Permit n CITY OF TIGARD MECHANICAL PERMIT
�
• COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00159
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/31/2008
PARCEL: 1 S125DA -08000
SITE ADDRESS: 09115 SW 69TH AVE ZONING: R-4.5
SUBDIVISION: KINGS VIEW LOT: 073 JURISDICTION: TIG
PROJECT: KELLAY
Project Description: Duct work, hydronic piping and gas piping for new boiler.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: 0 VENT FANS:
OCCUPANCY GRP: R3 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:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
CLYDE KELLAY Description Date Amount
9115SW69TH
TIGARD, OR 97223 [MECH] Permit Fee 3/31/200E $72.50
[TAX] 12% State Surch 3/31/200E $8.70
Total $81.20
Phone: 503- 245 -3945
Contractor:
THE HEATING SPECIALIST INC
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 257 -7000
FAX 503- 257 -7702
Reg #: LIC 56628
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: — At; �� Permittee Signature:
Call 503.6 - . • 175 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.
From:The Heating Specialist 503 257 7702 03/31/2008 10:30 8378 P.002/002
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Mechanical Permit Applicatio cEINIE.Ii,
City of Tigard \ Received
Datemy: M /314 Permit No.: /?& , ,,, ._
III • 13125 SW Hidl Blvd, Tigard, OR ' -^ - Za Phin Review AP. ....
' Phone: 503.639.4171 Fax: 503.598.1960 " \ 1-{ j,) '.,,- Date/By: Other Permit:
TI G A R i) Inspection Line: 503.639.4175 \ \!‘
Ggk . : i i Da_te dy/By: rafts: lit See Page 2 for
Internet: www.tigard-or.gov I Supplemental Informed=
CsV it
TYPE OF :::00P0.00#.47****;$0000::4:0*00001101.:
Mechanical pemtit fees* are based on the value of the work
0 New construction Nt Addition/alteration/replacement
performed Indicate die value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
t''' ... 'E' 7 7 -7 ,:r:P:D7::1SAT,E9,04 1 .g0f;:17 10 PgrYlkiTTPPk;":; - 71.': .. .';': - '1'":"::: ; :!;':
010.000#4:40VISOOt(0********0':
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family ['Master builder 0 Other:
Description I Qty. 1 Ea. I Total
:,::::::.. . !:'. 1:..:::: Heating/coolin
„ Air conditioning or heat pump
Job site address: • t t s s ,,,,..) u ft-- a
(requires site plan showing placement) 14.00
City/State/ZIP: -- i 0 z, cl-taa. Fumace 100,000 BTU (ducts/vents) 14.00 ,
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgiapt. no.: x j Project name: K.. e.Axck. , A
Gas heat pump 14.00
Cross street/directions to job site: .36--'-'1 Duct work
• 10.00 la CO
_dronic hot water systmn I
( , 14.00 1 t-(, rk)
' boiler (racliato
' tt.9 Ift-I \ IA k e'tilr tp .
A --1 (NI Unit heaters (fuel-type, not electric),
,, ‘.1 ,:-, LCI" in-wall, in-duct, suspended, etc. 14.00
Ae■ 21 ° n t:, Flue/vent for any of above ' 6.80
Subdivision: ' it) Lot .:
Other. 10.00
Vs-
Tax map/parcel no.: Other fuel appliances
E Water heater 10.00
r_ IN Gas fireplace 10.00
r A. eliA., Q5AnkagLI 1 / 4 /1/4) I </v.0 Nkr ito,a-.../\ Flue vent for water heater or gas
• fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplacelin.sert 10.00
110itiiOtANtli':ft'r!;F:.::iie.:;.;: CilimileYliner/flueivent 10.00
1 10.00
Name: e_A Lid 1\c Environmental exhaust and ventilation
Range hood/other kitchen
Address: Ct t j5 3 s vo (so t -43. 0 ,
1- ):
9 4 - equipment 10.00
City/State/ZIP: - "ri wr6 n (1 LI 1 a (2.: - Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: )3) c 9,,/„6„. 3c:i 45 Fax: ( ) toilet compmtments, utility rooms) 6.80
01/ W Attie/en/vitt/Pace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: 85.40 for first four; 81.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: WaWsuspendecVunit halter
Phone: ( ) I Fax: : ( ) Water heater 47 5 I IC
Fireplace
E-mail:
P":;,::44= Barbecue _
Clo
Business name: - ii, Q.,,,,k_ . Other: thes dryer (gas) 1
Address: Ot IA 5 s ...„, '11;.Egiogowtiott4g.*****:***03.,9-40,Rogi
,
City/State/ZIP: . -id. go Subtotal 38' 00
- Minimum permit fee (S72.50) 7,R SO
Phone: (53e6) 9 , 5 1000 Fax: (503) 5? - 770,2
Plan review (25% of permit fee)
CCB lic.: _
564eczq State surcharge (12% of pamit fee)
TOTAL PERMIT FEE % ,A 0
A ■,,■
Authorized signat6;; ‘4,1p11110 • Thb permit applicadon expires If • permit Is not obtained within 180
/ days after it bas been accepted as complete.
