Permit - ! tr �.
• CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2004 -00304
��; DEVELOPMENT SERVICES DATE ISSUED: 5121/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111 DA -12200
SITE ADDRESS: 09013 SW PIPPEN LN
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 115 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC install.
Owner: FEES
MEDEIROS, FRANK Description Date Amount
9013 SW PIPPEN LANE [MECH] Permit Fee 5/21/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 5/21/200 $5.80
Phone: 503 - 598 - 9805 Total $78.30
Contractor:
SUN GLOW INC
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Phone: Cooling Unt Insp
hone: 253 - 7789
Final Inspection
Reg #: LIC 48131
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: ert\ ce424CLIA e G ll1tiJ
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
05/19/2004 15:40 5032537693 SUN GLOW INC PAGE 02
,05/12-4204 ,4 09 :43 f9% 503598198 IRECEIVE13 TIGARD 0001
Mechanical Per igicatiOlIMAY i 9 . 004 FOR OFFICE 1,1.5E ONLY .
Reea von
City of Tigard D6tene PetmitNo.: /^
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13125 SW Hall Blvd., Tigard, OR 97223 CITY 0 , ' 'D Flan Rea Other ?trot! 503.689.4171 Fax: 503$98.1460 PLANNING r .' i'i` -1 (L�aam/ov:
Ist6peedoo Line: 503.1139 4175 .,1,14- '_ - pnteReady/By: ® S!0 Page 2 rar
Internet: wwm.m.eigerd.or.ue laes;5, p etted Supplemental tatermadon
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[a New construction 1Q�Addition /alteration/replacamant Mecbaniea) permit fees" are based on the value of the work
/ _ patatmed. indicate the value (rounded to the nearest dollar) of all
I:1 Demolition ❑ Other. snechaaical nutterials, . u'. - lobar, overhead, and •ro5t.
i ri'•rr- t v t''ea,. mltk rn Vain: $
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pose
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lob site address. J Air conditioning or heat pump
` _ goo P ' / / , _�' ( rallates site plan showutgphceettatLt) lsAO � �'
Qty /Statc/ZIP: r ,., / Lard: 22 FNmeee 100 000 BTU duets/vents 14.00 .
Suite/bldg./apt. /apt no.: . 1 Ptojcet name: Furnace 100.000* BTU (duc®Nents 17.90
(333 beat pump 14.00
'
Cross street/directions to job site: Ductwork 14.00 '
Hydronic hot water system j 14.00 1
Residential boiler (radiator or
hydronic) 1
Unit beaters (fuel -type, not electric),
' v1 -wail, in -duct, surpended, etc: 10,0o
Subdivision: Lot no.: - Flue/vent for an of above 10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances ,
t (7 .. , •rn r' .- i ui• „.` �..r.>:..r J I, �` I l
j } I t ? , Cy 1 :{i� Q , L 1 . . , 7+ 1 ,, 11 _ --' 7. 1 1 ilf,l:F k ' I 7 1 , !1{ I>_,d. w3tCflle2le 10,00 - IJ
t...., f . _- .1�.,. _ JJ� L : � „ , .
Gas fireplace _ 10.60
Flue venttor water heater or gas
£rcplece 10.00
Log lighter (gas) 10,00
_ Wood/pellet stove 10.00
10.00
'Wood flreplat�nsert _
' ;:e - :. L ,�-.T I Chittmo /liner /f1ue/vent - 10.00
I - � ? 'y"1? ; I �a7 . -� ° If I l e f � ll�u }I 1Lrs_y 'I V� ! ��r l
:�.d. c�lU. -.i.. ...111.11. ..Li .I,.. .a , .l.y.,,:1.. --- .' . T,. '.' Odin.:
]0,00
Name: • 41 ,1 / ' CO Environmental exhaust and ventilation
Range hood /other kitchen
Address: r 1 1 ', - I / equipment 10,00
City/Stare/ZIP: 111 h �� Clothes dryer exhaust 10.00
• Single-duct exhaust (bathrooms,
Phone: 4, 5/ it e ' Fax: ( ) toilet compartments, utility rooms) 6.80
; ' 1 _ ,.a F ! i� l urr ,ii. ;t ii r 1 � 1 1 1 1 i 1; fr a � } L :9 lr f ,,,,,,/ y ell rla ; ^s ?„(�; � 1' Attic/c ii ace fps 10.00
_i_ , y .- „ ;� V h - �. _ ] t . ��" a i. �_l � _ ❑ Dth I 10.00
Business name: (l Fut�iEing -_•
Con= name.: $5.40 for first four: $1.00 Or eneb additional •�
Address: _ tmdace, ex- - _
j Gas h
City/Siatc/ZIP: Wall/suspended/unitheater
r Water heater ; 1
Phone: ( ) I I?ex: ( ) I - I -
- --'- - ^�•- --- Fireplace
13-mail: Ran: c
i �d ' i i 1 'I l l� It , r .; f;llli,{ •,2ri,tli .'':,.'.a1.-L..1 ;
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r �V I ' 1 d L4 Clothes drim(€as)
Business name: Otter:
Address: ji. f . ..1 115 Q / / ^r: 1.1- ,..yq'x , :i "yT' rx�;a,'ao N:;.r -r;. r
Csd /State/ZIP: v..i1 Iyl dl t7 Subtotal 1 ^: -J1i '
phone: ( ec Fax / )'5 Minimum permit fee (.1,72.:10) 2 2 53' 710 71093 flan review (2555 of permit font
CCB lie,: State surcberrge (A4/a o£permlt fee) 5/ ti
TOTAL PERMIT FEE I T/, �, n
Autlxorized signature: f ., 1 0\) w w ow ", ' prr.n:e opi ate:Wan =piece if n prlrmtt le net ob within leen
any. eher It tin been lemma oa complete.
r PriAt nmae: , - i I , al 4 . , � I Date: 1 v 1 • pm methodnloay :el try 7ri -ca' sty Hui:ding indu,try S., Maud
,
I: tBuilding \anel:AMC..Pe:tieaeradoe 12/03
P 440.461"'T Li t/091 M/wE6)
05/19/2004 15:40 5032537693 SUN GLOW INC PAGE 03
03/25/2004 16 :06 FAX UIJ V4L/ VV Y
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CITY QF TIGARD 24 -Hour
BUILDING , Line: (503 • '9-4175 w
INSPECTION DIVISIN Business Line: ( • 639 -4171
MST
BUP
Received 4014 Date Requested 17 • PM BUP •
Location O 3 L F 096-r% uite j_e 44. - 3 oy
Contact Person (UAit Ph ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC O'V\-
Footing
Foundation Access: s 4t`Trc - FAC rr —otter � e-Af jb , ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear /°�
Ina Sheath/Shear am /✓ fi f C7- 7
• Framing
Insulation ` o C <
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 • RT FAIL (
ME gl L
Pos
os :- :earn
Rough -In
Gas Line
Smo. Dampers
40 1 PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. P t City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
ADASupply Line ` D L
Approach/Sidewalk Date / Inspector
Other: \.
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL