Permit � is
C ITY OF TIGARD MECHANICAL PERMIT
,,,I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00692
J II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/19/2004
PARCEL: 2S 112CB -11000
SITE ADDRESS: 15369 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7
BLOCK: LOT: 124 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of gas furnace & A /C.
Owner: FEES
CANASO, JUDY Description Date Amount
15369 SW KENTON DR [MECH] Permit Fee 10/19/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 10/19/20( $5.80
Phone: 503 968 - 5493 Total $78.30
Contractor:
ALL TEMP PROFESSIONAL
8230 SE 72ND ST
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt lnsp
Reg #: LIC 58513 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: /� ,�Or��2 Permittee Signature: j, PAR
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
OCT -18 -2004 MON 11:38 AM P. 001 /003
t „
. FOR OFFICE i1S1 ONUS' echanical Perm � Uil lica on Received Mechanical,
DaIe/B : / ` ° N Permit No.; t,� C/ 006't
City of Tigard RECE11� /I Planning Approval building
�// E ((� P any: Permit No.:
13125 SW Hall Blvd. II�� Plan Review Other
Tigard, Oregon 97223 r •� 9 nalc /l3Y: Permit No.:
Phone: 503 - 639 -4171 Fax: 50 -196 MI'. Pod-Review Land Use
om,;;.2 , (•t� Da1e/By. Case No.:
Internet: www.ci.tigard.or.us CITY OFT . q„ r.T�;II Contact ma.: ® See Page 2 for
24 -hour Inspection Request: 503yr63 5 � IVI � (C � Name /Method: -�I (r' Supplemental Information,
';;.: ''ti!: ;. ; ` : ' +YRE +:O OR { . :sVr. , ;,:ti;c';' .4.:4.� ' }iIZ�% 1 > tS ID :_: »:'�J +B'it '+.�1XcI IS)t' ?2., >;;t:
11■ N- . .w construction • Demolition Mechanical permit fees* are based on the total value of the work
dition/alteration/re . lacemexit • Other: performed: Indicate the value (rounded to the nearest dollar) of all
' >:,,:?�"sVI'Lt't e ' VOR; Oligl R MTt't N: ;5:': 1 , .: ;
mechanical materials, equipment, labor, overhead and profit,
u t rial Value: $ See Page 2 for Rae Schedule
:; ./ ' 2 2- 1;an�il dwellin � ■Commercial /Yndusi
III Accesso Building I■ X Multi -Famil ,. EsrbtlorAt Ef TlaV TENA'i 't11 1S. 1AILE'_
Description P'ae(ea.) Total
1r Master Builder II Other: Hoatirig/coolln
,i h:r 14
„ • {; ,G�;� " '.YO �$ � ?1z1 • - • ` YOI� +�'ki�'`I:OC'''TIb�T Furnace - add -on air conditioning **
; . Z,R-
Job site address: /199 Gaa heat pump - _ 14.00
Suite #: Bldg. /Apt. #: " Duct work _ 14.00
Project Name: Gaffs Reside tial boiler ater system 14.00
Cross street/Directions to job site: (for radiator or hvdronic system) 14.00
Unit heaters (fuel, not electric)
(in wall in -duct; suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12,15
Other :Fir A (lances .
Tax map/ parcel #: Water heater 10.00
v;gtr;MiNg1aP ` T 1230al ,1'i is � ' ' . ' "! f "' !:,Mi.l i:':st ", 'lace • 10.00
•;,,ri.- Air._ - -- ` t Flue vent (water /gas fireplace) 10.00
x/010 -may Log lighter (gad 10.00
i' • Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent
.1 I 0.00
P ag , • 7 INxt:Tb �t'f , �.� ' ti ; ;1 k: ihtigg j. , . ZO'ill' `.Jr" , i '',.e,Vs ': Other: 10,00
Envii nmehttll'l nitiSt:& .veutltafittitf:,':'. _. 1 ,
a1ne: 41 - " � « � � � � � Range hood /other kitchen equipment 10.00
Address: '1 Clothes dryer exhaust 10.00
it /State,/zi.: . /rr yl . . ..-__ Single duct exhaust .
Phone: ''% �MI Pax: (bathrooms, toilet compartments,
C niPS .!°t ain ! , :i ,,.: n , n ; . >: rri: • : - - ei:,, utili rooms 6,80
►�_____ f ►T Attie/crawl space fans 10.00
�! Other: 10,00
h z- ��. = _ . ViVilrltilna
• , * *($5.40 for first 4, $1.00 each additional)
f `� Furnace, etc. 4,,t, rhone. n a .M **
G as .h eatiump
E-mail: }} yy�� ♦ ,..,,,t„-.. ��� g j• �.. �� � Wall/ suspended /unit heater
$ i ��� liti �°? ,' BELTS "8'.54,."!.7, •y'i, bi. rf.:':'w 417,''' Water heater **
Fireplace
Address: i BB **
City /State/Zip. �' '' —' � � y
Clothes dryer (gas)
Phone: I Fax: Other: **
CCB Lie. ,#: ,. /3 Total:
Authorized Mechanical .reMmit• Fees*
/� Subtotal: $
Signature: ` / % / •- ./ ..Z.," Date: /' Minimum Permit free $72.50 $ 7a9. .7-...;
lit _ Plan Review Fee 25% of Permit Fee $ —
(Please print name) 7 - - —State Surcharge (8% of Permit-Pee)- _$. t 9
TOTAL PERMIT FEE $ 7f
Notice: This permit application expires (fa permit is not obtained within *Fee methodology set by Trt -County Building Industry Service 13oard.
150 days alter it has been accepted ae complete. * *Site plan required for exterior A/C units,
i:\ Dsts \PermitForms\MecPermitApp.doc 01/03 --
OCT - 18 - 2004 MON 11:38 AM P.002/003
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CITY OF TIGARD 24 -Hour
BUILDING Inspectioi Jne:_ (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested �¢ — /1 —/ 9 . AM PM BUP
Location /3 '? / ,4_ —' % Suite MEC eZO g - °6 9
Contact Person "h ( ) PLM
Contractor Ph ( ) 6s l / / / SWR
BUILDING Tenant/Owner ELC (90 (7z,--00 6 ! c�
4 /
Footing
Foundation ELC
Ftg Drain Access:. NW. � )13/ ; - ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear L V A / . �� r
Framing t
Insulation
Drywall Nailing , t.4 Z--d .i.rad ,r. i - - 7C: , A
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,a ` ",, -. gbilP
Post & Beam
Rough -In
Gas Line
yoke • - •ers -
40 •
*ART FAIL
RICAL ° ,
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
F 0 Reinspection fee of $ required before ne_ spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
. ° " °' 0 Please call for reinspection RE: AII . / 0 Unable to inspect - no access
Fire Supply Line . /' Ext
ADA ` ( triLtsa.._ Approach/ Sidewalk Date Inspector
Other: V
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL