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13290 SW GENESIS LP �
CITYOF TIGARD MECHANICAL i'ERM!T
DEVELOPMENT SERVICES PERMIT#: tEC2004-00205
,�+ DATE ISSUED: 4 4/20/2004
y 13125 SW Hall Blid., Tigard, OR S7?23 (503) 639-A171 PARCEL: 2SI03DB-07500
SITE ADDRESS: 13290 SW GENESIS LP
SUBDIVISION: GENESIS NO. 3 ZONING: R-4.5
BLO(,K- LOT: 060 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: `)F UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 :BENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERSIC0MPRESSOR S HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
I PG A 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPER`)?: 30 - 50 rip: WOODSTOVES:
GAS PRESSURE: 50 + HP. CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
TURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Furnace replacement.
Owner: —__.-_ FEES
BJERG, DAVID A Description _ Date AmL;11nt
BJERG, GENELIA R IMEC'IiJ Permit Fce 4/20/2004 $72.50
13290 SW GENESIS I'm]S%State, Surchar� 41201200' $5.130
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
SPECIALTY HEATING &COOLING
1601 SE RIVER RD
HILLSBORO. OR 97123 REQUIRED INSPECTIONS
Phone: 503-t)40-3607 Heating Unt Insp
Final Inspection
Reg #: LIC 66578
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 donna in accordance with approved plans. This permi!will expire iiwork is
not starter within 180 days of issuance, or if work is suspended for more than 180 days. A i TENTION: Oregon !;J.
requires you to follow rules adopted in the Oregon Utility Notification Cer," i Those rules are set forth ir. OAR
952-001-0010 through OAR 952-001-0100. You may WPM copies of these rules or direct questions to OUNC by calling
(503)246-6699.
Issued B Permittee Signature: Gp�
Call (503)639.4175 by 7:00 P.M. for inspections needed the next business day
FOR OFFICE USE ON Ly
)/I ec;hanicai Permit AG li tion Reccivc4+ McOanicet/
Permit NU.;/
r+
Planning Appro,�i Building
City cif Tigard Daic/B : PcrmitNo.:
ri1 ��t1 Plan Review
' Otfter
13125 v JV Hall Blvd. t)
n Permit
Tigard,Oregon 97223 �R _
Phone: :f03-639.41 71 Fax: 50�-599.1960 Post Review Land Use J
• DntrJH : Case No.:
Internet: wwnu.ci.tigard.or.us V jIcl Contact ri .: See Page t for
24-hour Inspe:rior.RCt{ueat. 301�i 9t1 Q�`1 —�� NamcMcthod! \u tnmental hformati,n.
l�lSl�
TYPE Or WORK � r0MMERCI. E'SCHEDULE-USE CHECKLIST
Nest con itruction Demolition INlechanical permit fo.:c'are brsed on the total value of the wor,.
_H performed. Indicate the value(rounded to the nearest dollar)c-f all
Addition altetation/replacem.ent ether; mechanical materials,equipment,labor,overhead and profit,
CATE(iUKY OF MYST.RUCTION
1 &
2-Family dwellingCommercial/Industrial value: s See Page:for Fee Sche:lulc
Accessm y Buildin Multi-Famil RESIDENTIAL.1: UTPMENT/SYSTEMS FEE*SCREDULE
_ Descriptioit ry I ree(ea.) I Total
Mast-.r E uilder I Other: Heatin Coolie
JOB SITE INFORMATION andLOCAriON u -add-on air conditionin '+ 14.00
Job Hitt adt31 Cs3: fl Z O Q ti. 1 1 gas heat oumv _ 14.00
� B ldg•/Apt.#: N G Duct work 14.00
Hvdronic tot water System 14.00
Project Na1T e. _ Residential boiler
Cro33 Street•Direo,:ions to job site: for radiator or hydropics arrm) 14.00
Unit heaters(fuel,not electric)
(in wall,in-duct suspended,etc.) I 14.00
Fluc'vent Lfor any pf above) 1 10.00
Repair units 1 12.15
Subdivision; Lot#'_ Other Fuel Appliances
Tax Map pa-cel#. Water heater i o.00
DESCRCP ION OF WORK Lias fireplace i 10.00
Fluc vent(water hcateriga t lcti2 ace) I 10.00
— Lor lighter(gas) I 10.00
4_12.i�{-t"(;Q I't`,tt' — Wood/pcltct stove ^-- 10.00
Wood ^—
fire lace/insert 10.00
Chimnc /liner/flue/vent _ 1 10,00
PRCIP_E�tfy G'1!lrlK L TEPtANT__ C)thrr. 1. J_ 10.00 —
G Environmental Exttsust 5 van:tlatlon
Name__t 4'l _ Range hood/othcr kitchen equipment �� 1000
Address: __. _ __ Clothes dryer exhaust 10.10
City/.State Zip: Single duct exhaust j
Pho :(PS 4--(p v Fax: (bathrooms,toilet compattmcnts,
PI-LIC_.NT __r- coNTACT PERSON i. : utili moms) 6,5U
Attic/crawl s acc fans 10.00
Narne: l O.Oq
—_^- Other:
Addr'ts5: Fuel PI in —
95.40 for nr*t 151.00 each additinnell
City/:;talc Zi --1----
Furnace etc.
Phont;: Fax: —� Gas hent um
E-mail; __ Wall 1suv endediunit heater
_r^- CONTRACTOR Water heater
,d e'. 4-i r� Fireplace "
BUSir.CSS �10.[Y18: 1� C — ..
Addr,.SS: G tv �. ( , Range ..
BB
Clt /State/Zip: l lS 1i C-r dryer(gas) I "
Phon"__-�`ic ;t: Fax: 4,,5-I p �`t Other; I ••
1 Total: I t
CCB Uc. 1'.: L,lam"�_ /ri_ - _ Mechanical Permit Fees'
Authofiied r J __ Subtotal: I S
Signarire: i'l�tl.u_.�: ���`-v _ Datc:N�L'°!bW 04 um P.armtt Fcc$72 50 1 S 2 v
�1..-s Plan gavial Fee 25 1 of crrtut Fee) I S
State Surcharc_•.18 ',,of Petmit Feel S v
(Please print name) TOTAL PERMIT FEE 5�_ ,
Notice This permit appilcation expires Kit permit is not obtained within *FSII pt hoan doler s for exterior CbutI 'a ineustr. service tion rd.
1 fla da rs artt r It has been acccpl*d as complete•
t:tDsu\Permu I'onrA\mecPermttwpp doe 01/03
z 'd SILO SBS EOG 3utaeaH c,4te1aaclS ei0 :130 40 n2 JcIH
CITY OFTIGARD 24-Hour
BUILDING Inspection L.Ir„:: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 / MST — --
-,; BUP -- ---_
Received __ Date Requested PNI _ BP-
Location _. _ 1 ;U = - Suite __ (MlEg/
Contact Persr i _.-- .c ' Ph PL.M
Contractor—._'._- _ Ph(----) - — SWR — -
BUILDING Tenant/Owner . _ E.LC
Footing E LC
Foundation Access:
Ftg Drain ELR - -
Crew.Drain
Slab Inspection Notes: SIT
Post&Beam I l —
Shear Anchors Yy
Ext Sheath/Shear �U
Int Sheath/Shear
Framing __-
Insulation �c�y �f
Drywall Nailing - -
Firewall
Fira Sprinkler ---
Fire Alarm
Susp'd Ceiling
Roof
Other - - --
Final
PASS PART FAIL
PLUMBING
Post& Beam
Under Slab - -T
Rot-gh-In
Water Service
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain
Shower Pao
Other:
Final
PASS PART FAIL
kltCHAmcA ---
Po-.! oam
Hough-In — --as Line
Smoke r`ampers -
Fin
PASS PART FAIL — J J---
EL tRICAL
ervice
Rough-In -
UG/Slab
Low Voltage
Fire Alarm
Final [� Fininspection fee of$_ _re juired before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL_
SITE �] Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
r '
ADAoach/Sidewalk Dote / 1 Insp actor
pp
Other
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL