Permit CITY OF TIGARD
MECHANICAL PERMIT
s r 70 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00623
1‘41,4114c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/16/2004
PARCEL: 1 S133AD -04700
SITE ADDRESS: 10960 SW SUMMER LAKE DR
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 021 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: 2
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:
• GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of heat pump, venting for water heater & piping.
Owner: FEES
PATTERSON, JANET + Description Date Amount
GAMBLE, DEAN G [MECH] Permit Fee 9/16/200 $72.50
10960 SW SUMMERLAKE DR [TAX] 8% State Surchart 9/16/200/ $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
REQUIRED HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 - 640 - 3607 Heating Unt Insp
Duct Inspection
Reg #: LIC 66578 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: 7, Permittee Signature: , 1
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next day
Mecilani :al Permit ATRINEIVED F OR OFFICE USE ONLY •
City of Ti i and Received 75 � / � _ �
13125 SW Hall I tivd., Tigard, OR 97223 CI [
Date/By: Permit No.:M C e /f _ r/41 / f
Phone: 503.639 4171 Fax: 503.598.1960 SCP 14 2U� ' Plan Review 1 `v &x l/ l/U ooC_r7
Inspeciior,Line: 503.639.41 ¢ ":,it' Date/By:
Permit:
Internet: Hww.c .cigar 39.41 CITY OF TI ' : �11.' . . II
Notified/method! Date Ready/By: Juris I Supplemental ® See Page 2 for
1 DIVISION lnformation
BUILDING
°.... a .. H ;;._ ; "r =. ;': '+ ::C;O1VIM RC iiI:.'ERE SCHEDULE - USECHECIQIST
Mechanical permit fees* are based on the value of the work
❑ New constr lotion ❑ Addition/ alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical I
,..,. -.�_, _ :: ; ,� tCa materials. labor, overhead, n pro
ft
r a
._.� � ATE
:.•...,.,> .... _.,GOR '(i O�: GO 'C L�CFION'•; :� , ;�,:y `: Value: $
1- and 2 -far lily dwelling ❑ Commercial/industrial ❑ Accessory building $... . L'EQUIPivIENT /SYSTEMS •FEES"
❑ Multi• famil / ❑ Master builder ❑ Other: For special information use checklist.
Description I t Ea.
... :eC :+ JO.$ y SIT Fa OR F'. O?I ip LOCA ION = : -,.•: ;;. Qty. Total
r�: _.:.. 1.,:. = <: : i. : - . :
:; `:: :,.; Reating/coolinG
Job site address: 1 Air conditioning or e at pump i
U ci,t,f ( -t (. C (requires site plan show () ' 14.00
City/State/ZIP: t 611. L `3 �V tVt Furnace 100.000 BTU (ducrs/vectts) 14.00
Suite/bldg./apt. /apt. t.e.: f Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross stre;Vdireaions to job site: _
j Duct work 14.00
_ Hydronic hot water system 14.00
F Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, nor electric), {
in-wall, in-duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /ven fo�r any of above I 10.00 !I
Tax map /parcel r o.: Other: LrtS f' I 10.00
+.• . .
* Other fuel appliances
D , r
.... ES .. Ni;dkl:{j,ORK :.�; : .,;; : • . e 1 ;'�::i,`'' . Water heater
l_
., . F' -. �;:r„_ = <: 10.00
Gas fireplace 10.00
1t- An Flue vent for water heater or gas AV
r 6 $4 i pc,.,� fireplace I 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
��� Wood fireplace/insert 10.00
.� ?E '_:P T �p - -- ..•: IE {:;:'. %;i ' ' ;,i , i - :; �,;:,,j. .:; :' Chimney/liner/flue/vent
•;, i .... �t { , f:1.
.;,,.. .. .., :F:..:r- ,.'i ' i�: ":-4K'r : ... „ ✓'L, i�Itll�Ia�'` i *Sj.1 10.
