Permit MECHANICAL PERMIT
, CITY OF TIGARD ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00532
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/28/2008
PARCEL: 1 S134DA -04100
SITE ADDRESS: 10563 SW NORTH DAKOTA ST ZONING: R -12
SUBDIVISION: VENTURA COURT LOT: 006 JURISDICTION: TIG
PROJECT: VVILLIAMS
Project Description: Furnace replacement.
CLASS OF WORK: ALT 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:
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
JAMES WILLIAMS Description Date Amount
10569 SW NORTH DAKOTA ST
TIGARD, OR 97223 [MECH] Permit Fee 10128120C $72.50
[TAX] 12% State Surch 10/28/20C $8.70
Phone:
Total $81.20
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503-538-1950
FAX 503 -538 -0165
Reg #: LIC 97152
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ` :�i 'ermittee Signature: � 75
Call •5 ‹4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/28/2008 15:12 FAX Z003/003
' itirechanical Permit Application IOU (11 1 1 1 `F 1)\ i.!
City of Tigard D •00 of _ . i
I
13125 SW Hall Blvd., Tigard, OR 9 Plan Review
1 II 13125 503.639.4171 Fox: 50 '0 4 Date 13y: Other Permit: /
1 . 1 „. ,, i . 1 Inspection Line: 503.639.417 % Date Ready/By: Bffil B Scc PRIM 2 for
Internet: www.tigard-or.gov � ,(N Notified/Method: Supplemental Information
(,\ :' . . T1fp$` OF ,.°., o :N ", r .., a . 00 • x. ( ,
a F
El New construction )tddition/altc lacemcnt Mechanical permit feels are based on the value of the work
may' performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit
C ATJl •41 1, l� 7° ." °
1 d , c '�" Value. $
ti . utn ( a w < r
b i- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building � * �u i
1:1 Multi-family ❑ Master builder ❑ Ohr ': For special informal, ter_ , ,
Description Qty. Eat T. r:,
w � p n N a m
JOB ' sztE;4* IA . s s
.. , � 64 ,� . , . � � "ak"i'� � � ` _ �:4.> Heatlnp,/coolinit .._
Job Site address: Air conditioning or heat p ■ . .
/� 6 ""�`� I YtT� t tip ` I r t (requires site plan showing P •smart) 14.00
City/State/ZIP: Ol a U b 1 f � l -)--2-t-( [ Furnace VI C aca 100,000 BTU (d • .. . s) I 14.00 I
t J / r, R ( { Furnace 100,000+ BTU (., a/vents) 17.90
(A_/
Suite/bldg./apt. no.: I Project name: i L L cp..4k)._,,A Gas heat pump 14.00 _
Cross street/directions to job site: Duct work 10.00
—
Hydronic hot water system
Residential boiler (radiator or
t r�" / I m o t 4.00
VVV Unit it heaters (fuel-type, not electric),
1 1 i in-wall, in-duct, suspended, ctc. 14.00
Subdivision: i I Lot no.:
Flue/ventfbr any of above 6.80
V Other: 10.00
Tax map/parcel no.: Other fuel appliances
C"z : f w ,�) A z l o ' �� " Water heater 10.00
() [ � �� / 1 Gas fireplace 10.00
,d1 t t,,•' �J Flue vent for water heater or B'
fireplace 10.00
Log lighter (gas) , 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
„ . 'r , . , �,t 1 , ' 1"1" I f I I ~ ;;: , Chimney/liner/flue/vent 10.00
Other: 10.00
Name: �w
Pa i r-e.m. 7 1A Environmental exhaust and ventilation
Address: l b S 63 W /� r (4 - Range hood/other kitchen
// __`_ t equipment 10.00
City / Statc/ZIP: —}— ; , !1l O k "[ L •-- q- Clothes dryer exhaust 10.00
( Single -duct exhaust (bathrooms,
Phone: (S _ , . _ • ilr Fax: ( ) toilet compartments, utility rooms) 6.80
' 0 , t1 ICAST,: i , ' l ?,, ' A t ti c / craw l spacc fans 10.00
Business name: FQ U�j SEASONS HFAJ"ING Other. a ipiog 10.00
Contact name: A AIR CONDITIONING, INC. $5.40 for first fouri $1.00 for each additiona
• 1005 INDUSTRIAL PKWY Furnace, etc.
Address: NEWBERG, OR 9713 Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phalle: ( .51) ) S --- g — t q , Fax:: ( -3 tr r0 f 6 S Water heater
Fireplace
E -mail: Range
,; .. ,.,. ,, „ a ' ,' mrr ' ;, ,41'> F ' ; °A Barbecue
Business name: FOUR SEASONS HEATING Clothes dryer (gas)
AND Aim UUNDITIONING , INC, other
Address: 1 005 INDUSTRIAL MA ... suatotal .. h
City/state/ZIP:
Minimum permit fee (
NEWBERG, OR 97132 ubtotal '
Phone: ( ) I Fax: ( ) ,--
_ Plan review (25 %ofpermit fhe)
CCB lic.: _ 1' - 1 1 S State surcharge (12%ofpermit fee) 3 i 7 n
TOTAL PERMIT FEE 61 , ...co
Authorized signature: his permit application expires if a permit Is not obtained within 180
{ Y ' drys after It has ben accepted as complete.
Print name: \I (1 t _ 1 V\ Date: 1 Q �' • Fee methodology am by Tri -County Building Industry Service Board ,
I: hail diperam dc
tts1MEC-Pemrpp..doee Ot/197 r � V 440.1617T (11/02/COM/A'EB)
. .
• CITY Of TIGARD • . •
BUILDING DIVISION , / PERMIT #: NW-C.2008-00532
?
13125 SW Hall Blvd., Tigard, OR 97223 .. ,/ DATE ISSUED: 10/28/2008
Phone: (503) 639-4171 ii
at ,
Inspection Requests (24 Hrs.):: (503) ,639-4,175
INSPECTION WORKSHEET FOR DATE: 12/3-000'' TIME: 7 PAGE: 30
a.,-e-c..oci., ft,v__• ,
SITE ADDRESS: i OF,;63 SW NORTH DAKOTAST CLASS OF WORK:
SUBDIVISION; VENTURA COURT LOT #: 006 . TYPE OF USE:
PROJECT NAME: VVILLIAMS •
DESCRIPTION: Fiirriace replacement
OWNER: WILLIAMS, JAMES PHONE #:
CONTRACTOR: FOUR SEASONS HEATING & NC INC. ' PHONE #: 503.638.1960
,
Inspection Request Scheduled For: Date: 12/31/2008 Pour Time: '
COde Inspection Description Confirm #• Contact # Message
699 Mechanical final » 079253.01 503,684-3199 N
Corredtions/CommentslInstructiOns:
Li2S
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RTIAL APPROVAL ' PI CANCEL F NO ACCESS
. ---, FAIL 611 FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
/
ee .
Inspector: . Date: / , /C 'Phone #: (503) 718