Permit CITY OF TIGARD
4 , u MECHANICAL PERMIT
i° ti_:: COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00705
TIGARD. DATE ISSUED: 12/4/2007
:.......:. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112BD - 05800
SITE ADDRESS: 14736 SW 76TH AVE ZONING: R -7
SUBDIVISION: PROSPECT MEADOWS LOT: 001 JURISDICTION: TIG
PROJECT: SAFSTROM
Project Description: Install furnace
•
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
NICK SAFSTROM Description Date Amount
14736 SW 76TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 12/4/2007 $72.50
[TAX] 8% State Surchar€ 12/4/2007 $5.80
Total $78.30
Phone: 503- 572 -4869
Contractor:
AIR PRIDE, INC.
18605 WILLAMETTE DR
WEST LINN, OR 97068 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 655 -0556
FAX 503- 655 -0534
Reg #: LIC 154359
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
/ �
Issued By: Permittee Signature: A
C ( Il
Call 503.639.4175 by 7:00 a.m. for inspections that business da�.
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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Mechanical Permit Application ' . , , Y + . ••=i,,,..442,0, OR Ur ,4, ,o k E y . e k . , 14 , -, ,x 1 : - , ;1
R = City Of Tigard t 1 Dac eivcd Permit No.:
t3' g �.. \JE Date /By. A.u. lY\a -oo18.
° 1312S SW Hall Blvd., Tigard, OR 97 ,01- Plan Review
. ' . ' Phone: 503.639.4171 Fax: 503.598.i.9i;f bate/By. Other Permit: f'L/Yl b10t - 0G 9g)
Sec Page 2 for
ection Line: 503.639.4175 Juri
T I C A R D; fns p 2 ��� Date Ready/By: e .. 'a .ua Internet: www.tigard or.gov D E C 0 Notified/Method: Supplemental Information
TYPE, OF W , • •- . L�tmr01U1' i . COMMERCIAL :FEE* SCHEDULE'.: - •USE.CHECKLIST
Mechanical permit fccg" arc based on the value Of the work
❑ New construction gj Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. CATEGORY OF CONSTRUCTION Value $
RESIDENTIAL: EQUIpMENT / SYSTEMS FEES*
El 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi - family ❑ Master builder 12 Other:
For special information use citecklisi,
Description Qty. Ea. 1 Total
. 3013. SITE INFORMATION AND LOCATION . H •
Job site address: 14736 SW 76 Ave. Air conditioning or heat pump
(requires 51te plan shpwinp placement) 14.00
City / StateJZIP: Tigard, OR 97224 Furnace 100,000 BTU (ductstvents) I 14.00 14.00
Suite/bldg- /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
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, ctc, 10.00 ,
Subdivision: Lot no - Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' , DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water beater or gas
Install Furnace fireplace 10,00
- Log lighter (gas) 10.00
Wood/pellet stove 10.00 •
• Wood fireplace /insert 10.00
„ • ';` PROPERTY -'OWNER ❑ TENANT Chimney /liner /[lue /vent 10.00
Other: 10.00
Name: Nicholas Safstrom Environmental exhaust and ventilation
Address: 14736 SW 76 Ave Range hood /other kitchen
equipment 10.00
City /State/ZIP: Tigard, OR 97224 Clothes dryer exhaust 10.00_
Single -duct exhaust (bathrooms, .
Phone: (503)572 -4869 Fax; ( ) toilet compartments. utility rooms) _ 6.80
APPLICANT . ❑ CONTACT PERSON Attic /crawlspacc faro 10.00
Business name: Other: 10,00
Fuel piping
Contact name: 55.40 for first four; $1.00 for each additional •
Address: SEE BELOW Furnace, etc. 1 5.40 5.40
Gas heat pump
City /State /Z1P: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heate
Fireplace
E -mail: .
.
Range
CONTRACTOR Barbecue
Business name: Air Pride Inc. Clothes dryer (gas) -
Ocher:
Address: 18603 Willamcttc Dr. . ,
• ' ' '.. .MECHANICAL PERMIT FEES.: •
City / State/ZIP: West Linn, OR 97068 Subtotal 19.40
Minimum permit fee ($72.50) 72.50
_ Phone: (503) 655-0556 I Fax: (503) 655 -0534 Plan review (25% of permit fee)
CCB Iic.:154359 State surcharge (8 %ofpermit 5.80
�I //�rQ� 9 [� TOTAL PERMIT FEE 78,30
Authorized signature: 4 �'�( `� G . � }c- �� r� This permit application expire: if"; permit is not obtained within 180
I days after it has been accepted as complete.
Print name: Jaylene Patelziak Date: 12/3/07 • Fee methodology set by Tri -County Building Industry Service Board
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CITY QFTIGARD
BUILDING DIVISION PERMIT #: idl S-; f107. t101t75
13125 SW Hall Blvd., Tigard, OR 97223 DATE' ISSUED: 12/4/007
Phone: (503) 639 -4171 v����lit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7 :03AM PAGE: 88
SITE ADDRESS: '14738 SW 76TH AVE CLASS OF WORK:
SUBDIVISION: PROSPECT MEADOWS LOT #: 001 TYPE OF USE:
PROJECT NAME: SAFSTROM •
DESCRIPTION: insfail furnace
OWNER: SAFSTROM, NICK PHONE #: 503-572-4869
CONTRACTOR: AIR PRIDE, INC. PHONE #: 5.03 -655 -0555
Inspection Request Scheduled For: Date: 12J21l2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 061967-01 503.572 -4859 Y
Corrections /Comments/ Instructions:
ASS ❑ PARTIAL APPROVAL n CANCEL _ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED , ,_____,,
Inspector:
/.
A Dat 1 1 -- — 2-1 --C1 Phone #: (503) 718- Z
CITY.O.F TIGARD
BUILDING DIVISION PERMIT #: Ivi C2O07 -00785
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/412010i
Phone: (503) 639-4171 ^ICI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/60007 TIME: 7:06AM PAGE: 65
SITE ADDRESS: 14736 SW 76TH AVE CLASS OF WORK:
SUBDIVISION: PROSPECT MEADows LOT #: 001 TYPE OF USE:
PROJECT NAME: SAFSTROM
DESCRIPTION: Install furnace
OWNER: SAFSTROM, NICK PHONE #: 503 672 -4260
CONTRACTOR: AIR PRIDE, INC. PHONE #: 5n655
Inspection Request Scheduled For: Date: 12/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line O60E380 -01 503 - 655 -0556 Y
Corrections /Comments/ Instructions:
1 1)
PASS 1 J PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: / 2 -- - C;— Phone #: (503) 718 - 2_4-9-5—