Permit il a C ��Y I MECHANICAL PERMIT
''' ' ° • , COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00304
ITIG -ARP 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/16/2008
PARCEL: 2S 111 AD - 14400
SITE ADDRESS: 14921 SW 91ST AVE ZONING: R-4.5
SUBDIVISION: MALLARD LAKES LOT: 010 JURISDICTION: TIG
PROJECT: CHIAPUZIO
Project Description: Replacing furnace, air conditioner, duct work, and vent for water heater.
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 /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
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: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DOUGLAS & BARBARA CHIAPUZIO Description Date Amount
14921 SW 91ST AVE
TIGARD, OR 97224 [MECH] Permit Fee 61161200E $72.50
[TAX] 12% State Surch 6/16/200E $8.70
Total $81.20
Phone: 503- 684 -5088
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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.
1
Issued By: ` �> s `' ermittee Signature: ��
i
C all .639.4175 by 7:00 a.m. for inspections that business dla .
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.
•JUN -13 -2008 10:19A FROM: TO: 5035981960 P.1
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-- echanical Permit A p� 1.., i C r ,A of Ti and ,, g Received
•J g Permit No.: •
u « ' 13125 SW Hall Blvd., Tigard,OR 97223 u'� Date/By �
^ � � 41A
Plan Review Other Permit.
F 9 Phone: 503.639.4171 Fax: 503.598.1 ¢ 01 08 1 3 20 Date/By.
i t k K n, Inspection Line: 503.639.4175
503.598 UN U U Date Ready/By: Jura ® See Page 2 for
wt s,t t1 e+.tot Internet: www tigard- or.gov � j �
LsBT 1 t� r Notified/Method ed/hod Supplemental Information
1 6JSs ft A t -E>tj
TYA (di. 1.,1 \ , 1 i Q COMMERCIAL FEE" SCHEDULE — USE CHECIO.,IST
❑ 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
1- and 2-family dwellin RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
For special irorma
6
y g ❑ C Master builder i lde usvial ❑ Accessory building
Multi-family ❑Master builder rfnon use checklist.
❑ Other: Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: 14121 . W / motto Air conditioning or heat pump J �
(requires site plan showing placement) 14.00
City /State /ZIP: T9 i 4 9,7224 Furnace 100 BTU (ducts /vents) '1 14.00 ` tCD
V w Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.. Project name: ch , rj n (421.0 Gas heat pump 14.00
Cross street/directions to job site: " /I�/ Duct work — 1 10.00 I (�, (f
Hydronic hot water system 14.00 i
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
1 ) 6 1 Gas fireplace 10.00
:I C O - 1 ALL . !� O Flue vent for water heater or gas ,` P�
`p fireplace 10.00 �(Ji CA-)
1 • "' . v • ik + AminigAtom Log lighter (gas) 10,00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
PROPERTY OWNER ❑ TENANT
Other. 10.00
Name: �va Environmental exhaust and ventilation
�'_ ��! Range hood /other kitchen
Address: 0._ equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
� Single -duct exhaust (bathrooms,
( .
Phone: (U3 50�$ Fax: ( ) toilet compartments, utility rooms) 6.80
AAPPLICANT 0 CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
name: nae: + ' , - ro ' i n $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) F. x :: ( ) Water heater
..i Fireplace
E-mail: ti' Range
CONTRACTOR Barbecue
Business name:Tr) cctt. l , A f Clothes dryer (gas) {
Other.
Address: 13 l60 a � r � " / Mlle► JAI — MECHANICAL PERMIT FEES*
City/State /ZIP: 0/Wilt OIL 11645 Subtotal
Minimum permit fee ($72.50) '71
Phone: ( r', , 5s Fax: ( l�. 867 Qq / R" cb
Plan review (25% of permit fee)
CCB lie.: '72/42 State surcharge (12% of permit fee) 1 8,
TOTAL PERMIT FEE tILJ
Authorized signature. ( — This permit application expires it a permit is not obtained with 18D
das after i
days has been accepted as complete,
Print name: I ! J mown Date: GA{ /](UD I • Fee methodology set by Trt- County Building Industry Service Board
11BuildinglPermitu\MEC- PermuApp doc 01/19/07 440.461 ` 7T (t l /02/COM/WEB)
TUN -13 -2008 10:19 FROM: T0: 5035981960 P.2
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CITY OFTIGARD
BUILDING DIVISION PERMIT #: A46-1' 2ZW– ?2 O 'Y
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 W 'nl�Ll L.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /'' 2 SW '7/ 5r '.. e •
CLASS OF WORK: X"
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
6'97 mn«h.24« /�;n a�5' /602 -oi
Corrections /Comments/ Instructions:
CC(
( v1 (
n PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 2 5 Date: CA O Phone #: (503) 718 - 2 (K?