Permit r.
CITY TI GARS MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00562
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/15/03
PARCEL: 2S111 BA -06800
SITE ADDRESS: 09541 SW INEZ ST
SUBDIVISION: BUTLER TERRACE ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT 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 A/C unit. A/C cannot be placed within required setbacks.
Owner: FEES
BEDARD, ROBERT P + CAROLYN J Description Date Amount
9541 SW INEZ ST
TIGARD, OR 97224 [MECH] Permit Fee 9/15/03 $72.50
[TAX] 8% StateTax 9/15/03 $5.80
Phone: 503 - 598 - 7363 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 66578
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 -00
Issued By: / // Permittee Signature: X&7 , ,°Gi e.9
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
• . . •
hanical
. -. .
.1
Recei FOR OFFICE USE ON1,V
"cation ved , Mechanleal
Date/8y; 7/03 ren-oit istolLigi00.g ---40-5-6-1-ji
•
Planning Approval Building
City a Tigard
Date/B : Permit No.:
13.12.5 S W Hall SIVd. SEP 1 1 2003
Plan Review Other
TiEtard, Oregon 97223 Dat/By.: Permit No.:
Phone; .J03-639-4171 Ettin56/§)g " :A A .4 , ,N Post-Review Land Use
Date/9y: Case NO.:
intornat: wWW.Ci.tigaid. (BOLDING A DIVIS I • N _ L
Contact .: la See Page 2 for
.i.,
24 Inspection Request: 503-639-4175
Name/Method; .
. Su .. lemental Information.
-- ...,;:'...'. ••••• 7 0 . E.;'0FW.ORICO • ., • ,,.. ' , .i•. , . .: ' ' ' • . • .commEmerxtTEEtsciiEnuLE.- caEcuirsr '.,*::•.,
0 New constrolitiou Mechanical permit fees* are based On the total value of the work
0 Addi tion/alteration/replaeement 0 Other: performed. Indicate the value (rounded to the nearest dollar) of all
77: ' :;gel K i tGORVO.FCGOSIVY.C.PIONg:Ott's' , ..4,. :. mechanical materials, equipment, labor, overhead and profit.
Tgl & :! El Co:mmercial/Industrial Value: $ See Page 2 for Fee Schedule
n Acce ssory Building EI Multi-Famil , • .RXSIDENTiffeTKENT/SYSTEMSTEVcSMEEDT,
Description r Qty I Fee(e-) j Total
El MaSter Builder • 0 Other: -
Heating/Cooling
,
_
rOBSIT EINFORMATIONAilarOWatfi.:iti';''' '..: Furnace - add-on air conditioning" 14,00 I
Job site ; tddress: '?ti / ..S-u 7 4-1..4_,2_ I Gas heat pump 14.00
Suite #: Bldg./212.t.#: Duct work . 14.00
. .
,
Pro: fame: 1-tydronic hot water system 14.00
ect l'
- Residential boiler
Cross str aet/Directions to job site:
(for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
On wall, in suspended, etc.) 14.00
Flue/vent (for any of above 10.00
I —
Subiivis on: I Lot #: Repair units . 12.15
other Fuel Ap 'lances
Tax rnaR parcel #:
Water heater 10.00
:.:' . ''..: ..:'• : ..!.!.::' DESeRritTION:00WORIC'• .,:Itgg:•:,.':'. Gas fireplace 10.00
) /t,t , ■.4" - ' - ‘■_t 1 1: kit Flue vent Niatcr heater/gas fireplace) 10,00
Log Ii,ghter (gas) 10.00
____
— ______.
Wood/Pellet stove 10,00 . • _—
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
...
V440019 wrOUNT,W.;;P;V:g.: .. Other: 10.00
Name- 40-atz-,...1- Y Environmental Exhaust & Ventilation . _
• Range hood/other kitchen equipment 10.00
Address: 5
_
— Clothes dryer exhaust _ 10.00
CitylStat a/Zip:
-
Single duct exhaust
Phone:, — 7,Sev, '3 I Fax: (bathrooms, toilet compartments,
MiT.I %IT. . ' . utility rooms) 6.80 .
Nansi.e: Attic/crawl space fans 10.00 _
_
Otl-icr: I�0()
.
Address:
_
— - . . . Fuel Piping •.
City/StatilZip:
**($5.40 for first 4, $1.00 each additional)
Phone: I Fax: Furnace, etc. **
Gas heat pump **
E
Wall/suspended/unit heater *all
..
_
, ...::,;... , •
CONTRACTOR •• • : "..::,:....:.•-:;?:::•:•••• ... Water hewer **
..
Business Name: in ,.z. c c--t +1- ( c — vl Firc•Iace -
Address: 1 Lc, 0 1 ct: Pts v 4<-1 . Range
BBQ **
City/Statt 1Zip: 1-h . 2.-0 , (i. • C i i- / a- 7 Clothes dryer (gas)
Phone: (40 - i.; 0 •. I Fax: Leg'i — o 7 1 - 3 Other: **
_
CCI3 Lic. #: ( lc C I A> Total: .
Mechanical Permtt Fees
Author izcd L ,, .A _
c i ...,,,
Signature: _
. E7Y-L- pate Subtotal: $
: ( - I 1 `--- -- -
.
-
Minimum Permit Fee $72.50 $ ??„ 5
R e) t ce----.
Plan Review Fee (25% of Permit Fee) 5.- ..
(Please print niune) State Surcharge (8% of Permit Fee) S , • s TrO
TOTAL PERMIT FEE $ e ' 0
Notice: This 1 application expires if a permit is not obtained within *Fee methodology set by Tr-County Building Industry Serv Board.
180 days after it has been accepted as complete. **Site plan required few Pxterior .&/C unita.
iz\Dsts\i' CITIlit i , ounswiecPermitApp.d0c 01/03
ZuT.1,eaH R '4. 1 T 0 a d S eity:60 ED TT daS
2 ' d BILE] BBS LOS
. _
11 ,‘,
SITE PLAN
PL
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P1. PL
l� I'
PL
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
E•d BTLO BSS EDS ZuizeaH Rzieioads ei*:60 ED IT daS
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received -t Z /q / 2 1 Date Requested / 2 -/w /o_1 A PM BUP
Location J _�� _ Suite
r� �i 2.
Contact Person 4i7 ca Ph ( ) PLM
Contractor 24 Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain 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
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
lampers
Fi
1 * ART FAIL
347 RICAL
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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL