Permit k --' CITY OF TI GAID MECHANICAL PERMIT
I4 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00021
�`' A ' I I - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/18/2005
PARCEL: 1 S 125DA -10100
SITE ADDRESS: 06612 SW WALNUT TERR
SUBDIVISION: PP1993 -011 ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
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: AIR HANDLING UNITS CLO DRYERS: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Gas line to dryer.
•
Owner: FEES
CHIMIENTI, VINCE + COLLEEN R Description Date Amount
6612 SW WALNUT TER [MECH] Permit Fee 1/18/200f. $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart. 1/18/200: $5.80
Phone: Total $78.30
Contractor:
SUNSET HEATING & COOLING
PO BOX 42289
2944 SE POWELL BLVD REQUIRED INSPECTIONS
PORTLAND, OR 97242 Gas Line lnsp
Phone: 503 234 - 0611 Final Inspection
Reg #: LIC 161085
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: St: _ p,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bu iness day
01/17/2005 04:40 0000000 ABAB:AAAAAA AA PAGE 02/02
•
. Mechanical ?hermit An li . . . 1 1 i 1 :111 I i 1 I 1 i l 1\ I'i
City of Tigard ved
,
1 3125 S W Hall Blvd., Tigard, OR 9922R E C IV / fit l 1 `- L ■` f
Phone: 503.639.4171 Fax 503.598.1960 1� Revues - Otter Permit:
5 Y
I
Inspection Line: 503,639.4175 o 1 4.- • 1 I . Date Ready/By: 0 See Page 2 for
Internet'. www.ci-tigard-or.us 1 JAN 10 L :: � ... Notified/Method: Suppiemeatal information
':
e l
❑ New construction i'i i , ,' .11 . : !ill s1.. t . ' . MechaNcil permit fees* are based on the value of the work
❑ Demolition • Other. performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
1 `fi 4:21..".':';,-.4'.',1":47:7,,:i value: $
.
, . -
.., i A :, e
'.� I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ' i
ui El Other.
For special information use checklist
❑ Multi - family 0 Master builder E
ra. •. �, 4 , i r
T, . k 1 ,, • ` , C . Description I Qty . I Ea. I Total • - •
'4'' ie,ti. .. �. � it rr { .k r � 1:I. 2 . . 7:7..,,I=1;,,';';':,.. V ' ; } . t .,H r, P 1, ;(. ,• „f ti[Cat /00 0Ii
. ,n._ i 1l , . „ , ,r.r ..,r. ;. , u ..- r::c.+r r :+.:,:•• l.� ,...E.: ,. 'r _
Job site address: rrnn ��q� p e l Air conditioning or heat pump
lX� I W t�U( /L� �V►' - . Lrevires site plan showing placement) 14.00
City/State/ZIP: ` 1 - ( Ki( tr� q'1 3 Furnace 100,000 B7TJ (ducts/vans) 14.00
() ' Furnace 100.0x0+ BT ( ts/vant9) 1 7.90
-
Suite/bldgJapt. no.: I Project name: /' r �i (y en
t; � heat pump 14.00
Cross street/directions to job site: � Duct work 14.00
Ilydronic hot water system 14.00
- Residential boiler (radiator or
hydronic) 14.00
Unit heaters (ttel•type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.:
Flue/vent for annof above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
. ", j7� -F lrl � a y �, t : u•.t tr, 'FU7'ri '1 1 7,:g s. r { i r , 4 1k 7111 1 � .
ti 'I'' t5_ mi f, i . ; I 1 r '?( y,, e 1 t � ,,, r , , f i 3 r , ,� r u • 1 r i , 1 i ( . H . :'t Water beater 10_00 _
./ . .. . N „..;r . St U, • ,,, 1. ,,,,,.,,„ _,,,, Sr .,,,,,,;.1, ,. ,, „.i•,,,!i � r„ i. 1 , :ii L,., ,,,,,.;ri - Gas fireplace 10.00
S , tl NE 1 U 61.1(16e/r Flue vent for water heater or gas •
fireplace 10.00
- Log lighter (gas) r 10.00
Wood/pellet stove 10.00 _
Wood fireplace/insert 10.00
� t � t tl' S ' 2 r � VF .. r T ''r +1T'P Chimney /lint /f uc/vent 10.00
' �“ c5 7 65 - 7,72 : 11 :;''' ' i w..�t� �.. ti :-, - -''r lA ', . ;- ._' r. .= ',Oltli.:� 1 , 1 I . PIr
100
t rim.r{ /• : . .r( � � . .