Print name: 4 j ki ,
T5 I l ° 1 Date: 3-3 k • Fee methodology set by Tri Building Industry Service Board
1:Suadiss \Permin■Nmc 01/19/07 440-4617T (11/02/COM/WEB)
CITE OF TIGARD
BUILDING DIVISION -, a PERMIT #: MEC2008 -00159
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3!31120013
Phone: (503) 639 -4171 / W� •
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I � ..
INSPECTION WORKSHEET FOR DATE: 411/20013 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 09115 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 073 TYPE OF USE:
PROJECT NAME: KELLAY
DESCRIPTION: Duct work, hydronic piping and gas piping for new boiler.
OWNER: KEL_LAY, CLYDE PHONE #: 503-2453946
CONTRACTOR: THE HEATING SPECIALIST INC PHONE #: 503.2.57- 7000
Inspection Request Scheduled For: Date: 4/1/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gus line 067653 -01 503-257 -7000 Y
Corrections /Comments / Instructions:
/
�' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4 / -d r Phone #: (503) 718- 2.11-1
•
,
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: MEC2008 -00159
13125 SW Hall Blvd., Tigard, OR 97223 // DATE ISSUED: 3/31/2000
Phone: (503) 639 -4171 a id Bi' li /
Inspection Requests (24 Hrs.): (503) 639 -4175 ' ��
INSPECTION WORKSHEET FOR DATE: 6/25/2008 TIME: 7:OOAM PAGE: 28
SITE ADDRESS: 09115 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 073 TYPE OF USE:
PROJECT NAME: KELLAY
DESCRIPTION: Duce, h+�d ronic i in and gaga for new boiler.
OWNER: KELLAY, CLYDE PHONE #: 503- 245 -394a
CONTRACTOR: THE HEATING SPECIALIST INC PHONE #: 03 -2,17 -7000
Inspection Request Scheduled For: Date: 6/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071811 -01 503- 257 -7000 N
Corrections /Comm is /Instructions: v%.16., ill Q n `
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1 $ 117
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(1 I ► 0.r`'; ' , ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
•
0 ,-",:la AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES A SESSED
Vt;4044, V/2 "1 6 ne #: 503 718 7
Inspector: Date. Phone )
CITY OF TIGARD %E(/ 00 I' ',C
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A it
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' _
INSPECTION WORKSHEET FOR DATE: 1/10/ D 5( TIME: PAGE:
SITE ADDRESS: qt 16 1.24 YA•(, • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: , A 1 1
OWNER: Ct'ir (k K 1A (A 'PHONE #: J r
� 45.1. % f#1 at . k e `` '- * H(3 #:
Inspection Request Scheduled For: Date: YV ` p fj. ll� Pour Time:
Code # Inspection Description Confirm # Contact t Me. "Of L5/7-77
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Corrections /Comments /Instruction
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❑ PASS PARTIA APPR ‘FW 13 CANCEL ❑ NO ACCESS
FAIL i' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 T7 �� o - J ( Date. / Phone #: (503) 718 4
1 [ \ I1EG2roi - to 6C
BUL®IING ®9MI1®N PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639- 4171 ti7 I:a. i�t'r 4?��1. ,
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: I A 0 0 0 5( TIME: PAGE:
SITE ADDRESS: ql 16 , d Pim-t, • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: aE)lr \L( OWNER: A PHONE #: Pig-16 45
CONTRACTOR: ..rh g 5, e t'- ``� vs 4 �HOI�E #:
Inspection Request Scheduled For: Date: IAAPtt Pour Time:
Code # Inspection Description Confirm # Contact Me- : 4!") L0 77
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Corrections /Comments /Instruction
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i 1 P! ASS + PARTIA APPR CANCEL ❑ NO ACCESS
I t �I4 FP, 1 ► CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: 1,/(./1 Date:A / Phone #: (503) 718 - 4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: al EC O06?— 00 $9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /o�enrei�W�i�li!
Inspection Requests (24 Hrs.): (503) 639 -4175 .. R __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: //S / 9 t �V`�� CLASS OF WORK:
SUBDIVISION: ( LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: 81-11-6g Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 g
Corrections /Comments/ Instructions:
Fill(
/ 8 J2/1}--t-it.t-0--e–C1) i2j16'—
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PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS '
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( 6 Date: F/11 /9
Phone #: (503) 718 - o( ti`t