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Permit C ITY OF TIGARD MECHANICAL PERMIT IN = n PERMIT #: MEC2008 -00591 COMMUNITY DEVELOPMENT DATE ISSUED: 12/3/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 104AA -13600 SITE ADDRESS: 12320 SW 128TH AVE ZONING: R -4.5 SUBDIVISION: BELLWOOD NO. 3 LOT: 155 JURISDICTION: TIG PROJECT: BERG Project Description: Replace existing gas furnace. CLASS OF WORK: ADD 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Owner: FEES JON BERG Description Date Amount 12320 SW 128TH AVE TIGARD, OR 97223 [MECH] Permit Fee 12/3/200E $72.50 [TAX] 12% State Surch 12/3/200E $8.70 Total $81.20 Phone: 503- 840 -7904 Contractor: CHASE HEATING CO 2236 NE 82ND AVENUE PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 254 -1274 FAX 503- 254 -1816 Reg #: LIC 153390 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: e El-- Permittee Signature: SP.P /C.st 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. Mechanical Permit Application tOR (►l 1 -it i I .�1 (PO 74 x :` City of Tigard *4•AIC) Received : 1,�"` -12/ ■ 13125 SW Ha Blvd. Tigard, OR O Q� • Phone: 503.639.4171 Fax: `:�� Q ■ ::: Other Permit: 503. I I i_; ', I' ,, Inspection Line: 501639.4175 < r �, #/a\fb • O . 1teUdY/BY, ® BI See Page 2 for Internet: www.tigard- or.gov l O t o p ed/Mmhod: kir/ Supplement llaformation ," ... ..,, try .;, . ,'''. t .. , . �•,. V �,' r .�wK 1 4/4;• ^,, 2/ ) p ;; Alt, x • � r 5 1^ i i �s^ S 1 a . , , ' r F ;q I ,N ... Y, �^Cy �.. k ----, 1 ❑ New construction re Addition/alteratio w' 1 lacement Mechanical permit fees* are based on the value of the work peaformed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. IF Value $ t o , , " " 1 , 7 , ;: 0., " . :.-"-• ' !.,. A'� , a mr- r n-,.' 1* PA 1- and 2- family dwelling ID Commercial/industrial ❑ Accessory building 1 '� ° " For special irifotmatron use checklist. ❑ Multi- family ❑ Master builder 0 Other Description I Qty.I Ea. I Total $ r ...... .....Catlrrp,/C941rA ,. r .d.. ',�Yl it r .' • r �} . �T�.kr.'.. _... .x.. .:.,'�v:. �� ' i Sob site address: / Air conditioning or heat pump 4 ark a (requires site plan showing placement) 14.00 Furnace 100,000 BTU (duotsJvems) 14.00 City /State /Z1P: �` II " ..r.., /� Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: ` - G heat pump 14.00 _ Cross strect/dir©ctions to job site: Duct work 10.00 Hydronic hot water system ^ Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in - wall, in suspended, etc. 14.00 Subdivision: Lot no.: Flue/vent for anul' above 6,80 _ Other: 10.00 Tax map /parcel no.: Other fuel appliances J a ,ti , n� ° r a g w. r , : w S t , y ..... , ,.:: n r , ? :3 um Water heatef . 10.00 Gas , I ,. ,,. � •W.. ate �° • ... " } ..., icrcplacx 10.00 .. / M / . y�jr /' I Flue vent for water heater or gas fireplace _ 10.00 Log lighter (gas) 10.00 Wood/pellet stove - - _ 10.00 _ Wood fireplace/insert 10.00 u e� • r - r ,s T Chimney /liner /flue/vent 10.00 other: 10.00 Environmental cxhaust and ventilation Range hood /other kitchen ,� , �, / equpmot _ 10.00 / y Clothes dryer exhaust 10.00 + ` � Single -duct exhaust (bathrooms, Phone: ()3) ♦ toilet compartments, utility rooms) 6.80 r," 'A oxw VEV. Jrri t1T ...- 1 r+-, .. ...... �,- Attic /crawlspnce Bins 10,00 .. Other: 10.00 Business name: Fuel piping, Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump _ Wall /suspertded/unit beater Water heater Fireplace E -mail: Range .. Barbecue / ■ ,� L Clothes drier (gas) � C7�/ /•� ,� Other: ., Address: 1 Zy .. art G t i[ _ . / 662-) r , „ ...,..i.:7 ' V 4 - .7,„:7,2 p ..: City /State /ZIP: ` r 4 4 / j 1 * l _ Subtotal ,� Minimum permit fee ($72.50) 7 50 Phone: (31)3) _ , 7 Fax: (52 0 254 ` , g „ Plan review (25% of permit fee) CCB lic_; - - D State surcharge (12% of permit fee) cs • 70 TOTAL PERMIT FEE ` f,,9 n Authorized signature r' f Thls permit application eapirea if a permit is not obtained within 180 � days after it hag been accepted as complete. Print name: j SI(ea, l Date: j _: 3 ° � " Fee methodology sot by'1'ri County Building industry service Board ... ,.. .. ....... _ n, r.nrnn ganghr"YT 11 tK leflMfeJa 31 CITY OF TIGARD 4 CC BUILDING DIVISION .; yo . PERMIT #: MEC2008-00591 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1213/2008 Phone: (503) 639-4171 4444i A f i D''' Inspection Requests (24 Hrs.): (503) 639-4175 La■ P1.11. INSPECTION WORKSHEET FOR DATE: 2127/2009 TIME: 7:01AIVI PAGE: 12 SITE ADDRESS: 123 SW 126TH AVE CLASS OF WORK: SUBDIVISION: I3ELLWOOD NO. 3 LOT #: 155 TYPE OF USE: PROJECT NAME: BERG DESCRIPTION: Replace existing gas furnace. OWNER: BERG, JON PHONE #: 503-840-7904 CONTRACTOR: CHASE HEATING CO PHONE #: 503-254-1274 Inspection Request Scheduled For: Date: 2/27/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 080900-01 50a-254-1274 N Corrections/Comments/ Instructions: eig 1.1.)--.D---0 f „,../ .... IAA rr AS r - 1 PARTIAL APPROVAL 0 CANCEL n NO ACCESS 4- 4 n FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Vt je ......._ Inspector: Date: Zone #: (503) 718- , CITY OF TIGARD „ BUILDING DIVISION PERMIT #: ( ` I�iEC200 -00591 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1213/2000 Phone: (503) 639-4171 _ inilt Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/28/2009. TIME: 7:01AM PAGE: 19 SITE ADDRESS: 1 'MO SW 128TH AVE CLASS OF WORK: SUBDIVISION: BELLWOOD NO. 3 LOT #: 155 TYPE OF USE: PROJECT NAME: BERG DESCRIPTION: Replace existing as furnace. OWNER: BERG, JON PHONE #: 503 -840- 7904 CONTRACTOR: CHASE HEATING CO PHONE #: 503 - 2541274 Inspection Request Scheduled For: Date: 112812.009 Pour Time: Code # Inspection Description Confirm # Contact # Mess - • - 599 Mechanical final 079998.01 603-254-1274 0 Vfii Corrections /Comments /Instructions: .�! - b. _ .as_ L< <_ '�-z(T t!"L_D_t 1. ru. U - • -0 4 ---7- ■ ! 'C , 0 2?, ❑ PASS PARTIAL APPROVAL jt CANCE ❑ NO ACCESS n FAIL % CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: p (- Date: / 7_13 �l Phone #: (503) 718- 70-/Z/ -