Permit y/ _
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00133
DATE ISSUED: 3/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136CA-90521
SITE ADDRESS: 10900 SW 76TH PL 52 ZONING: R - 25
SUBDIVISION: TIGARD WOODS A CONDO COMM LOT: 052 JURISDICTION: TIG
Project Description: Replace gas furnace.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
,HALL, BARBARA T Description Date Amount
10900 SW 76TH PL #52
TIGARD, OR 97223 [TAX] 8% State Surcha 3/28/200`. $5.80
[MECH] Permit Fee 3/28/200`. $72.50
Total $78.30
Phone: 503- 639 -3240
Contractor:
PERFORMANCE MECHANICAL
1915 SW 25TH ST
GRESHAM, OR 97080 REQUIRED ITEMS AND REPORTS
Phone: 503- 762 -2474
Reg #: LIC 147003
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: : 7/701 . Permittee Signature: -2., Q
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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,Mectfank . al Permit Application , . FOR OFFICE USE ON LI? ' . .• .
,-.•- ,
City of Tigard ' - 1
P -PGEWED A Received ...,
Permit No.• C . 5" --- a) )1 '
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13125 SW Hall Blvd., Tigard, 0._ 972-23 Date/By: ipp ....5"
Plan Review
• Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit:
6111/44#10 :
Inspection Line: 503.639.4175 MAR 2 4 2005 _ A I Date Ready/By: Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: - I" (G.- Supplemental Information
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El New construction KlAddition/alteration/replacement Mechanical permit fees* are based on the valueof the work
performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
ZAidiiii.VbP3,edi4-§iiiiiefiiSSiV...,•:ti;?,±Xli.,;;:iX:',IM4';.:: Value $
ARE'SlOiltl‘iTtALTQUIIMENT'/
Ife1 and 2 dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. Ea. Total
Zielgli:: CPIRM,d0P$'...itt:545itit".t ti:tikgs Heating/cooling
Job site address: I b 700 Suf -- 76, 4 ` 1 to/ /-`5-iD- Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: ' i / .ef / OR__ 3 Fumace 100,000 BTU (ducts/vents) 1 14.00
Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other: 10.00
Tax map/parcel no.: • Other fuel appliances
" . ' ''''''"''''''''-'•''•'-',>' , Water heater
Mi 4:1•-•:',Pi:::r.';::.•11.-!-';.,.:::'.:•:1'1::':;. 10.00
Gas fireplace 10.00 - . • .-
0 2 4 0 /QC e./ ga -S /CIA-11 0' ( -e- Flue vent for water heater or
fireplace 10.00
- Lue, 41Itcr (brab) 10.00 --
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
'""--..•,''" ' 7 .'''',1 r , 1•:•'. : r**.Y.C;:: ',-1in1V.,-..,,' ,: Chimney/liner/flue/vent 10.00
- :,',,,50„vq:,:;':,v. .; ,,,goiT,R,Typyv.Np3, ,:l:r-eirri;'i ;,:,,,,..,:•.:::::•::,:i.q,•: Other:
_ 10.00
Name: . (1 - i *X ffeai - Environmental exhaust and ventilation • --- "
Address: I 0 9 SW - 1 t'' P/r6 re 14 5 `- Range hood/other kitchen
equipment 10.00 . .. _.
City/State/ZIP: I i '0A4 , 0 6-- 9 - 1 a d 1 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
.....
Phone: ( ,50 cSol_ 3,,,„)yo Fax ( )
1 .
toilet compartments, utility rooms) 6.80 . ....
:. '.'''' , '''' : ''''''' 1 "' ..:' 4 .1 -'::::': Ill ;t0NTACT 'PERSON: i .,: ..:,-.' .,' Attic/crawlspace fans 10.00
Other: , 10.00 ,
Business name: Performance Mechanical Heating & Cooling, Inc
Fuel piping
Contact name: Brian Vanderpool 55.40 for first four; $1.00 for each additional
Address: 1915 SW 25 Street Furnace, etc.
Gas heat pump
City/State/ZIP: Gresham, OR 97080 Wall/suspended/unit heater
Phone: (503-) 762-2474 Fax: : (503) 667-8823 Water heater
Fireplace
E-mail: sales@performancemechanical.com • Range
I•VVNoNgv,o),iv too#0*APMM Barbe
Clothes dryer (gas)
Business name: Performance Mechanical Heating & Cooling, Inc
Other:
Address: 1915 SW 25' Street • . . ..,"•. „ .. ,, .. ,.- . _ ,Y, ,4., r.•1. . , , .,. .
'''4"'' "''':'''"...'''''''''' ,MEC11ANICAL
City/State/ZIP: Gresham, OR 97080 Subtotal j q.
Minimum permit fee ($72.50) 7 a , •
Phone: (503) 762-2474 Fax: (503-) 667-8823
Plan review (25% of permit fee)
CCB lic.: 147003 e,Ny ,2- -a-7 , State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1ga°
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Authorized signature: fA...4_ d&32.-Pr This permit application expires if a permit is not obtained within 180 .
days after it has been accepted as complete.
Print name: " & WW (/r d 1 Date: Z, - 2 - 6 s * Fee methodology set by Tri-County Building Industry Service Board
i: \ Building \ Perrnits \ MEC-PermitApp.doc I 2/02 440.45 I 7T (II /02/COM/WEB)
CITY OF TIGARD
BUI,LrMN ' DIVISION PERMIT #: MEC2006-00133
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �!
INSPECTION WORKSHEET FOR DATE: 6/16/2005 TIME: 7:10AM PAGE: 109
SITE ADDRESS: 10900 SW 76TH PL 52 CLASS OF WORK:
SUBDIVISION: TIGARD WOODS A CONDO COMM LOT #: 052 TYPE OF USE:
PROJECT NAME: HALL
DESCRIPTION: Replace gas furnace.
OWNER: HALL, BARBARA T, PHONE #: 503 -639 -3240
CONTRACTOR: PERFORMANCE MECHANICAL PHONE #: 503 - 7612474
Inspection Request Scheduled For: Date: 6/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009145 -01 503 -639 -2240 7 Y[—'A A
Corrections /Comments /Instructions: -'" p l�v�
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ` El CALL FOR INSPECTION 111 ADDITI NAL FEES ASSESSED
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Inspector: ® � � Date: — Phone #: (503) 718 -