Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00191
. 14- --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/14/2004
PARCEL: 2S110BC -03600
SITE ADDRESS: 12365 SW WINTERVIEW DR
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 007 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:
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: Installation of a/c unit.
Owner: FEES
STANLEY GEORGE Description Date Amount
12365 SW WINTERVIEW DR [MECH] Permit Fee 4/14/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 4/14/200 $5.80
Phone: 503 624 - 8901 Total $78.30
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
Final Inspection
Reg #: LIC 102030
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) 6699. / -
Iss d By: ` :i! ' /,_, Permittee Signature
Call (503) :394175 by 7:00 P.M. for inspections needed the next business day
•
FROM :FIRST CALL HEATING 8 COOLING FAX NO :503 -286 -5194 Apr. 14 2004 05: 42AM P2
hOIt OFFICE USE O \I.Y
Mechanical Pe 7 t tie 1 i on Received./ B , / Mechanical ,�
Date : 1 /i 0"9 - z _ PcrmitNo.:' —ell 7
�
P, 200{ Planning Appro al Building
�-1t of Tigard ,�' -- Date/By Permit No.:
y Tt G��0 �t v �S Plan Review Otnrx
13125 SW Hall Blvd. CITY O� nate/a : Permit No -:
Tigard, Oregon 97223 `1 Date / Tand Use
Phone: 503- 639 -4171 Fax: s�A1k9P- ,;; , I .EVICw
r C on tac t , ualeB : Case No.:
Inletnct: www.ci.tigard.or.us !
—
- J a See Page 2 for
■■'' � �. r.T �
i .. �/� ® Su. Ietncalal lnf°rmallon. •^
24 - hour Inspection Request: 503 - 639 - 4175 Nain /Method: , y . ip�
rtl 1 �• % .V ', �.. 1 i'm• tl �'t ��.� �'a• +`Y�NN. -L= .11:11 •• .1�'.�LI.JI.i •�•, J E i4(J11.'
, •' 1 ' • .! ? ` � ^, fi �•.„i ? i I `tl 12.4 " :q.,'PP Ni Y � 1 �., it; .' l ° .ir. �I,L.i1. �;R,...v
❑ New construction ❑ Demo1ition Mechanical permit fees'" arc based on the total value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
it lacement • Other: mechanical materials, equipment, labor, overhead and profit.
• ' rr.. ,. , t, e;}?grgit ; ?!1.1.009 Wl '. ;a`..:'!,: •• .11?'r.; :_ : : ; :. Value: S See Page 2 for Fee Schedule
Commercial/Industrial Miam , �� g - +5 r t� . for F �u
1 & 2-Family dwelling ❑ . .; : fa' i :l IrtE.�a`�. a D'' F�i�ff; i.,.�' �. L: .
Accessory Building ❑M - Faintly — - pcscrlptiotl Qty Fce(ea.) total
Builder ■ Other: fie8tiiadfceej tg
coed 14-
Master i o `. ' !0.••• Furnace - add -on air itioning "• 00 H ''
_ . i� � �:- 'i�,�� i' �.ati9�.�? �' /02N � fr. � -� � C :`� � �r1r'; �g 14.00 _ _ —...
Job site address: /Z,3h SG✓C ervi heat pump _ —. •-
Duct work 14.00
Suite #: I31dg. /Apt. #' — Hydronic hot water system 14.00
Project Name: _ — - • — Residential boiler
Cross street/Directions to job site:
(for radiator or hydronic system) 14.00 •
Unit heaters (fuel, not electric) la 00
(in wall, in -duct, suspended, etc.)
Flue /vent (for any of above) 10.00
• Repair units _ 12.15
Subdivision: 1 Lot #: Other Puta•Ap kalif is - •
Tax ma. /.arcel #: t- y �, y � yy ) Water heater 10.00
" s ..1'h�.. y;�•� 9 1\ lY�?. ��A 6 �C' �, -'.' ° • . 'l.!,. ' .' Gas fireplace 10.00
1' ✓� 1; 9.Iiia .- -: ',.. ..�� 11.: .' �• 10.00
• Flue vent w heater /gas fireplace) •
/1�r..� - — Log lighter (gm)__ 10.00
- Wood/Pellet stove 10.00
r._� Wood fireplace/insert 10.00
�' Chimney/liner/flue/vent 10.00
.: �,- Other: 10.(H)
wQ G4�'���� ''•;;:::!:'-;.: 1Il r, ,':a ..:;r — er:, afio
e h �' Ifs s ' - ' Envirenine itpl: ti ttat••&'�'.entil u •
acne: 54aserlev i6e_o_ t_.. _ — Range hood /other kitchen equipment 10.00
�
AddresS: 3 rC' ', ..0I,) c i� osPa` Clothes dryer exhaust 10.00
City/State/Zip: :17 C' r 4, 7 _ Single duct exhaus
(bathrooms, toilet compartments,
'Et •'Fils 4. , ','-:I. utility rooms
'' �• ;:i ;. a 8�l�ti�o , �e1 ',i�?I �.'� • �. ��
:Attic/crawl space fans 10.00
Name: r Other: 10.00
Address: _ .- 1t _rpJp
City /State /Zip• es (SS:40 for first 4, $1.00 each additional)
Furnace, etc. .."
Phone: Fax .• Gas heat pump
Wall /suspcnded/unithcater ""
_
E-mail: mail: _ - - :"
7 �„ ':
+4 ,::i:�iFi4i''�4 gN dir : ''ifiI, l ift ', 4 ' if. ) - '�.'',:I'I' ;r,1.. • 4 : !;: 1 _Water heater s'•
Business Namef , i ,g•�4 . G�Qe % S Fireplace -
Range rr
Address: /moo i g/ /e.r. �1ae T — RAQ •• — —
Lit tate/Zip: , _ ii�
7. ._ Clothes dryer (gas) rr r r
— _.
Pkac►ne:�x Fax: ! —S /rim Other: _ total: ,— .
CCB Lic. #: fO1Q•�] MecbanlclalPcrmitEcea' —.
Authorizal !,/ Subtotal; $
Signature: »ate�J /ay Minimum Permit tee 572.50 d'1_5� —
777777 _ Plan Review Fee (25% of Permit Fcc) $ —
l'-- — State Surchar a (8% of Permit Fec $ 5'� — .
(Please print name) TOTAL PERMIT FEE S 1
Notice: This permit application expires Ira permit Is not obtained within *Pea methodology set by Tri- County Building Industry Service Board.
IRO days after It hat been accepted as complete. "Site plan required for exterior A/C units.
i. \Dsts\Permit Forms\MeePcrmitApp.doc 01/03
FROM :FIRST CALL HEATING & COOLING FAX NO. :503- 286 -5194 Apr. 14 2004 05:43AM P3
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received l Q T 2 Date Requested ��S —6 � PM BUP
Location Z �O 5 ..GIu/�L:1 W ite MEC 2 - O r a / 9/
Contact Person ,10110191 U..5) 62 1 - n F 9O / PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ wner ELC
Footing 1=
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: kg/ tt/1,-‘41 S IT
Post & Beam (�
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Other:
Final
PASS PART FAIL
PLUMBING
frit
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole s c �,, 1 �.D 1 �(
�
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
ampers
�� -�•�; : T FAIL
• CTRICA
Service
Rough -In
UG/Slab
Low Voltage
larm
, Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA C /
Approach/Sidewalk Date 7 U Inspector • LZ1 Ext
Other:
Final DO NOT REMOVE this inspection record rom the J ' site.
PASS PART FAIL