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109460 SW CENTER ST
CITY OF TIGARD ---- --- -
/ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00720
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12./18/03
PARCEL: 2S 102AB-00205
SITE ADDRESS: 09460 SW CENT'R ST
SUBDIVISION. I'AARIELI. 'ZONING: R-4.5
BLOCK: LOT: 305 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: 1
STORIES: BOILERS/CO_MPRESSORS HOODS:
_ FUEL TYPES _ 0 3 'iP: DOMES. INCIN:
I l'C 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPER-;?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR_ HANDLING KNITS OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS: 1
> 10000 cfrn:
Remarks: I irchluce u,srrt and Ilur �cui
Owner: FEES
RUSSELL, MICHAEL C + ROSE M Description Date Amount
9460 SW CENTER CT �%II (•III permit fee 12/18/03 $72.50
TIGARD, OR 97223 1 \X1 R State 12/18/03 $5.80
Total $78.30
Phone: 503-619-2282 —
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503-044-.1bu7 Gar Line Insp
Mechanical Insp
Reg #: LIC 66578 Final inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicabie laws. All work will be done in accordance with approved
pans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100 You may obtain copies of these rules or direct questions to OUNC by tailing
(503)246-6699,
Issued By: ' G- c_!t. vGr.C�lLa __.. Perrnittee Signature: 'T ' ,�f L.
Call (503)639.4175 by 7 00 P.M. fog inspections needed the next business day
aermit Application Received Mechanical
DWO/By; Z Pctmit No.: 13-gym
Planning Apprtivalf Building
0 T rd Date/B : Permit No. _
131 .ti V�' l Blvd. Plnn rtc.tew c)tncr
I'Ig1t� egon 97223 Dnits/By.' Yrtmit No.:
Uso
Phone; '03-639-4171 Pax: 503-598•-1960 volt-Review [and-Case
and Case Nn.:Date/BY:
:
Internet; www,ci.tigard.or.us Contact 21 See Page 2 for 7
24-hour 1 nspectton Request: 503-619.4175 NanWVethod: _ S-welemental informatio r.___j
�'_--_`— I'YpE'U>t''WO.RTC• _ COMMERCIA'riFEE*SCHEDULE-USE CHECKLIST"•':::..•
T
New -0nstnletion Demolition Mechanical pet,. Fs-cs•are based on the total value of the work
Perfoud. Indicate the value(rounded to
Udiiion/alteration/rS lae_ement Other: etc noarcai�luUar)of all
m
rr "t EGWF OF CONS >frCCTIO +'Y:. mechanical materials,equipment,labnr,overhead and?rofit,
F-- 3t Z-Fanul dzg!�
Commercial/Industrialvaluo: S See Page 2 for Fee Schedule�►tccet soryB dMulti-Family SII,DEI 'UM IMSYS7'V43 BEE`SCMDYIL,E'r'
Dever) tion tv Fee(ea•� Totai
1`dasu r Builder Other' Heating/co U _
O$°SITE-INFORM TIOtt i idILOCAS'ION- Furnace-add-on air conditioning'"" 14-00
!0b site a Adress: 6i N b o_ Se..) Com-•A.4 ? vas heat pump 14.00
Suitt#: _ Bid ./A t,#_ Duct work 14.00
PmZ�ct N Sme Hydronic hot water system _ 14,00
[?esidLntittl boiler
Cross stye et/Directions to jab site: for radiator or h dronic s stem _ 14,00
Unit heaters(fuel,not electrio)
in wall,in7duct,sugrPrided,etc,) 14.00
Fluo/vent for any of above) 10.00
Subdivision: Lot#: , —Repair units 12.15
Other Fuel Amiliances
Tax inaE�tarcel#; Watcr heater 10.00
DES C[Ur, WORK Gas fire lace 10,00
tF-(y Flue vent wator hestcr/ as Ile lace 10.00
Log 1 i ter as _ 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
imne /liner/flue/vent IOAO
rRa`P��; Q1pNERT._LU18�1N ;.; — Other: 10.00 —
Nam.: VL,�l�� e- 1-e—" �— EnvironmentalExhaust :Ventilation
F - Range hood/other kitchen equipment 10.00
Addr;ss: _ 1/`!! 10.00
----- - Clothes dryer exhaust
Cit /;hate'Zip:
.�.__...., .._. -- Single duct exhaust
Phone:(f,•' `'1- Z Fax. _ (bathrooms,toilet compartmeritc,
p ?LW,kp coJy.TAC1'IY.ERSON:." udlit rooms) 6.80
1vB171E~_ J Anic/crawl ace fans IU.00
er.
ethI o.nn
Addros5: _ - Fuel-r- to
Cit /States L�_ ••(55.40 for lint 4,51.00 each additional
Fax: Furnace,etc.
..
P}1011c': — -- Gas heist Rump •:
E-mail Wall/suspended/unit heater "
CONTRACTOR;a Water heater
BUSinI:SS (`ally: c L&
Range
Addre s.s; 0 tt.r -c F BB ..
City/State/?i : t,IS c' . in-', ^I ], Clothes dryer(gas)
Phone '• . - t, Fax 4� i- o `i other: "_�--
CCA Total:
r
Mechanical Permit Fees
Authorized / L`� 1i L ��y, Subtotal: S
Signatures 1, t!L Date: Minimum Permit Fee$72.50 S U
r�h;(,v _•` L l��'^ Plan RevieN Fce 25%of Pettttit Fee 5
(Please print name) _, State SurcharSc(86/a of permit Fec S
TOTAL PERMIT FEE j S C)
Notice: This pe mit application expires if a permit Is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
100 days r iter it has been a,ccpted as complete "Site plan required rot exterior A/C units.
is\Dsu\Pcr,nii Fo ms\MecPermAApp doc 01101
fres Fos
9u t aeaH W41"OadS eEi* 180 EO L11 Gall
CITY OF TIGARD 24 +our
BUILDING Inspection Line: (503)6394175
'NSPECT!ON DIVISION Business Line: (503) 639-4171 MST
Received -D equested M BUP
� _ BUP_ ___
Location _ Suite _-- MEC --� U?�ZZ
Contact Person — - _ _ _ Ph(- ) _-_ PLM
Contractor Ph(_ ) - SWR
BUILDING Tenant ne ELC _
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain --- --
Slab inspection Notes: SIT
Post&Beam
Shear Anchors - -- -- -
Ext Sheath/Shear
Int Sheath/Shear --
Framing
Insulation
Drywall Nailing ----
Firewall
Fire Sprinkler -- -- -- _ -- _
Fire Alarm /f
Susp'd Ceiling _-
Roof
Othor: ---
Final
PASS PART FAIL -�-
PLUMBING� _
Post& Beam
Under Slab
Rough-In
Water Service -_—
Sanitary Sewer
Rain Drains - -- -- - ---- _
Catch Basin/Manhole
Storm Drain -- - -- -- - _
Shower Pan --
Other. --- - -- �_
Final -
__ FAIL --- -
_
Post& Beam _---___--- -
Rough-In -
Gas Line-
_SMQke Dampers ----
Fin
P S PART ------ ---- - - ---
ECTRICAL
Service -
Rough-In _
UG/Slab - — ------- �. - _-.._
Low Voltage
Fire Alarm -- --- --
Final Reinspection fee of$ required before next by Hall, 13125 SW Hall Blvd,
PASS PART FAIL inspection. Pay at City
SITE ❑ Please call for reinspection RE: _- _--- -__- __- Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk D#Aq416 Inspwctor - Ext _
Other:
Final - - DO NOT REMOVE this Inspection) record from the Job site.
PASS PART FAIL