9900 SW KIMBERLY DRIVE da Ala38INDI MS 0066
t
0
co
0
0
cn
A
Q7
m
v
9900 Si►ii KIMBERLY DP
i
\ CITY OF T I GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2 J4-00740
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/12/2004
'ARC E L: 2S 111 CD-00300
SITE ADDRESS: J9900 SW KIMBERLY DR
SUBDIVISION: KERWOOD ESTATES ZONING: R-4.5
BLOCK: LOT: 02", JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENZ FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES _ 0 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: PTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPEr.:?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: CLO DRYERS:
ODSTOVES•
FUt'N < 100K BT'J: 1 _ AIR HANDLING UNITS C
OTHER UNITS:
FURN -=1('0K BTU: — 10000 cfm:�
> GAS OUTLETS:
10000 cfm:
Remarks: ItCL nuuCcI furn,i,C
Or,-ier: _ FEES
RUZICKA, DIANE L Description Date v Amount
9900 SW KIMBERLY DR IMI CII 1'emw I cc 11/12/20( $72.50
TIGARD, OR 97223
1 1',1t1 8°', tiiitr tiuir,mui 1 1112/20( $5.80
Phone: 5ii3-620-8671: _Total $7830 -_
Contract.r:
SPECIALTY HEATING &COOLING
1601 SE RIVER -')
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Heating Unt !nsp
Phone: s03-64(1-3607 Finallnspecti,m
Reg #: L!C 66578
This permit is issued subject':. the regulations contai,,ed 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 sAt 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:
Call (503) 639-417.11,17:00 P.M. for inspections weded the next business day
M. &0 PerMglt Application
FOROFFIeEUSEONLY
CitPerml(No.
Citi or Tigard
13123 SW Hal Blvd.,Tigard,OR 97223 PlanReview!I I
Phone: 503,639,4171 Fax: 503,598.196c, 0AI4/8Y: OCiar Pornt:
Inspection Line! 503,639,4175
Internet: w%#Pw.ci.dg&rd.ar,uz pate 541 Pace 2 im 7
ffirn*UCAI thformiqUori
7
�! ,,7 -
,7 New const-i-iction ❑Addition 101teration/replacerneat Mechanical permit fm,are based on the value of the work
performed,Indicate the Value(Founded to the nearest dollar)of au
J Demolition C Other:
-mechanical TriltdriA13,egutiament,labor.overhead,ane ,rofit.
CAktTtEd6k*.'-6llr,tG1kI RqC XON Value:S
F� ;
and 2-finily dwellingCornmercial/indiistnal L-1 Accessory building R ,SiMLJTI'�LQXrOWNT/S-YS7dM FEES'
Multi family ❑Master builder Other: Ali.Speetal Infoo-wallon .,a CANC&II,
DescrpCc.iEa.
HeAtInWrooling
Job site addrese- Air cond doning or heat PUrrT
0 _(etiquirls sit_PjanAL=irap 14.00 1
rl Lq Furnace 1.00,000 BTU_t1ductwvf..nu) 14.00
Ci /State/ZIP
uste/bidg./apt.no _ju�r�adc 100.000+BTU ducwvc.ii) 17.90
�Sl.11 o.. Project name- Gas heat pump--- 14.00
Cross streitt/diracnons to job site: Duct work 14.00
Hydronic hot water stern 14.OU
ly1w-
Pentidowai�ridcr(radiator or
h%dronic)
Unit heaters(fuel-typo,not electric),
in wall ,.-duct,sus2cndcq_,etc. 10-00
Subdivision: Lot no Flu*/vantfor any,3f uLovc 10.00
Other 10.00
Tax map/parcel no.; Other fuel lippilikoIC011
A:u F womWater heater'., 10.00
Cal fireplace 10100
Flue vent for water heater or jai
fireplace 10.00
V Los lighter(izu) 10.00
W024 10,00
Wood fireplace/insert 10.00
Chimney/liner/clue/vent 1U 00
Other:
Name;
T )A_q:4 n7l Environmental exhaust and vendist I*"
Address: Range hood/other kitchen
10.007
0tY1StAWzM Clotces dryet exhaust lom
Phone;( 11 ^ Single-duct exhaust(bathrooms,
Fim, toilet corn 680
`17'17 .10. �ARSCIK IU-00
Business name: J Other.
Contact n=e:
__ Lklt tA i2Z IF%t' $5.40 for first four;51.00 for Inch additional
Addrails; Furnace,etc,
-I X Gas heat,urea
— � -
L_P_10!!c:(SOL) L water heater
Fir
ant!
Barbecue
Btainess nameCloches dryer(gas) —
-
Er
Address-
71-7/statetzIP: -T PftS-
Subtotal
Phone: Fax, Minimurn V'rmit Ice(572 50)
CCIS I ic.; P1211 review(25V at 7ermit red
Sta.a surcharge Arge(AV$of ptrmIt fee)
To T.kL PERMIT FEE tat I I
Authorized ligature; Thi,permit Ippli—ca7l•I qXplri1_-1--p-irmilt It no,obtained within 110
days after it I' "@Pn accepted-complete,
PT, ll Fe-mell-oftlailyfelbyTri
Date -a Inty Building Industry Service Board
\0u1lding1em*9*fflC.P"1APp doo U133 "c"d I?T(I 1A=ohVw9U)
Z00/ZOOM XVJ ZZ Z1 000Z/OF,/L0
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST _—�—
BUP
Received — _—_Date Requdstr �D KAW _ PM _ BLIP
Location % �>�6) 4vc _Suite MEC
Contact Person _ / /14. I ph( vS) ����
Contractor— _ Ph( _ ) _ SWR _._._...
B_UILDING Tenant/Owner L�`_ _ ELC
Footing
ELC _
Foundation Access: ,-- —
.=tg Drain '-'''L r� �- ELR
Crawl Drain
Slab Inspection Notes: SIT
Post 8 Beam
Shear Anch,jrs - -- --- - ---------
Ext Sheatn/Shear
In(aheath/Shear
Framing -- ----
Insulation
Drywall Nailing ---- -- - -- - -- -Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ------------ -- - - -------- - -- ---- ---
Roof
Other ___--- -- _-------------- �
- ---- -- -
Final f,
PASS PART FAIL -
PLUMBING
-------------- ---
Post 8 Beam
Under Slab --------------.----
Rough-In
Water Service --- -------- _ _ - - ----
Sanitary Sewer — �------- --- --------�_._._- -
Rain Drains - ----
Catch Basin/Manhole
StormDrain -- --__--- - --------- - ---- --- - .---- ---- ---
Shower Pan
Other: - -------- ------ - -------- -----_ ------ _
Final
DAQQ DAM r'!IL
--- -
Post 8 Beam
Rough-In
Gas Line ----
Smokenampers --- - —-- - - ---- - -- ----—.- -_-- ---- --------- -- -
to
PAS SART FAIL
CTRICA
MM__
M �--y - -- ----------
Rough-;n
UG/Slab ---- -------
Low Voltage �l
Fire Alarm \ _-------- --_----
Zma—
PART FALL Reinspection fee of$ -.. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE r Please call for refnspecticn RE: _ _ —_—_ [� Unable to inspect no access
Fire Supply Line
ADA — �-- -- Inspector
Ext
Other:
Approach/Sidewalk Date Ins actor
—
Final DO NOT RE;10VE this insp�3ctlon record from the job site.
PASS PART FAIL