Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00083
DATE ISSUED: 2/9/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103BB -08200
SITE ADDRESS: 12280 SW 124TH AVE ZONING: R -4.5
SUBDIVISION: LAKE TERRACE LOT: 009 JURISDICTION: TIG
Project Description: Replace furnace, add A/C.
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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
FRITZ BOYCE Description Date Amount
12280 SW 124TH
TIGARD, OR 97223 [MECH] Permit Fee 2/9/2006 $72.50
[TAX] 8% State Surcha 2/9/2006 $5.80
Total $78.30
Phone: 503 - 550 -7273
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -0611
FAX 503- 234 -0439
Reg #: LIC 161085
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: � �� , c.) Permittee Signature:
Call 503 - 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.
Feb 08 06 03:14p p.2
Mechanical Permi ication Received n � /' 7/21 {)� %� // 13
�` - / r,/ I P ermit No. c(r 7 f
City of Tigard Received �I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598r 4g qn �� , 4171717 I's Date/By:
AND .,J ••i I Date Ready/By: Fa 'ege 2 for
Inspection Line: 503.639.4175 rd.or.
Internet: Hww.ei. tigard.or . us
Notified/Method: i Supplemental Information
CITY OF TWA n
s a ../.[�.y�,.,.,�tr Np�+wnN O �l }v; c ME + , + Its uECK4
' �` Mechanical permit fees' are based on the value of the work
❑ New construction ® Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
. Value: $
t TEGUAY l<fF u ., r ., . , . _r Ety MESt SYSTEMS: .I'EES*
,ter ..,, ; � .
Ii 1- and 2- f amily dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SUL iNFORMt1T_ION 04010CA ?N r. " ?. ' ' . Heating/cooling
' ' Air conditioning or heat pump
Job site address: / t :,./2-,i �.( :r j C " ` ) ? (requires site plan showing placement) 14.00 . 4 —
Furnace 100,000 BTU (ducts/vents) t, 14.00 ! � _
City/State/ZIP: 3'� `'� '; .__. t `j ..,f 17.90
i G , Furnace 100,000+ BTU ( ducts /vents)
Suite/bldg. /apt. no.: 1 Project name: i , %' Gas heat pump 14.00
,.! Duct work 14.00
Cross street/directions to job site: Hydronic hot water system 14.00
Residential boiler (radiator or
I hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended. etc. 10.00
Flue /vent for any of above 10.00 l
Subdivision: 1 Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIIFTION OF .. r 10 00
W a te r b 10.00
.A' , r r F. 6. t'.... i (..
Flu f vent i for water heater or gas
,+ ;.y 11, z t d 1 ..<.. + i fireplace . 10.00
k
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
a �ENA�IT 1 U 00
Chimney/liner/flue/vent 10 00
P,ROPE . 17.3( WNER Other: .
.. Environmental exhaust and ventilation
Vane: ti� �,. ' %; y , �, ; Z;' Range hood /other kitchen
7' ' .( y / {,, equipment 10.00
Address' ; r ? :_.
- -, — Clothes dryer exhaust 10.00
City /State /LIP: 1 1 ° "y^ .l t__: ' 4 . . Single -duct exhaust (bathrooms,
-- Fax ( ) toilet compartments, utility rooms) 6.80
Phone ` ) ) t i } f 1 craw p ce fans
Anic/ is a
Other: 10.00
Business name: Fuel piping
S5.40 for first four: S1.00 for each additional
Contact name:
Furnace, etc.
Address: Gas heat pump
City /State /ZIP: Wall /suspended/unit heater ,
Water heater
Phone: ( ) I Fax: : ( ) Fireplace
E -mail: Range
y ' 3.4 W4 w;� r i r i Barbecue -
k,rt,.�,i- ,., ,.,, .. F Clothes dryer (gas)
Business nano: Sunset Heating and Cooling .
Other: � �.�
Address: 0607 SW Idaho Street ,�* -��
Subtotal ,f_ - -�_
City /State /ZIP: Portland, OR 97239 Minimum permit fee ($72.50) ";•`'.f ``� T
Phone: (503) 234 -0611 Fax: (503) 234 -0439 Plan review (25% of permit fee)
CCQ tic.: 161085
State surcharge (8% of permit fee) c5-,- _
- , TOTAL PERMIT FEE r��• x
7 ----,\'‘,...Q__):: ,- This permit application aspires if a permit is not obtained within 180
Authorized signature: :'' days after it has been accepted as complete.
1 Print name: Simms D'Ambrosia I Date: rte' i c • Fee methodology set by Tri- County Building Industry Service Board
- t ''-'-1 ;` 1
, V 3uilding \ Permits 6MEC- PermitApp.doc 12103 440- 4617T(11 /02JCOM/WFB)
Feb 08 06 03:14p
p.3
A/C & HP
Site Plan
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