Permit I N r CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00057
T; G� A D'; 13125 SW Hall Blvd Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/29/2007
�� g PARCEL: 1S135DD-04403
SITE ADDRESS: 11950 SW GREENBURG RD ZONING: C - P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Replace furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BUSCHBACHER, LOUIE J Description Date Amount
PO BOX 23955
TIGARD, OR 97281 [MECH] Permit Fee 1/29/2007 $72.50
[TAX] 8% State Surcha 1/29/2007 $5.80
Total $78.30
Phone:
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -0611
FAX 503- 234 -0439
Reg #: LIC 161085
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 503.246.6699 or 1.800.332.2344.
Issued By: 12 „ . r—a Permittee Signature: _ S,� C> " YY Call 503.639.4175 by 7:00 a.m. for inspections that business 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.
Jan 26 07 03:16p p.2
M echan i cal Permit Appl fi in . FOR oil I(1 t SE O\1.'
City of Tigard , :QOM Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: ►� ---2==, Permit No '_ o -, 7
Phone: 503.639.4171 Fax: 501598.1960 Plan Review
Inspection Line: 503.639.4175 1 `��: I `I4 Date/By: Othcr Petmit:
Internet wuw.ci 9,41 � ` t , '�' •�� •" .• Date Ready/By: 6d See Page
t ill ( NotificdR 1ethod: - Supplemental Information
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` 'rG`€�o:S�DUL.b: rF�.;35* E (
❑ New construction ® Addition/alteration /replacement Mechanical permit fees* are based on the value of the work
performed- Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical materials, equipment, labor overhead, and profit.
.? „-:.CITEGO*Y OFCONS tUCinly r r
;-�( ,.; , a < >�:. .,,g,� " - , alue $ .�'�'
Cp:
1- and 2- family dwelling (22/ Commercial /industrial ❑ Accessory building SIDE1V A LE V Q[lIPM7�ir / SY..... . FEES"
Multi-family ❑Master builder 0 Other:
For special information use checklist.
JOB = SITE FORMATION, ANA LOCATION
Description Q Ea. Total
H .
;; r I'
ea to coo rng
; I.i i ;t At` ra . 1�:.
Job site address: i f4 ' L I ' C : i. ' '1 . " Air conditioning or heat pump
i
(requires site plan showing placement) I 14.00 1 4
Cit' /State /ZIP: _
� ; ,..,) c ,'.) .,) 2, % Furnace 100.000 BTU (d uctstvcnrs> 14.00
Suite/bldg- /apt. no.: I Project name: : Furnace 100.000+ BTU (ducis/vcros) 17.90
I Gas heat pump 14.00
Cross street/directions to job site: # ,
PO: .,-
.I7: _ru tcA_/, -;.. Ductwork
_ 14.00
i 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: l Lot no.: Flue/vent for any of above 10.00
Tax map /parcel no.: Other: 10.00
DE.SC3tIPTION OF'WORK Water heater
n appliances
1 0.00
• �;; y f Gas fire place 10.00
�a a �. x
i is Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
•
,4ROPERTY OWNER , Chimney /liner / Fue/vent
10.00
10.00
Q TTNANT
Name j� Other:
./ �' f d • (� t Environmental exhaust and ventilation
., r , Range hood/other kitchen
Address: { t
` equipment 10.00
City /State /ZIP: Clothes dryer exhaust
- � �{ 7,3 .) .a 10.00
Phone: (SI` j ) CI ,.' .r> ' - i -� S Fax: ( ) Single -duct exhaust (bathrooms.
APPtICANP ys r fl toilet compartments. utility r m
oo s) 6.80
. r 0.0** ? RSON., Attic erawlspacc fans 10.00
Business name: Other: 10.00
Contact name: Fuel piping
S5.40 for first four; S1.00 for each additional
Address: Fumacc, etc.
City/State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( ) 1 Fax: : ( ) Water heater
E- mail: I Fireplace
Range
r -_•; Y! g"5. • } ra' t3: ?' i , �+�+O x v,�^5 �� t t .,* 7 t •� :f? L - 'w;'u a l f;;'
��,r a.��ZS''tr ..,�?�n,.3r „�.�a,.,a .d.na.crrr:. r o..iatr? rt); �„�hi` =.;� Barbecue
Business name. Sunset Beating and Cooling Clothes dryer (gas)
m
Address: 0607 SW Idaho Street Other
City /State/ZIP: Portland, OR 97239 gl ""'`0 *
Subtotal i Li ' -
Phone: (503) 234 - 0611 I Fax: (503) 234 - 0439 Minimum permit fee (S72.50) 7' -1
CB fie.: 161085 Plan review (25% of permit fee)
r State surcharge (8% of permit fee) 4 •- •,
N• -' TOTAL PERMIT FEE "7� 4;
authorized signature: (' L,y;� Ibis permit applic ation expires if a permit is not obtained within 180
days after it has been accepted as complete.
'rint name: Shauna D'Ambrosta j Date: i ( Fee methodology set by Tri-County ��;i �. , • sy y ty Building Industry Service Board
\ Buitding\Permiis\MEC PermitApp. doc 122/03 440.46177 (11 /02/COM/WEB)
CLTtOFTIGARD
BUILDING DIVISION „ ,/ /. PERMIT #: MEC2007- 00057 .
. 13125 SW Hall Blvd., Tigard, OR 97223 1 < ; ;' DATE ISSUED: 1/29/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 s -v.!�i t'7-...0 -.'`” •
•
INSPECTION WORKSHEET FOR DATE: 2/6/2007 TIME: 7:05AM PAGE: 28
SITE ADDRESS:. 11950 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: lI } }TEC;RA ED DATA ,
DESCRIPTION: �- .p atT
OWNER: BUSCHBACHER, LOUIE J, PHONE #:
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503-23-4-0511
Inspection Request Scheduled For: Date: 215/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
•
699 Mechanical final 042959 -01 503-968-2625 N •
Corrections /Comments /Ins ructions: 17085-6-1 •
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PASS n PARTIAL APPROVAL _ CANCEL _ NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
ci-c __________ Inspector: ‘ 72,:i— Date: 2 - - /\ 7 ) Phone #: (503) 718- 2-`1 2