Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00200
13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 5/15/2006
to
PARCEL: 1 S136AD -03900
SITE ADDRESS: 10750 SW 71ST AVE ZONING: R -4.5
SUBDIVISION: VILLA RIDGE LOT: 006 JURISDICTION: TIG
Project Description: Replace furnace, install ductwork transitions, install chimney lines.
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: 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
EDITA SMITH Description Date Amount
10750 SW 71ST AVE
TIGARD, OR 97223 [MECH] Permit Fee 5/15/200E $72.50
[TAX] 8% State Surcha 5/15/200E $5.80
Total $78.30
Phone: 503- 617 -4560
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: rj). Permittee Signature: \e
Call 503 -639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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,1 312$ SW Hall Bh+d , Tigard, OR
Ptah Review
Phone 503.639.4171 Fax 503.5 0 `\ . P' t� ✓.,; e . . . .. i 'i p gy; Other Permit:
Inspection Line: 50 39.4175 > �� Nt OF �\V \ S \0 AIM., S'1 S'1 1 L bate Ready/By. J 1 ® See Page 2 for
interns. 'www.ci.ti aor.us Y�,1k� Notified/Method: supplemental tnforratatiou
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❑ New construction ,ddition/altetzttion/repiac entent
Mechanical p it fens' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition , ❑ Other: mechanical materials. equipment, labor. overhead, and profit
u ' ,. • J . n e r 19d' ,, t gq: * Value: $
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- and 2- family dwelling 0 Commereialrindustrial ❑ Accessory building rJ k ?L ' r �� ",c
"- For special information use checklist.
Q Multi- family 0 Master builder ❑ Other: Description Qty. Fn. Total
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Job site address. Air conditioning or heat pump
Q� 5 0 5 W 1 s} j�U Q, (requital sire plats showing Olacemear) 14.00
City/State/ZIP: v� i 091 9'1 2Z 3 Furnace 100,000 BTU Noels/vents) 1 14.00 1 X1.00
�_+ Furnace 1 00,000+ BTU (ducts/v�ents) 17.90
Suite/bldg./apt. no.: Project name: �-d,.1ko. S yvhvs
Gas lent pump 14,00
Cross stmt/directions to job site; , .... Duct work ( 14.00 (y. CO
Hydronic hot water system 14,00 i
•
Residential boiler (•adiator or
hydronic) 14.00
Unit healers (fuel -typo, not electric),
in - wall, in - duct, suspended, etc. 10.00
Subdivision l Lot no. Flue/vent for any of above 10.00
. Other: 10.00
Tax map/parcel no.: Other fuel appliances
r ' :,-. sr,. „ •r uxut,:ic.,� '�ys av�e tntx Myr ;-•r,cyp;�s.,r q ' +K= E "., 5_; Water Want heater 10.00
y r' : ' A S i rr to e i, t e 6 i Sf� r '1 . Qit; 0, Fr'.8 ; : dZ:.; iV_4 till t'3 ,j
to..�:..YG'L.�.�:b.v` 1.:•s5 {n...� .:!. i; Ah,., r: tif Y.. i. tl d. .,: c, Al. l'a.i:�.;,ii,••yJ,;.' /.'('S�aM✓ ,L�:�L'�(.ir;la %',r% ,.d•`F• ry-ld fireplace 10.00
D I 1 5 VN / V A ‘ U f \ C 'e. _ _` -' Log Flue vent for water heater or gas
•4 v. 1 ckucA A- COJ5 A-No ✓ l 10.00
Log ligh ghter (gas) 10.00 •
1 rNie0 1 c r v yv\ lAe. 1 j h Wood/pellet stove • 10.00
Wood fireplace/insert 10.00
•+ee- �- 4;:1:L'i •.'^ir � . r . I' ^:71r,^!-,�w'd vrs ,• r J'ra, Y /llncr /flue/vent I 10.00 - 10. CO
a fit `.
