Permit " CITY OF T MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00032
1-1GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/17/2008
PARCEL: 2S103DA -04100
SITE ADDRESS: 13365 SW 107TH AVE ZONING: R -3.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: LASATER
Project Description: installation of unit heater and vent
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: 1 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KARL LASATER Description Date Amount
13365 SW 107TH AVENUE
TIGARD, OR 97223 [MECH] Permit Fee 1/17/200E $72.50
[TAX] 12% State Surch 1/17/200E $8.70
Total $81.20
Phone: 503 -314 -0652
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503 - 282 -5722
Reg #: LIC 8897
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: See' /CcrX.O/`}
Call 03.639.4175 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.
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I �`,! ' Received i
, J r q �„a City of Tigard Date /By: f r , Pennit No.: ,� /. d - (DCA
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13125 SW Hall Blvd., Tigard, OR 97 N 1 6 U U� Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
� Date /By:
;..,:e., t,io; Inspection Line: 503.639.4175
CITY o - 0 � Date Ready /By: J: H See Page 2 for
.i■ Internet: www.tigard- or.gov B1isse. l�®,,,IS1 ®iv Notified/Method: Supplemental Information
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❑ New construction ►:! Addition/alteration/replacement
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.
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1- and 2- family dwelling ❑ Commercial /industrial
LL ❑ Accessory building
My Far special information use checklist
y ❑M aster builder 0 Description 1 Qty. 1 Ea. 1 Total
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Job site address Air conditioning or heat pump
' ' Y , 1 - (requires site plan showing placement) 14.00
City/State/ZIP: L • - i Furnace 100,000 BTU (ducts/vents) 14.00
S Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg./apt. 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. 1 10.00 /0
Subdivision: Lot no.:
Flue/vent for any of above I 10.00 in
Other: 10.00
Tax map /parcel no.: Other fuel appliances
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Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
14 , A 4.1J Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
i, : tia>1~: , :A . . ;tl i ii � {{ v l..t t '' F.t ;;z. - . ' t: Chimney/liner/flue/vent 10.00
. °t Other: 10.00
Environmental exhaust and ventilat
Address: ���__ Range hood/other kitchen
�.�/ A. / -Ph , 1 141 equipment 10.00
City/State/ZIP: 1 / , / 0. 0 _ Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: 1503) 1 /l Fax: ( ) toilet compartments, utility moms) 6.80
,Tro..1x'i y.0 1A-, r ..}. k ' 1 ;c 4 , , , l-.. a ..u v b , a 15ft. `,3 L$.:'.7F. ,
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alibi AiM . .£14i �W * e; »-i ' E- :%:`:a,:.:.: i' i, a =x ;" Attic /ctaw►s fans J 0.00
Other. 10.00
Fuel piping
Contact name: 5 4_, or . $5.40 for first four; $1.00 for each additional
r' Furnace, etc.
Address: N e&V ■ A. , . _AA.. a . _ Gas heat pump
City /State/ZIP. c> / - Wall/suspended/unit heater
Phone: Si ) Ap, Fax: : n ∎ - = - _ Water heater
Fireplace
E-mail: I A- f 1 • ■/ i_ • -, �i Range
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Business name: • • 0 Clothes dryer (gas)
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City/State /ZIP: 1 °V e/ Subtotal •
7' 4� Minimumpennit r ,,?t FAO
Phone:( Fax:( )
Plan review (25% of permit fee)
State surcharge (12% of permit fee) g .-0 ,
�y TOTAL PERMIT FEE 5 1 , 6?-c-.... Authorized signature: 1 Iv -���
This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: l 15 r ( G vn Date: into/OS ` Fce methodology set by Tri -County Building Industry Service Board
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CITY- :OF TIGARD
BUILDING DIVISION PERMIT #: MEC2000 00032
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2000
Phone: (503) 639 -4171 �,����
Inspection Requests (24 Hrs.): (503) 639 -4175 s' '`__..
INSPECTION WORKSHEET FOR DATE: 3/7/2000 TIME: 7:00AM PAGE: 0
SITE ADDRESS: 13365 SW 107TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LASATER
DESCRIPTION: installation of unit heater and vent
OWNER: LASATER, KARL PHONE #: 503-314 - 065'2
CONTRACTOR: ANCTIL HEATING & COOLING PHONE #: 503 - :281.0762
Inspection Request Scheduled For: Date: 3/7/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6&"9 Mechanical final 066301-01 503.3140652 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 " 7 -� 5 Phone #: (503) 14
P � ) 718-