Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00417
` VIII 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/29/2004
PARCEL: 1 S133DC -11400
SITE ADDRESS: 13423 SW LAURMONT CT
SUBDIVISION: ARI GREEN ZONING: R -12
BLOCK: LOT: 005 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:
ELE 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: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC install.
Owner: FEES
DISNEY, BRIAN Description Date Amount
13423 SW LAURMONT CT. [MECH] Permit Fee 6/29/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 6/29/200 $5.80
Phone: 503 - 524 - 1923 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 640 - 3607 Cooling Unt Insp
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
- - ( =6699.
Issued By: /A1' / A, fr. , Permittee Signature: O)I
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
_ Permit Application FOR OFFICE USE ONLY
�{ } Received
k.
g ItV 2 LUU� Mechanical Date /Dv / '
ON o f Tigard TIGARD Planning • ppro al Building
13 ti 25 S Xl Hall Blvd, CITY O Datu,B : Permit No
Tigard, Oregon 9722i3,JILDING DIVISION Plan Review Other
Da[UB : Permit No.:
Phone: ' 03- 6394171 Fax: 503 - 598 -1960 Post - Review Land Use
Internet: www.ei.tigard.or.us M, Date/$ ; Case No.:
24- lour 1 nspec don Regrte-st: 503 - 630 -4175 � �/• - Contact RR spa Page 3 for
NameNethod: Su .lementai Information.
TYPE Ora WORE: COMYIETtC:IA1: FEE* SCHEDULE USE C.FIECI LIST '
(7hrew construction 7 Dem olitio n Mechanical permit fees" arc based on the total value of the work
al Add :ionlalteration/replaeeme ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
•'CATECOR'Y OF CONSTRUCTION .. mechanical materials, equipment, labor, overhead and profit.
g & - Family dwellin Y Li Commercial/Industrial Value: S See Page 2 for Fee Schedule
l i Acce 3S0 Building ■ Multi - Family RESID .ENTTAL.E'Y1IPMEEN'T' /SYST.EMS FEE* SCHEDULE
• J'4aSo :r Builder U Other: Dc lion Total
IO.S SITE INFOILMATXON and'.I,OCATION • Job site t ddress: 1
' L ' � - 4 1 �+-L� 6-,,,,•a _ Gas heat oumn 1 14.00
Suite 4: Bldry. /Apt. #: 0_,,,,4 F - Duct work
P ro cct i amt.!: - Hvdronie t water stem 11
Y� 11
Cross str to _job site:
, Residential boiler
(for radiator or h dronic system) . 14.00
Unit heaters (fuel, not electric)
in wall, •
Flue /vent for an of above 10.00
Subdivisi On: 1 Lot #: Repair units _ 12.15
Tax map /Dareel #; _ Other Fuel Ap'llances
DESC.I2II'TION O� WC >IZTI - busier heater I 10 ,00
Gas fireplace I 10,00
Flue vent (water heater/g= fire. lace) I 10.00
� u) 00
.
1
Chimne /liner/flue/vent i
• 0.00
PF :OPE .FY OWNER
TENANT •.. Other:
Environmental Exhaust Se Ventilation .
t
Address: et -� hood /other 10,00
City /Stall ; /Zip: 1 11
Phone: �, '-i.- ./c1 Fax: (bathroom toile•
• APPLiC AIYT
_. LI CONTACT 'PERSON 6,8
Name: _
Address:
1 0,00 _
1
ddress:
City /3tatt /Zip:
t for first 4.51.00 each additional)
Phon I Fax: Furnace, etc. r
E -mail: Gas heat .um•
CONTRACTOR; •
Busir..ess S - Water heater **
a (. C. i c { 1 ' r,w Fireplace
mil
Address: I le t'i I L v 1,'.. r -c (, Range
Cit /; >tate, se
P i • t (S L cti� z- , 9 Q
Phone: - o (. C: - I Fax : 1�';I - C; ?. 5 3 T Clothes r dryer (gas)
""
CCB Lic. `: j 1[' C .- Total:
Authorized T"
I p _ Mechanical Permit Fees*
Signalu:e LGN--(l.1� � `-!�0 _ Date :VA -: - �C , gl Subtotal' I S
1 ` ,L. (_°∎ L) l ce. Minimum Permit Fee X72.50 5
Plan Review Fee 25% of Permit Fee)
(Please print name) Stare surchar
Notice: this rntir appliC tion expires Ka permit is not obtained within TOTS, - ti T ' —1— ' - CS
p„ '
180 days after ,t has been accepted as complete. *Fee plan required sei by exterior ounty un t
i;\Dsis Industry Serv'tcc :acrd.
\Pc ran F writs doe 01/03 " *Site plan required for exterior A/C amts.
pp. .
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SITE PLAT
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STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 5 03.620.5643 Fax 501598.07
I�i 1_ls_b -ox-o Phone 503.64=0-3607 1 S
-
Fax 503.681.0793
E'd BTLO 869 EOSuzzeaH RziezaadS d9i:E0 170 Lz unC
CITY OF TIGARD 24 -Hour
. BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: "(503) 639 -4171 MST
BUP
Received Date Re ested — / v AM PM BUP
Location /3 LI 2 3 a ° Suite ditC Z y _O d 7 `!
`7
Contact Person Ph ( ) (o go -36, O 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors x, co
Ext Sheath/Shear t
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling //� G�
Roof �� �Z ��\ � S i I �7 ( , S2
Other:
Final •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole n ' 7
Storm Drain ��`� /)
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In WILI
Gas Line
Ssi..ke Dampers
inal
I • ASS PART FAIL
Service
Rough -In
UG /Slab
Low Voltage \�\
Fire Alarm
3=S•j Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date w Inspector • Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL f
• I G-