Permit CITY OF TIGARD
MECHANICAL PERMIT
I�
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00389
��� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/18/2004
PARCEL: 2S114BB -02100
SITE ADDRESS: 16380 SW SYLVAN CT
SUBDIVISION: PICKS LANDING NO.1 ZONING: R -4.5
BLOCK: LOT: 035 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: DOMES. INCIN:
LPG 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 gas furnace
Owner: FEES
RICKMAN, LAUREN W + RONNA D TRS Description Date Amount
16380 SW SYLVAN CT [MECH] Permit Fee 6/18/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 6/18/200L $5.80
Phone: Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 76359
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)246-6. !•.
Issued = y: i, / �I ,! / Permittee Signature . - , i' itt iii ' •
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ext business day
Jun 16 04 10:22a PAM DALBY 503 - 598 -0270 P.
I icatiO1 - ,, FOR OFFICE USE ONLY l
Mechanical P App Received ,
i Pernit Na.: Hie , ,, ,:06 l
City of Tigard Date/13y: i
13125 SW Hall Blvd., Tigard, OR 97223 / Plan Review Other Fermi:: ?hone: 503.639 4171 Fax: 503.598. 1960 �/ �r Date/ily
♦ j I )u 0 upp See Page emeatal 2 t'o
rma
Inspection Line: 503.639.41'75 '4I'''`4401 W „ I Date ecV e cho J �
�/ ""' ! Notified/Method: r Sllafation
Internet: www.ci.tigard.or.us v `
,,; — (S
`r :.;' .::., � " r:' .- , .. - , . ,.. 1 � e F s E ' ar b ase d on i the value USF hH� work �I
.QF. ' `��� �' �` - �, � • •� '' :,; - I�COh'SIVIEItCY ., ,
I : � � . .. � �' � Mechanical permit - .e
❑ Nev.' construction 0 O th ition/alteratio �a� �t • performed. Indicate the vale (rounded to the nearest dollar) of all '
Other � O mechanical materials, equipment, labor, overhead, and prof.:
• ❑ Demolition ❑ - -1 3 . ..•., value S
W. SLUCI'IQN, i-, �4S FEES"
rRi
,; �., • . , , . �. .. •�..� `� UIPMEIti SYSTEMS ,.. .. ,,� :. -.. ' - . -... :... ' ' S ID.E I`YI' =I i
• Va - and 2- family dwelling ❑ Commercia /industrial ❑ .Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other Description l Qty. i Ea I Tc.a }
Heating!cooling •
`
JOB . SITE'.. •. NIAT.._ . ,At D 'YvOCATION •:■ Air conditioning or h pump
Job site address:
/4, t o ,5 � 5 am (7-- (requires site plan sot heat e g placement) c 14.00
I ,
Furnace 100,000 BTU (ducts /vents) J J 14,00 {
City/State/ZIP: Furnace 100,000+ BTU (ducts/vents) I 17.90 I 1 •
Suite /bldg. /apt. no.: Project name:
1
P 0
Gas heat pump
14.0_
Duct work 14.00 I '
Cross street/directions to job site: Hydronic hot water system 14.00
1
Residential boiler (radiator or 1
I 4.00 l
hydronic) {
Unit heaters (fuel -type, not electric), l G.GG I
in -wall, in -duct, suspended, etc. I
Flue/vent for any of above 10.00
Subdivision: I Lot no.: Other: 10.00 I
Other fuel appliances 1
Tax map /parcel no.: 10.00
r Water heater 1
... :`A scl *- troy; o 1,/i0A.1 . ,: :. , 10.00
fireplace
��'• '� ! - "� •"..,�: - :• ' „• :'.� :.. • Gas Flue vent for water heater or gas
2" p /A. tc_. l .. / Cl c 44.11'1 ex/r..4--, fireplace I ` 10.00 I i.
\ Log lighter ( Stove 10.00 I I
Wood fireplace /insert
10.00 I.
.. Chimney /liner /flue/vent 10.00 , •
: T 1":t;!\E J 10.00
1ZQRE* Y :.O *NER . ' ,�„...4 -}, ';;[}.: Fi . Other:
Environmental exhaust and ventilation
N ame: Q t G /L/L{ 4_,. Range hood /other kitchen •
/ ` s � /i t( 10.00 j
Address: 3 rJr7 equipment
� �*' ,/ Clothes dryer exhaust 10.00 I
City/State/ZIP: / / «
Single -duct exhaust (bathrooms, 6.80
( ) / 0 7 / p' I Fax: ( ) toilet compartments, utility rooms) 1
Phone: (O 7 _ ,!!( d " Attic/crawlspace fans 10.00 i
'❑ :^ U5 ` P.g ii : _,, 6; ! 10.00
:': P:YYL,Y�AI`kT , . :' f >_; 'i :'. = ,.: Other:
Business name: Fuel piping
Contact name: /�n44 44V. $5.40 for first four; $1.00 for each additional
I Furnace, etc.
Address: Gas heat pump
City /State/ZIP: Wall /suspended /unit heater
Water heater
Phone :sfpg) 6,a � Q [� I Fax: : ( ) Fireplace
E -mail: age
r ,,,,..,_, .. R. _ tk :, ,.: :� ?' . l t. : Barbecue
CQN,RA�]It. (gas) I I 1
• :,r` : :rz�., ,1� :�� :. :.i'_r,''� _ ?L -... ' / .. ':a,._. • .:.,... .... . , .. Clothes dryer
Business name: (...4-_-, � a "I h /a. y!�tA Cg. "'" C--° • 1 N Other:
w ,.
Address: o JO k oR 3 e 3 '7 I .• - r ,:' .r•IE,CHANICAT.•PERMIT FEES
Subtotal
City/State/ZIP: / / 4 � ,QrJ Oa- 97o Minimum perm fee (permit 572.fe50)
Phone: ) (. a of 02 1 p L1z I F ax: 4 ,..5 --. 1 , ,..5 --. 1 , f d '7G Pian review 5%otf e)
State surcharge (8% of permit fee)
CCB lie. 7 3 6 9 TOTAL PERMIT FEE {
it application expires if a permit is not obtained within ISO
days after It has been accepted as complete.
AL'lhOri2ed 5;3 �� ex-44S,, This perm Building ttd�.is[ry Service 3oa:�]
Print name: �Q� e r� 4. 4 ,9, 9 A �� I Date: Il /1 - Fee Methodology set by Tri- County Building
e40 -4617T (I I,OVCO1$IWE
r. :Bu ;Idmg�Ptrtr�tsa�LEC- Pe:mitApp doe 1'J07
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: (503 .: 9 -4175
INSPECTION DIVISION I - Etiusiness Line: J ^'") 639 - 4171 MST
BUP
Received Date Requested — _- AM PM BUP
Location , 3:6 y am 11' Suite a.6, q- d3
Contact Person , �''� Ph ( ) 2 o' 4 1 PLM
Contractor Ph ( ) SWR �
BUILDING Tenant/Owner
'A/
Footing
Foundation Access: p e' 4 g 4 M 5 EP.eNA — � m#1 ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath/Shear LNG /' Q '7
Framing V ` \ C�C�
Insulation �CG�
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
Sm. a Dampers
ed
PART - FAIL
C 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 Please call for reinspection E: Unable to inspect — no access
Fire Supply Line �J
ADA "�
Approach/Sidewalk Date Inspector _ Ext
Other:
Final DO NOT REMOVE this Inspection re from the job site.
PASS PART FAIL