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Permit 0. CITY TIGARD MECHANICAL PERMIT 4 DEVELOPMENT SERVICES PERMIT #: MEC2006 00009 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/5/2006 PARCEL: 2S1 12 C D -00 701 SITE ADDRESS: 15950 SW 76TH AVE ZONING: R -12 SUBDIVISION: DURHAM ACRES LOT: 001 JURISDICTION: TIG Project Description: Replace furnace. CLASS OF WORK: ALT 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: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES BLACKWELL, JAY M + TRACI N Description Date Amount 15950 SW 76TH [MECH] Permit Fee 1/5/2006 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchar£ 1/5/2006 $5.80 Total $78.30 Phone: Contractor: AAA HEATING & COOLING 2915 NE MLK JR BLVD REQUIRED ITEMS AND REPORTS PORTLAND, OR 97212 Contact #: PRI 503 284 - 2173 FAX 503 284 - 1552 Reg #: LIC 222 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: 0 / ;' „ Permittee Signature: d�') a 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. • I 1--- t Ci ty' of Tigard Permit No.: L �r �G/ eNVf ��y► „ — Op0OCJ 7 �j y. Kecervea 13125 SW Hall Blvd., Tigard, OR 97223 7223 ��� 0 5 ` Pla 16,101„ G� Phone: 503.639.4171 Fax: 503.598 s l 60 /4ff.4 (A Date/By: Other Permit: Inspection Line: 503.639.4175 LiTY O F 1 1 1 r ' 1vtCi ' Ready/By: l Da te Re ad Jura: 10 See Page 2 for Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Medtod: r Supplemental Information COMMERCIAL FEE* SCHEDULE - USE CHECKLIST : E ,, WORK Mechanical permit fees* are based on the value of the work ❑ New construction Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ .; . CATEGORY OF CONSTRUCTION ° RESIDENTIAL EQUIPMENT / SYSTEMS FEES* vJ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special utjantatiat use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. Total _` ` •JOB SITE INFORMATION AND LOCATION Heating,/cooling Air conditioning or heat pump Job site address: / 5-5 S, 5- -7 h `h 4 //� (requires site plan showing placement) 14.00 Furnace 100,000 BTU (ducts /vents) 1 14.00 / 1/ City/ State/ZIP: . ��«( t� ?Z 2 �� Furnace 100,000+ BTU (ducts/vents) 17.90 , Suite/bldg. /apt. no.: Project name: _ Gas heat pump 14.00 Cross stree1/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 /U Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances - - ' -. ..1 - Water heater 1 10 00 l s a t DESCRIPTIONt OF WORK + Gas fireplace 10.00 ("7(--- C. ,�� . e "- t /9” 14 //12-- l/ 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 - Chimney/liner /flue /vent 10.00 ,.{PROPERTY OWNER 0 TENANT Othe 10.00 • - Name: tJG,, giG € t( ‘...,.(1 Environmental exhaust and ventilation Range hood/other kitchen Address: 5A.,,, 6, c a l, 4,, 1 equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ONT PERSON Attic /crawlspace fans 10.00 ;ice °tAPFGICANT TAC Other: 1 0.00 t Business name: Fuel piping Contact name: U(, O Se. 22 (''- $5.40 for first four; $1.00 for each additional Furnace, etc. Address: S 80�A ` tj ..l ,7 ,-... ' Gas heat pump City/State/ZIP: Wall /suspended/unit heater • Water heater Phone: ( ) - Fax: : ( ) Fireplace E -mail: Range +F;;.l g, +laU , '" }: 1 CONTRACTOR' • Barbecue ' Clothes dryer (gas) ��I. � Business name: A d 7 n b)-7! Other: Address: c2 4 / 5 — y) E r 1 K ` , l( vd lJ MECHANICAL PERMIT FEES* w A Subtotal 2' City/ State/ZIP: 0 4/ �..cp - % G7 � � Minimum permit fee ($72.50) 7� 1-7. Phone: (5 3) �% QJ t Fax: (,5 Z/ � `552. Plan review (25% of permit fee) CCB lic.: =A._ State surcharge (8% of permit fee) 5' TOTAL PERMIT FEE 7 - g 7 This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. 1 Print name: /4,.k p,� ,e-- Date: %2'3 1' ©r * Fee methodology set by Tri-County Building lndustry Service Board a.\p.,a,u,,o\p..+ni.c tanC.P.r*ni,An*,. 12/03 440 - 4617T (11 /02 /COM/WEB) CITY OF TIG/4RD p 1 , I - en% '1b ' kim ik droil), BUILDING DIVISION Pte± PERMIT #: MEC2006 00003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: �Pl,a Phone: (503) 639 -4171 � � Inspection Requests (24 Hrs.): (503) 639 - 4175±+` INSPECTION WORKSHEET FOR DATE: 17/20()6 TIME: 7:06Am PAGE: 74 SITE ADDRESS: . 16.950 SW fEiTH AVE CLASS OF WORK: SUBDIVISION: DURHAM ACRES LOT #: 00./ TYPE OF USE: PROJECT NAME: BLACKWELL DESCRIPTION: Replace furnace. V OWNER: BLACKWELL, JAY M + TRACI N, PHONE #: CONTRACTOR: AAA HEATING & COOLING PHONE #: 503 Inspection Request Scheduled For: Date: 2717/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 027071-01 W3-284-2173 Y wt Corrections /Comments /Instructions: .02),i/(2 --6j-c ' S 7 7 / a/ c i-C_ r--6/1a6 PASS 1 1 PARTIAL APPROVAL 7 CANCEL _ NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: ;77 4 6 Phone #: (503) 718 - ,).77'0 p