a= e ( rt + 11 r�# i � :°g,++ Value $ ... ,..:& SI:flr :: . 1° � - _ - a-* , )..A 111... x: . as,44,;. ., . Ai " -'ate 1 -and 2-family dwelling „e ■�+ r ` '*713" 5wtt_t?.S3 a 1 TSN'SFEMS•FEES* y g ❑ Commercial /industrial ❑ A ccessory building For special information use checklist. ❑ Multi- family 0 Master builder 0 Other: Description I Qty. Ea. Total Heatin 'a . . 7 s ,Vr s a t� - 4 '.q.. s7 g 4 `.� 14 `" L'/ g 1 11' cM ,_ _ . zr. a 4 ' . ' 1 -.,V(, 'a-K ?; 42. C"lin Job site address: ' (7 Z' + j Air conditioning or heat pump 1/4.1,3 ��a 0 . (requires site plan showing placement) 14.00 City/ State/ZIP: ` ` C1('''i es:\ q r� ' , 0 Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg. /apt. no.: Project name: t ' ' Furnace 100,000+ BTU (ducts/vents) 17.90 • Gas heat pump 14.00 Cross streetidirections to job site: 1 (1_95T/S t _ I Duct work + j 14.00 1 MAPS l �Q (D5� V R ion t hot water system 1 14.00 r "`� � >r h t- '� Residential boiler (radiator or hydronic) 14.00 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 a map/ ' : Other fuel appliances l b - '- s : ''1 II' . 7 r 3 ' 1 x.., � ., � z a s ,° `- ,' -�x >y Water heater 10.00 Gas fireplace II 10.00 IEK \ ..) ('%) t...,. i,�., r Gl. F P (lo Flue vent for water heater or gas t A f .lace 10.00 v ~ t P l G T .4.- P5t..l._ r -4 N ( kt Lo: li:hter :as) -- 10.00 .Aink# V -.)-- Wood/.ellet stove y , 10.00 C V ' ` , 7 , l 1 1_ fi ' ` Wood .lac- '�i 10.00 ‘. `-'t/ \ V t ' �� , -. 11 Q L� Chimne /liner/flue/vent III. 10.00 _ ._ .' �- W. � _ � t ..? AiL _, ..c1ij.t� -?rz - Other: 10.00 Name: Drii..i1 tGc5" L Environmental exhaust and ventilation Range hood/other kitchen Address: t 2:1 "..i--1.. w , \._)■...) OZ._ equipment 10.00 City/State/ZI IL R -.% Clothes d er exhaust 10.00 Single -duct exhaust (bathrooms, Phone: 6_9 w, r Fax: ( ) toilet compartments, utility rooms) 6.80 , •* r . Attic/crawlspace fans 10.00 Business name: Other: 10.00 ti 'N Fuel piping Contact name: BE Ti �' Q . � ' $5.40 for first four; $1.00 for each additional 15650 SE PIAZZA AWE Furnace, etc. Address: XMAS. OREGON 97016 � Gas heat pump City/ State/ZIP: x-1184 (6C.ii'`- t 1 ,� `� \\ C- Wall/suspended /unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace I 5`t 5 E -mail: t - . Range ' s 1 �' sr'`` c -" -'` v " 'r 1 Barbecue Business name: BELL I4F NG, INC. Clothes dryer (gas) Address: 111660 SE PIAZZA AVE. ` '7 s - , a e, l.S ,'‘ City/State/ZIP: AMA � OREGON 8701* b -IS 1 Subtotal 2c `( 1 1 1M 1 ,o, Minimum permit fee ($72.50) la - 0 Phone: ( ) F ax: ) I� Plan review (25% of permit fee) CCB lic.: " I i State surcharge (8% of permit fee) 5 &:D . TOTAL PERMIT FEE 1 &- ° l Aut signature: � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: . , Date: • ' Fee methodology set by Tri- County Building Industry Service Board is Building \Permits\MEc.PernitApp. 12/03 445 •.17T(1 /02/CO % B) Mechanical Permit Application - City of Tigard • Page 2 - Supplemental Information Commercial Fee Schedule: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 -for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. .:1111 % D r ' .... Ina 34 AT'KA 141 :i2 Oazat a 1GC8 11CreiliQ .eAMA)!3A4 j$? t- Nit 1-818 AS7,Av 1 P. WS, isBuilding \Permits\MEC- PermitApp.doc 12/03. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (5153) 639 -4171 MST BUP Received Date Requested / O _a 1 AM PM B Location 1 /L-<-<) Suite a 2 O 65 4/— oGs gD Contact Person Ph ( ) to _ S�(o - l / � PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation SS E t<q. 1, -4-- Ftg Drain ELR Crawl Drain Slab Inspection Notes: ��� �- � u SIT Post & Beam TZS Shear Anchors Ext Sheath/Shear • b e) Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING i Post & Beam Under Slab Rough -In 1 t Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers PAW PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final E Reinspection fee of $ required before n- • • spection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date ` Z/, 0 Inspecto Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL