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Permit . CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00037 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2009 PARCEL: 2S114BB -07800 SITE ADDRESS: 16283 SW 104TH AVE ZONING: R -12 SUBDIVISION: SWANSONS GLEN LOT: 019 JURISDICTION: TIG PROJECT: LEE Project Description: Replace furnace and install b - vent for existing water heater. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: 1 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: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 0 FURN > =100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Owner: FEES ROBERT & LAURIE LEE Description Date Amount 16283 SW 104TH AVE TIGARD, OR 97224 [MECH] Permit Fee 1/23/200E $72.50 [TAX] 12% State Surch 1/23/200 $8.70 Phone: Total $81.20 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: Per Signature: �} j ,n kji Y� '� � Qf l � g �Q L ��b� 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. Niech `meal Permit Application RECEIVE I' t;c>,R orl lc•l; I_•sJ• ()NIA City of Tigard r, �d 2 3 2009 Received _ Tigard, OR 97223 DateBy: • •p ` A ,1 I • EM ° 13 125 SW Halt Blvd., Ti S P Review " Other Permit 11 Phone: 503,639,4171 Fax: 503.598.1960 p�te/t ;y; T I G A R l7 inspection Line: 503.639.4175 CITY OF TIG r I' Date Ready /By: B See Page 2 for Internet! www.tigard- or.gov BUILDING DIVISI0 N /Method: Supplemental Information . kr- n i� pt�1�1' , r ,' I q hPM;� F I a...t I.i y, .g ,. .iy,,r� ^1.i -0�",' -0i 1�1'��, °. r�lyfl .. �.eLq�i,, J{ I��.� ; xk N . . ,. :. ��..:i� �t,.4M���e "1�fW { ' �' 8 ,e lit i� - v,lla� � i ^: » {P i;iik 11 .t � �f �yy • r , ,. l , v) {r)i t ..,. l ,n i f �Ah ;i.id-r°r �i.�aY diti :P' tat L WC arati to i. . ,.. �m mY bn , Q Ncw construction Z ,Addition /alteration /replacement Mechanical permit fees" are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition ] Other: �y mechanical materials, equipment, labor, overhead, and profit- I0� "� . :, ra, A �. ,�,n M , 1� • Value S t� p � • rx. , r �r'r +.avai.av err t " )4 �� r1t w � •� il�fr� ��''r�'f,txu i na1,YP ,�� t r �y a�� . r r � � r r . 7 t. 4N+ i '(AVII {yrvatMl.iR'N�6��.1�1h.4 �.ara�17F��:411.Yi1 p1���: � �r a a ei a� a 'z P 1- and 2- family dwelling © Commercial /industrial ❑ Aooessory building 4.� :',,,Vi' '"�i °' " " )� Multi For special information use checklist. ❑ M qS ❑ Master builder ❑ Othtr. Description j Qty. I Ea. I Total Y f r�1 W y���} 1� �#5f'Id'of 7 'd� fY� �i :, �� Y o ry t' t �il� R 11 r�) N di -� r j � 1 y', C� '�fg � l �V +7i ir"BM�r..riz,F"ati t.AW.'. :„ ' aY •T: ``: a.:ar 4>y „,, r•.m wra KOi":ii,,, ++-2idaSBi[ rd�'SSSi1i�.'1„�,i.W «nt�A�po IleatinWo01rng Job site address: II II __ \\ Air conditioning or heat pump go �3 N OLD f5„)e,,-)4."-e___, _ Ircquima site plan showi.g placement) 14.00 City /State /ZIP: .�.y, 4 : r) y Furnace 100.000 BTU (ducts/vents) i 14.00 1 u ” Suite/bldg. /apt. rte. Project Warne Furnace 100,000+ BTU (duets/vents) 17.90 .. G heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 — - Unit heaters (fuel -type, not electric), in -wall, induct, suspended, etc. 14.00 Subdivision: Lot no.: Flue/vent for any of above 6.80 Other: 10.00 Tax map /parcel no. : • Other fuel appliances o ; y et 1� k _._. �.,. �'��i��,d't 1 � Pt Y�A3w� igt^,ii'�; y e •Ritob l', 11"1 '' MY l ' I lI ' � .•F 1 911 1 1' .�,,(� r'6 „ft,.1ilvw Water heater _. 10.00 '21.0)' j (u 1 I n � Gas vent foe gas 10.00 � � C"--.- Pius vent for water heater or as 1,-.4'.4 _fireplace 10.00 b' " Ail ` . I✓� t¢e Log lighter (gas) 10.00 Wood/pellet stove 10,00 q' y� ._... - Wood fireplace/insert 10.00 { I ' �r ,i'P 1 • '� ' r� i''I�,t;1;.' 