Permit j Y
CITY TIGARD MECHANICAL PERMIT
I i� DEVELOPMENT SERVICES PERMIT #: MEC2006 - 10027
il l T 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/14/2006
PARCEL: 1 S135AC - 03900
SITE ADDRESS: 09020 SW OAK ST ZONING: R -4.5
SUBDIVISION: ASHBROOK FARM LOT: 015 JURISDICTION: TIG
Project Description: Replace gas furnance.
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
GENE DAVIS Description Date Amount
10875 SW 89TH
TIGARD, OR 97223 [MECH] Permit Fee 4/3/2006 $72.50
[TAX] 8% State Surcha 4/3/2006 $5.80
Phone: 503- 246 -5862
Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 266 -3478
PRI 503- 266 -1249
Reg #: LIC 14008
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 Q.
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.
03/13/2006 16:40 15032632513 ROTH MECHANICAL PAGE 02
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Mechanical Pert !..1, .1/
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City of Tigard : ti i -: ; . : Date/By: i 0. -"'--)(.. Pem,tNa..
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13125 SW Hall Blvd., Tigard, OR 97223 Platt Review Other permit:
• Phone: 503.639.4171 Fax: 503.59' )101 3 2006 r� Date/By '{' I , ', hate Ready/By: ME M See Page 2 far
Inspection Line: 503.639.4175 - 'm� I : R
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Internet: www.ci.tigard.or.us Notiiled/Method: Supplemental Information
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s I r / Mechanical permit fees* are based on the value of the work
❑ New constructionddition/altetatitsn /rep': lO permed. Indicate the value (mtmded to the nearest dollar) of all
❑ ❑ Other: mechanical material,
Dem _ ��� y �� � equipment, labor, overhead, and profit.
Value: $
t Ys I Si i E a I I I S t4 0 e e 11 t) ar • m • ', ckl 4.0 j , ' c , .••- '
t 1 l .. •, I rlxrat . scl c 3
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi - family - 0 Master builder ❑ Other: Description � Qty- 1 Ea. 1 Total
l;� T T t e , . 11 ` a e, � -{ ' e 1 ., -. .t , . o t 'I r i �, A . e c e.. : : : ,1 f ' Henting/eooling
a r'' aiz2ttm ' �� tt ' " �,, � , � / / ' {jt + � �r Via`• Air conditioning or heat pump site address: r } ? Vc'`7` - (requires site pIan ahowina placcmen 14.00
Furnace 100,000 $TU�ucte/veala ( 14,00 1 r{•
�
City/State/ZIP: '7` 1 t 9 , ii 9�' Furnace 100,000+ BTU (ducts/vents) _ - 17.90 ,_
Suite/bldg. /apt. no.: Project name: Q� heat pump 14.00 _
. 14.00
Cross street/directions to job site: Duct work 14.00 Hydmnic hot water system —
_ Residential boiler (radiator or
hydronic) 14.00
Unit heaters (ibel -type, not electric),
in -wall, in -duct, SA ded, etc. _ 10.00
— — Fluelvent for : of above 10.00
Subdivision: Lot no -: Other: 10.00 —
Tax map /parcel no.. fuel appliances
ether
� . ..,., u ,.,., .u.:r 1 -0: 6 Watcrbeater
�' .rs...t:! , 3`, t a�•' <• . 'Rk,,frl;:,::' :...., ?h. • 10.00
Gas fireplace
Flue vent for water heater or gas
ElrePlace 10.00
�L I L �._ L — Lo li htcr as 0.00
4 Wood/pelle stout 10.00 ,
'447 / r 1 ' / 2 ,` Wood fi dace/insert 10.00 • . � rVF(r ,ur' :.,t , *., . . . . ri , ",yap'
10.00
?�i ; is. )s_ =, , j . " r ,,, r: ,r M 1 ),/.11,4?...... Chimney/liner /flue/vent
10.00
tj { } N• n ± o�` m4; t ' %L�� <Er7 M� ':: ,,.. zr � "` '� ' " „ t. '. K' i ;.j. .. ot
$nv
Name: *i ronmental exhaust and ventilation _
f ! 11' Environmental
Address: / Q 9 (,� , i i equipment 10.00
Clothes dryer exhaust 10.00
1111121 /1L Single -duct exhaust (bathrooms,
' / mpartments, utility ) 6.80
iiiiw ,s - ‘ �1� •�� t (Y Z— Fax: ( r ) a n, z • toilet
tti w s rooms 10.00
t ? 4. : ' , 6 4 .. te a:. y 1 i 1 ' u;40r Ego r :1 ;GO A ' F 7 , Ober 10,00
Business n: c: Fool Pining
SS.40 for first four; $1.00 for each additional
Contact name:
- Furnace, etc.
Address: Gas heat i:a.
City/Statc/ZIP: Wall/sus. ded/rmitheater
Water heater
Phone: ( ) v Fes ' ( ) _ .— • Fireplace
Email: a g e
p��; "rt'' x' _w n "s� + ,. ;; t 'I WO; x y)< ' k y Bntbecue - -
nW r ^Cp( t�� , d, !LL7!)'At a H.i•5 «r.�. i ,� (.TN- , „� n
Clothes d er :as
Business name: 1 , ' been accepted Other'
Address: f
r c "'Tc � ' • r;
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Ft / ..:ub :nh,ri
�� p, n/� Subtotal C
City /Statc/ZIP: C1 / ! / 0�. // Minimum num permit fce Su btotal "1 r9 v
Phone: ( 0 l (a(O —( Fax: ( ,) 2J4 7 ' 7i i P l an review (2596 of permit fee)
/�/� State surcharge (8°k of permit fe
CCB lio.; DO / I I TOTAL PERMIT _FEE e "7 k 180
3
�� I This permit application expires If a permit Is not obtain w hln
Authorized signature: „ !I / dads ailer it ham at complete.
1 F' , � � mat— / Date: • 7 • Fee methodology set by Trl- County Building Industry Service Board
Prin name: � /