Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00298
° �I 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/30/2006
PARCEL: 2S 103DB - 05100
SITE ADDRESS: 11175 SW NOVARE PL ZONING: R - 4.5
SUBDIVISION: GENESIS NO. 2 LOT: 048 JURISDICTION: TIG
Project Description: Replace gas furnace.
CLASS OF WORK: OTR 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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MICHAEL STREICHER Description Date Amount
11175 SW NOVARE PL
TIGARD, OR 97223 [TAX] 8% State Surcha 6/30/200E $5.80
[MECH] Permit Fee 6/30/200E $72.50
Total $78.30
Phone: 503- 781 -1249
Contractor:
MILWAUKIE HEATING & COOLING
PO BOX 220716
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -5562
FAX 503 -557 -0790
Reg #: LIC 104102
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: ��� Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. v'
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 30 06 10:45a Milwaukie Htg & Clg 503 - 557 -0790 p.l
Mechanical Permit A lic < ' i ,.. , 1 012`01 FI(1 1 Sl 0 t
i
City of Tigard b cw E® RC0G1VG� -
13125 SW Hall Blvd, Tigard, OR 972 DatcJBy • vl w / .� t /
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JU 3 0 2006 GM Date/By: Othcrpetmit;
Inspection Lane: 503.639.4175 ,a4:,1 I Date Ready/By: IIM El See Page 2 for
Internet: wtvw.ci.t►gard or.tu; CITY OF TIGAR = Notified/Method:
Supplemental Information
BUILDING DIVISION
OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Q 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: $
� d 2- family dwelling ❑ Cotmnercial/mdustrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ' !^� Air conditioning or heat pump
,I, (� J R L P � , (requires site plan showing placement) 14.00
City / State/ZIP: 1 Q .,,,/ or 9 1 3 Furnace 100,000 BTU (ducts/vents) ` 14.00
Fumace 100,000+ BTU (duets/vents) 17.90
Suite/bldgJapt. no.: Project name:
Gas heat pump 14.00
Cross 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 feel appliances
DESCRIPTION OF WORK Water heater 10.00
P4. ( r Gas fireplace 10.00
I.-* -- (. "4.S I fii✓ii 4 L.4. Flue vent for water heater or gas
fireplace 10.00
Log lighter (Ras) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER 1 ❑ TENANT mne'tineT /flue/vent 10.00
Other 10.00
Name: I 1 t e _ 1. 4 L. i S •7,- e , C. .Cr Environmental exhaust and ventilation
Y / ( r p Range hood/other kitchen
Address:
['!' ` S n (/>4R / / , equipment 10.00
City / State/ZIP: •7-- i ,,„4 og 9 '7 Z Z 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 1
( ) 1 ..., i z 4 et Fax: ( ) toilet compartments, utility rooms) 6.80
9 .2 CONTACT PERSON Attidaawtspace fans 10.00
/ , i Other: 10.00
Business name:
t^t l to J kit 14.04 i d- £ec is tvi
Fuel piping
Contact name: / + - Cr rJ WI ,a k S5.40 for first four; S1.00 for each additional
Address: C3 (I (p 1 L.) L I ., , 7 Fumace, etc
Gas heat pump
City /State/ZIP: C' iE .1 0,4I v(C. 9 7o /.S" Wall/suspended/unit heater
Phone: (5 ) s5 7 5 5- L . Fax: : (03) .5 U Water heater
E -mail. Fireplace
Range •
CONTRACTOR Barbecue
Business name: G �,
Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone: ( ) l Fax: ( ) Minimum permit fee ($72.50)
l Plan review (25% of permit fee)
CCB lic.: i U y /0 Z State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: Thla permit application aspires if o permit is not obtained within 180
days after it has been accepted as complete.
1 r 1 .-, . 1 • C..... ., ,1.4........1 1... 'R: r.....,... O..:I.1: .... r..a....... C.....;.....17,
- T rr K/ i. 4 . 6.... 3 0 --o k