1W M ?! � t 1 ,. i i k ''' '' M � fl � ' 1� F . � ii r , :i, "&� NPr(izi* 1 0,4?.',..' AL;;1 1 .M, Chim ley/liner /flue/vent I - 10.00 10 - Name: �j 1 kly C L , 0 1 is 5 Environmental exhaust and ventilation Range hood /other kitchen Addre ( ) 3, p /v J equipment _ 10.00 City /State/ZIP: .4,) 64-21 ? , y � � / 9 Clothes dryer exhaust 10,00 !� �'�'� � � Single -duct exhaust (bathrooms, Phone: (iti' ) g) Fax ( ) toilet compartments, utility rooms) 6.80 id, ptrw. 'd i �}, ") r jltei rr 6 lvflv�dlrW� r1 6 y h r q rl / ' kilY�i 1 / . u 0,04 10.00 ,:�:;r�f � t9 El_,., 1 t , /, m r r.w�r,r. aiMt, ;0 4 r f .. C+i, *. u pin Attic /erawlspace fans -�.,.. s , �,, Other: 10.00 Business name: ,f'9 , r > ,.j - I y ,.. 1143 (1 ) )5 Fuel piping C tact na me: l Il " t I t" 7 p p g C�?✓i5-1, } m - ^.— $5.40 for first four; $1.00 for each additional Address: L Furnace, etc. .4 _ 1 i I) t'',- -P _-. Gas heat pump City/State/ZIP: , 0 . / , W heater Phone: (Cs O'J) .D. r kax:: 3 ) , i ci. Water heater _ Fireplace E-mail: +' /' ~- -- A f AI Yl� ..Ar � p(�Ip +ly.y 1 � i lY r i y�yy�, �'1'� Range � �M�iY � �L F �. � r .. f:�'I A "{ �I P 1 : 1 .. r r v n r. F 1 NA � ! V 1 rA. aI r V AI i�17~ 1 i t rr ra' gAry� ,I �;� r{ t a . a' tl �� � f t v .d �ro�'.! n, �h �nr4�r'RP`� r(rt r ,rt ti fro r� �,� 4➢�frl�rlli�4 , (r� n'�i hjy oC Barbecue Business name: Clothes dryer (gsa? �r i - a 4 ,L) g .a .. Other:, a permit fee ($72.50) p ...,. -_. /' 1ii Ylyry + "V< A� t l �{ I y F tI r... r �, „' nF �fSk ' at {°r;ti City /State/ZIP: ' � t 1 ' - Minimum Subtotal Phone; ( ) _ L Fax: ( ) A M inn Plan review (25% of permit fee) CCB lie.: ?" ?- • Slate surcharge (12% of permit fee) ' . q -fa �. t +te Sutr ....__ TOTAL PERMIT FEE 1 , 20 Authorized signature: ,1 ^ ) , fr This permit application expires if a permit is not obtained within 180 -- ' 1H. t� l4 { - -, days after it has been accepted as complete, Print name: (I� fro em 'Le' _ D ote : I s .. ,_) ?, 71'1 1 Pee lttclhi,iI I 'In-County iy set by tluildin' h Service Eli ml - •i . ....- ii industry L,tiuile.ne,,r ME:C ('CI IIA (fl' n1'1''(7 440.4617'1 (II /t Td WdTE:SO 600E 2E 'upf EELSE8E 20S : 'ON dNOHd 6ui Ioo3 '8 6uT1 -2 H 1IlONd : WONd INSPECTOR'S SIGNATURES ARE NOT Inspections Required for: t viE CZ or3 . 0zGa 7 REQUIRED ON GREEN INSPECTION CARD. ✓ Code . Inspection Description• • PASS Date By .✓ . Code Irispectiori Description;' `PASS Date B BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground /slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG - Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post /beam structural 150 Hot tub /spa /pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors _ 199 Electrical final 240 Exterior sheathing • 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG - Structure set -up MEC - Mechanical Permit j - 280 Insulation 605 Post /beam mechanical 285 Drywall nailing 610 Gas line 287 'Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG - Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection • 635 Smoke detector shutdown . 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in • 915 Fire alarm rough -in 305 Plumbing underslab 920 Suppression trip test 310 Crawl drain 995 Misc. inspection: 315 Post /beam plumbing 998 Alarm final 320 Plumbing rough -in 999 Sprinkler final 322 Shower pan 330 Water service 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert /catch basin 410 Fill 350 Septic tank • 415 Grading 395 Misc. inspection: 205 Footing _ 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final . 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \ Building \Forms \InspCard- AOP- Blank.doc 02 /02/07