Name: r y�� r �^ / ...,. • r,._ _ . _ ,..!r::;:;ii
` /N I e(f.b S -0 ti a l,��A� 6 e'` Ether: I 10.00
�►1.� -� Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust
10.00
I
Phone: ( ) Z _ S . b Fax: ( ) Single -duct exhaust (bathrooms,
-
_ toilet compartments, utility rooms) 6.80
Bll' ''Akt, IGtANt:tr:; -°`.'" x , ' .:'fir ;tv..: t _.�t._,., 6.8
,... . . +.> =a- a ; ;Cf?i` th0h : ,ERSIIKr:ii�:z<,:E; : O t hwl f
er: raspace fans
,,.• G :, f I 10.00
Business name: O ther: L I 10.00
Contact name: J t Fuel piping i
I 6 ( S l la.; 6`er'- iafe. S3.40 for first four; $1.00 for each additional
Address: ,! eft k- 4;- Furnace, etc. I
City/State/ZIP: Gas heat pump
� )
Phone: ( U, i 7- L' 3 WalUsuspcnded / unit heater (
' (t L - i V - 7 L. tr - I Fax:: ( S'a ?) (c S7 ?_ - C `j 1 Water heater I I -
E-mail: Fireplace . 1
° :: ^ :
. , r ; '1,7--;-, : •$ ��,aa: Range I
, 3 A , ` ,,,pt ' p sti:;': : ,. L� t ;'e'tz Barbecue I I
Business name: Clothes dryer (gas) I
Address: - Other: I
Ciry/State/ZP
' -t''. " :ME.CHAtNICAL PERMIT FEES*
Suhtotal
Phone:( )
I Fax; ( ) Minimum permit fee ($72.50) '714)
CCB tic.: 4. G -. s - }- .(� Plan review (25% of permit fee)
State surcharge (8% of permit fee) . SI
TOT•4i. PERMIT FEE ' - " ?0 I
Authorized signatu •e: ( �",e �:..z C. ( - y - i` • This permit application expires If a permit is not obtained within ISO
tin) t ngUte• r (� days after It has been accepted as complete.
P
C � i let j---e l` C / ( ( ..I I Date: w(b4 1 • Fee methodology set by Tri -County Building Industry Service Board
i'\suilding \Pemdn\tv¢C•p nsntApp.doe 12/03
440 -46177 (I 1 /07./CONVWEB)
2 8 1 L 0 B6S SOS 2ut4eaH R4 j t c,adS d6S = Z0 t.0 i; i des
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SITE PLAN
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STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tizard, OR 97223
Phone 503.620.5643 Fax 50 3.598.
0 7 1 8
Hillsboro Phone
503.640 -3607 Fax 503.681.0793
E'd BIGO 86S EOS 2utgeaH RljeioadS dOO =EO bO daS
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: - c'503) 6 -4171 MST
BUP
Received Received l DGte R guested AM PM BUP
Location i /0 ./ Suite _2.5495/96761--3
Contact Person AI. • Ph ( ) . PLM
Contractor Ph ( ) SWR ^ l
BUILDING Tenant/Owner ELC Q '
Footing
Foundation / ELC
Ftg Drain Access: hF�++- K 5
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear L 1. k 7 o/
Framing `� ��
Insulation s O/, /L✓ „� Ca t
Drywall Nailing l� L,
Firewall
Fire Sprinkler
Fire Alarm H- Pu 1 p
Susp'd Ceiling ,o �,/
Roof 1 / / f ( / z i, /
Other: /�, _ ,.0 "� ,Q
Final i 4 /--c/ S e S 7 z C]C7 �-I`�/
PASS PART FAIL p
PLUMBING f� / Ns-c_
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
‘////iP
Shower Pan
Other:
Final
PA RT FAIL
CHANIC
sjBeam \>
Rough -In \-)1 J
Gas Line
.. fix"
oke Dampers SN'
WO PART FAIL
TRICAL
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 0 Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line / /
ADA
Approach/Sidewalk Dat / /` ' 0 Inspector _ .41( — Ext
Other:
Final DO NOT REMOVE this Inspection record ill the Job site.
PASS PART FAIL