,. .. . .. ..... ... other 10.00
Name: M Y CIA, t Al, b I P4k-1 Environmental exhaust and ventilation
Addre (� �� ��U •1- (�Nr Range hood/other kitchen
equipment 10.00
City /State/ZIP: -11 0 )2-, ck7 .)-...)-4 Clothes dryer exhaust 10.00
P ( .� L9.7- Fax: ( ) Single -duct exhaust (bathrooms,
Phone:
+' r" a '4 } ' - y r r ,I toilet compartments, utility rooms) 6.80
� P 4 b ¶ 1
„ ;l i , t ;, t i r L r it Zr11 } r � st I' i '
r i� 1 ^ i V ° Attic/crawls ace fans 00
• • 1 • • h . + , ;La i Oa''c-+
.- 2 bC i d, , - 4 ri"1. ; ,0 (9 r . t • J . , t ;, .. C N. , 1� 1 P 1
Business name: Other. 10
- Fuel piping
Contact name: $5.40 for first four: $1.00 for each additional
Address: Furnace, etc, - 1 5 lb
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
V
Phone: ( ) Fax: : ( ) , water heater .
E -mail: Fireplace
Range
- ;.i`:�:if ' ;,:a. :1 ;<<�% - ''"i >Mr,;1 r, .c03 R � '=� " 'K Barbecue
• , "v Sei �ii.�i�, `¢ •'�c�� � �t:. if. di?�c? rf' :�' ,'�',r- ,
Business name: Sunset Heating and Cooling Clothes der (gas)
Address: PO Box 42289 - Other'
ii itli* � •
City /$tate/zIP: Portland, OR 97242 �� ;
__ Subtotal
Phone: (503) 234 -0611 r Fax: (503) 2344139 Minimum permit fee ($72.50) 7 g)
Platt review (25% of permit fee)
CCB lic.: 161085 State surcharge (8% of permit fee) 513
0 � k,____ TOTAL PERMIT FEE ,, t �
Authorized signature: • This permit application expires Ira permit is not obtained within 0
days after it has been accepted as complete.
L Print name: Shauna D'Ambrosia Date: l 0 ' Fee methodology set by Tri- County Building Industry Service Board
1 \Building1PermhOZ. C•PermltApp 17A7
4 (1 Ug2.TOM/wEBI
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Ling: 639 -4171
I : ( 1: 30 - 3
Received 7 g Date Requested. /1 , AM BU /
Location Co (0 / d' W - [
uite � -4 `
Contact Person h ( 5 0 1 PLM
Contractor Ph ( ) X 1 3 ` SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: 6 9•
Ftg Drain 1 .30 – 3 ELR
Crawl Drain
Slab Inspection Notes: _ SIT
Post & Beam (? l ¢ —�� �S /Ifl.,-
Ext Shear Sheath/Shear Anchors 1/444 0 .Q J
Ext eah/Shear ���� -3 1 1 R- 3 ya �
Int Sheath/Shear
Framing
Insulation ,-,,IN. S 0 • -
Drywall Nailing
Firewall V YST S-' / z 1
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING , 1
Post & Beam
Under Slab I�.,_: ,r T ,
Rough -In
Water Service r-
Sanitary Sewer t ; I ' -., _,, ' .
Rain Drains a
Catch Basin / Manhole -
Storm Drain � _ --
Shower Pan
Other:
Final
PASS • _ RT FAIL _
Post & Beam -
Rough -In _ '�
Gas Line
/ , %' , _.;,•„1
• Smoke Dampe . - 't - Ps " / ) 1
4.g. PART FAIL -
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final . ❑ Reinspection fee of $ required before ne pection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please for reinspection RE: / Unable to inspect — no access
Fire Supply Line I I r
ADA / / 0
Approach/Sidewalk Date Inspector s Ext
•
Other:
Final DO NOT REMOVE this Inspection record f om • he Job site.
PASS PART FAIL