Permit CITY T MECHANICAL PERMIT
I j� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00443
. I" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/7/2004
PARCEL: 2S104CA -06000
SITE ADDRESS: 13585 SW WESTRIDGE TERR
SUBDIVISION: HILLSHIRE ZONING: R -7
BLOCK: LOT: 060 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A/C, do not place within the required setbacks
Owner: FEES
KNAPPENBERGER, JOHN D + SHERYL G Description Date Amount
13585 SW WESTRIDGE TERR [MECH] Permit Fee 7/7/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 7/7/2004 $5.80
Phone: 503 - 524 - 9113 Total $78.30
Contractor:
BELL HEATING
15550 SE PIAZZA AVE
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503 656 - 1184 Final Inspection
Reg #: LIC 447
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: I Permittee Signature: qg04 / �� � ■
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next • s' ess day
- Mechanical P; rm Applica on "`�` Y ` =)E*UR- o'FEIIrE =USG�O:YLY ::: y
Reserved Mechanical -0 DateB : Permit No ! / • r
City of Tigard r r •: Planning Approval Building
:
��
Date/B : Permit No :
13125 SW Hall Blvd. `�= -_,'' / Plan Review Other
Tigard, Oregon 97223 Da - :: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 `. "!P Post - Review Land Use
i ,;� �, it' �' A Date/B : Case No.:
Internet: www.ci.tigard.or.us
(:, ? �! I� Contact Juris.: ∎4 SeePage2for
ect Request: 24 -hour Inspection Re 503 - 639 ; r ' - 7 - "
—
P q J 9 Name/Method: Su. e lemental Information.
- > - TYPE OF WORK • . : :.. COMMERCIAL FEE* SCHEDULE='USE CHECKLIST. • ,
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
Ist Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
- :' - '''..`';'-''''''-=P;', :' `CATEGORY OF'CONSTRUCTION , -_,,,, ' . mechanical materials, equipment, labor, overhead and profit.
▪ 1 & 2 Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family IDENTIAL•EQUIPMENr /SYSTEMS FEE *? SCHEDULE. -. '
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other:
Heating/Cooling
` Y: SOB SITE INEORMATION•and LOCATION - , ' Furnace - add -on air conditioning ** ( 14.00 !Li vii
Job site address: t c,o4 U.)eelt^; Aqe .1 Gas heat pump 14.00
Suite #: I Bldg. /Apt. #:U 11 Duct work ■ 14.00 ('{ d= '
Project Name: t�ltJlaPPEnJlO r � r - 5) Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: NO t t 8 (for radiator or hydronic system) 14.00
O (. 0 55 (h -5 Unit heaters (fuel, not electric) -duct,
�� J � , � � 04 \ KA- • N - F l wall, i (for an suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
Other,Fuel Appliances
Tax map /parcel #: Water heater 10.00
•, 'TDESCRIPTION.OF WORK " e� - Gas fireplace 10.00
:) R /C 0.41,Q Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
da am� Wood/Pellet stove 10.00
F (L(A - c-a �As C Wood fireplace/insert 10.00
Chimney/liner /flue /vent 10.00
® ' : :-:: 1'_U TENANT . . _. ; :, Other: 10.00
Name: -Sohn t�'�C�L \,. Pe , :. •• Environmental Exhaust & Ventilation ,' .
Range hood/other kitchen equipment 10.00
Address: ‘;)- 6 t N. k eg r
lothes dryer exhaust 10.00
p • c . c C' ` a'a' Single duct exhaust
Phone: (0C6 6°!) sat w Fax: (bathrooms, toilet compartments,
?[ .PlICA'NT`:a'x' "'; _ . "a• : ;• ACiCONTACT'PERSON' Ott utility rooms) 6.80
Name: SIF�lE .ptv T., Attic/crawl space fans 10.00
Address: I. cSVO 5. 91p2zs (�, J Other: • , 10.00
City /State /Zip: �,�A Y q% Ol5 I first 4, $1.00 Piping n )
* *($5.40 for first 4, $1.00 each additional
Furnace, etc. **
Phone: � (a5(ta ' llg� Fax: (arj (>, - '� S \ Gas heat pump * *
E -mail: Wall/suspended/unit heater **
:. - ' ,._ CONTRACTOR. - • - . Water heater *5
Business Name: 1,\ 0.1 • LtJC Fireplace **
Address: k call � p Range **
BBQ **
City /State /Zip: C '�-/►G�'^I Clothes dryer (gas) •* ' _
Phone _,, , 5 e Fax: 3-NoStp -1 \ \ Other: **
CCB Lic. #' 7w G la t Cl Total: .
Authorized Mechanical Permit Fees*
// Subtotal: $
Signature: Date: 1p4�' �g --- <Mt0
Minimum Permit Fee $72.50 $ 1 1
- Ng-‘) , t, e■J s5 Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 580
TOTAL PERMIT FEE $ lbw
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
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SITE PLAN t v
•INDICATE NORTH FOR INSPECTOR•
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A • ►.. CONTRACTOR A/C -HEAT PUMP UNIT SITE PLAN A to[ 1-
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BELL' HEATING, INC.
16550 SE PIAZZA AVE, - -
CL.A KAMAS, OREGON 97015
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received • Date _
e Re uested n � d� AM PM BUP Ji1
Location \ �� i � S � `01� ���k t Suite MEC p Q ' I "1 `13
Contact Person r Ph ) j \ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 04- ooM
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
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 � F
FAIL
Post & Beam
Rough -In C (
Gas Line
Smoke Dampers
k\-t)
A S PART FAIL
' A
Service
Rough -In C
UG /Slab /
Low Voltage 4''
Fire Alarm
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'1 PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA ( l3 )o,\
Approach/Sidewalk Date I 1 "I Inspector LA.GiA y EXt
Other: Final DO NOT REMOVE this inspection record frob site.
PASS PART FAIL