4 ; �t4t • t ?,•: � - "y �te It u `tj 'k Chltnney
,e�.:�a::2i,:cL�u::evr�!T,y: ;acrlr� M G � .., ,.. c r, r,r7 a lv1, . ..a.t,,:i+i+'.S>,:r•h.s.... ,.�rt�, Other•. 10.00
Nom: ,*o. 1M "h Environmental exhaust and ventilation
• Address: 10 ._O :5 (/) `? 1 b)' Ave -Range en d/oihcr kitchen
10.00
City/State/ZIP: l k--01, _QR, ci 1- ZZ . . Clothes dryer exhaust 10.00
Singly duct exhaust (bathrooms,
Phone: (53) 61 , y () Fax: ( ) toilet compartments, utiti r rooms) 6.80
•.. • .. •«yy 1 ^ �. Ar n - """ ,�^ i r - 4ti1a Y ` ` y ^ ,Ti ' Attic/crawls fans 10.00
f
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•'�.1i�;3i`.f.�':- �.xs.`c:. .rr/_•_L_.r_��v� y. ,, " n . ,,� fk.L'�3:Y.•`• a. C7� ; ,. 4 .. t' 10.00
• i _ Other. _
Business name: tA ' . R- r w' o. \ f• Q I) fi Fuel pipi -
Contact thane: 1 a • e \ gigidlIMIlkilMillMI $5.40 for first four: S 1.00 for each additional
Furnace, etc.
Address: L\ 3zo m, w ) 1 \ ; ou S ANA Gas heat pump
City/State/'1P: Po r ` x c GK 9 Z) - WalVsus • ded/unit heater
Phone: (50 ) Z„; 1 , - 0 5 Z Fax: : ( spy Z j Z - S 0 0 Fire t e r he ter
E -mail: t h (A 1 • 11 / e • 0 Rai • e
F rar y r tS trih` �, �C?a 9q;,;;i '�;Ti ,, � "T ,� :c �; - �3'Af • , y .. iE y ,'i ,{y Barbecue
n..-J :. j� 7�j ,.e; > ?, i,57: . 1.4V. ,•.j 1. 4`Y ;, , ^ n i 1. ,,.: y, ^.,v , L .,i ld•:, t.:,1
.. . ��tli,b✓ f Y.ur. mJ`ae u' aL: sus •nwF;:;�aarYS Clothes dryer (gas)
Business namc: A y\ 1 1.-\ l ' - •, t 1 0 i A t ot her
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Ave_ - get 0r - +. :oer.- . tIg ` „ ,:rr 'r.
Address: � . ■ � OR C.13- [�} ` 'b �'�N warm �
No cx 4 . O - l T Z 1 ^ im um p Subtotal ...
City/State/ZIP: lCity/State/ZIP: T
` Minimermit fee ($73.50) ��
�_ Phone: ( O3) I , ' i'a 5 Z Fax; (507) Z.•Z - 5 0
Plan review (25% of permit tux)
rr I
�' CCII lie.: 0 0 'q State surcharge (8% of permit fox) E • •
`t' _ 'TOTAL, PERMIT FEF, j�
1 ' This permit upptication expires if a permit is nut obtained within 180
Authorized signature: C, ` / . - days utter It has lmc.t accepted se complete.
I Print mule: 7 - pus• to
Date: 5 4 ( f 1Q
• Fee methodology set by Tri- t:uwtty l)wldiar, lndte try Service 13um'd
M n - 4t, in (I t1O2 /COM/u/t:11)
■Q:uldu,pPeraitan:C Pen,WAppdoc 12/03
Id Wd00:90 900E ET 'hpW EELSE8E 20S : ON 9NOHd but Iooj '8 6ut1EaH - IIlONd : WOdd
CITY OF TIGARD ' =
BUILDING DIVISION PERMIT #: MEC2006 -00200
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/151200G
Phone: (503) 639-4171 1 ''
Inspection Requests (24 Hrs.): (503) 639 -4175 A I..
INSPECTION WORKSHEET FOR DATE: 6/14/2006 TIME: 7:05AM PAGE: 10
SITE ADDRESS: 10750 SW 71ST AVE CLASS OF WORK:
SUBDIVISION: VILLA RIDGE LOT #: 006 TYPE OF USE:
PROJECT NAME: SMITH .
DESCRIPTION: Replace furnace, install ductwork transitions, install chimney lines.
OWNER: SMITH, EDITA PHONE #: 503-617-456(3
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503- 21:31-0752
Inspection Request Scheduled For: Date: 6/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031622 -01 503.617 -4560 N
Corrections /Comments /Instructions:
r 12i/+?D /ot S 9' 71D
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._._._____..._._______„.
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 94/(/ Date: �� Phone #: (503) 718- �`" 9"