Permit ' { v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00195
pT DATE ISSUED: 4/10/2007
TIGARD, , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104AD - 03502
SITE ADDRESS: 12810 SW WALNUT ST ZONING: R - 4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: AUGUST ,
Project Description: Install heat pump and gas furnace.
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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
THOMAS AUGUST Description Date Amount
15707 SW BRISTLECONE WAY
TIGARD, OR 97223 [MECH] Permit Fee 4/10/2007 $72.50
[TAX] 8% State Surchaq 4/10/2007 $5.80
Total $78.30
Phone: 503 - 579 - 1245
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -1950
FAX 503 -538 -0165
Reg #: LIC 97152
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued y: i `, �� �VL Permittee Signa `�J _g %A e9-4.
i
Call 503.639.4175 by 7:00 a.m. for inspectionst .1 . siness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Malcolm Lamb 5035380165 p.2
Mechowiicai Permit Applicatio aatio �/
City of Tigard q NI Date'Bed y. L� 9 7 / fC J /9 / ( 0 Permit No.: 13125 SW Hall Blvd., Tigard, OR98g! + '� e Plan Review
Phone: 503.639.4171 Fax: 503. .1 Date /B Other Permit:
iMrr>
Inspection Line: 503.639.4175 ------w •1l Date Ready. By: �jctr! RI Sc e Page 2 for
Internet: k•ww.ci.tigard.oeus RnR O 9 200 Notified/Method: /� Supplemental Information
. t ° °. t lr l° i. if .', +• '' 1, ".r..,::.+ ... . .-_� .::.._ C�.3M AI! .: ;S ULE .,.:11E CHECKLIST
❑ New construction r: tiW is e' Mechanical permit fees* are based on the value of the work
1� R" p' 1� tNrli'aa performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ■; 1 er: mechanical materials, equipment, labor, overhead. and profit.
,tO 11 l $
and 2-family dwelling ❑ Accessory building - t;:. '.,-.1.,,,, YiEI �lL7 ` ImF 'N SiTVIfYSTEMS FEES*
y g ❑ Commercial /industrial Accesso Foi special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Qty. Description t . ton I Q I Ea. I Total
d0'8` S 1 F'O
1TE IFCNI ITIOO Ai tb
Air conditioning or heat pump
Job site address: ^ q l
acEL . Cam.. \.J j c..2.._\ NJ . (requires site plan showing placement) , 14.00
City /Stat Furnace 100,000 BTU (ducts:vents) 14.00
8 �_QT �� � Th Furnace 100,000+ BTU (ductvvento 17.90
Suite /bldg. /apt. no.: Project na r e•
Gas heat pump 14.00
Cmss street /directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type. not electric).
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
ilOt 1!'C' QN OF; WO ,: i Water heater _ 10.00
Gas fireplace 10.00
,- - .- - ,\ \,e-,i r -V ' - .PAS - - �1xti/""'‘V Flue vent for water heater or gas
fireplace 10.00
r ^^ C-r- >1 Ls_ (\.( -_ Log lighter (gas) 10.0(1
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
mer /flue vent
l ROJ?i VV oNivi J , .; ' Q ` :. i _ y 10.00
tmne
10.00
Other:
Name: Vim- 34_
� . t t� Environmental exhaust and ventilation
tI�
� Range hood,'otber kitchen
Address: \ • Q .. �) e�� k,2.3'• equipment 10.00
City /State /ZIP: .� ` ` Clothes dryer exhaust 10.00
��� l � Single-duct exhaust (bathrooms,
Phone: l�� -� � - --11i Fax: ( ) toilet compartments, utility rooms) 6.80
�� �l (1.00
�AyPPLiCtA�',. 1 .11 f �I � 4. • ��r: ,�.�:;��'�Ir� ,,� ,,,; -' Attic /crawls ace fans 1 P
Business name: Other: 10.00
v �1b��4�,., ' Pir �-t v� Fuel piping
Contact name: -- �s „.r.,w o+1 j $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
`�O S ���� � Gas heat putnp
City /State/ZIP: ^ 9 Wall/suspended/unit heater
Phone:a" '� _. Fax:: G G� F eP aterh
1 � G��$_
E -mail: Range
Barbecue
Business name. \ ' Clothes dryer (gas)
��LA- Jf��Q,�Y4S �Pd�TS •J Other:
Address: \ O - 1-- .. 1 „ Ai �S +` ► w
_ • _ _. rte t l itigrkti,ERMii.E6ES
1. I:E..
City /State /ZIP:�� t A .� .c �, ` ''1 -� , i Subtotal ��
�, Minimum permit fee ($72.50) J lJ
Phone c�?� c _ � t J� - � x� ) S -CUE (!7 Plan review (25% of permit fee) (�
CCB lic.: ez:I P--7 1 s �� State surcharge (8% of pennit feel ,�? � ^
1 . TOTAL PERMIT FEE n ( g .4 30
� � t �� This permit application expires if a permit it not obtained within 180
,Authorized signature: c_ t _ .^�.a�.`•(Z�t�L�
days after it has been accepted as complete.
Print name ` > d3 Date: 24 -9 ._ t ry-7 I . Fee methodology set by Tri -County Building Industry Service Board
, nuikling.Prrmits MtC- PcnsilApp.dor 1:•03 440 11'02.COM, WEB)
•
Malcolm Lamb 5035380165 p.4
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Flag lot front SW Walnut St.
CITY OF TIGAR®
0/16C - 7,60 -- )- cad tq
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: .
Phone: (503) 639-4171 A i l�
.�- !
Inspection Requests (24 Hrs.): (503) 639 -4175 i -
INSPECTION WORKSHEET FOR DATE: \ / /4 TIME: PAGE:
SITE ADDRESS: l 7, Si 6 Vv L.11C CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection
,, Description _� Q Confirm # Contact # Message
V I C I Corrections /Comment /Instructions:
e rry ■ J2..t./3
. , V itt) . -
\ 1/ W
1\16 et-c
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1'PASS n PARTIAL APPROVAL fl CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 7(;(1 Date: l /7 3 /6 rPhone #: (503) 718- 2 " . { 2-ve
CITY OF Y IGARD
BUILDING DIVISION PERMIT #: MEC2007 -0019f
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 4/10/2007
Phone: (503) 639 - 4171 .. ,, '�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 �' "__..
INSPECTION WORKSHEET FOR DATE: 9/11/2007 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 12810 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: AUGUST
DESCRIPTION: Irns1211 heat pump and gas furnace.
OWNER: AUGUST, THOMAS PHONE #: 503-579.1246
CONTRACTOR: FOUR SEASONS HEATING & A/C INC. PHONE #: 503 - 533 1950
Inspection Request Scheduled For: Date: 9/11/2007 Pour Time: ,�
ro ll
Code # Inspection Description Confirm # Contact # Me s`' ge
699 Mechanical final 055492 -01 503- 579 -1245 Y
Corrections /Comments/ Instructions:
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kJb 1 ;5 .
V
i►; VPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: V6:(- A Date: ( f \ ib Phone #: (503) 718- 41, q