Permit CITY TIGARD MECHANICAL PERMIT
' ! ! ''' ` COMMUNITY DEVELOPMENT PERMIT #: MEC2007 00449
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/23/2007
PARCEL: 2S 112BA -00700
SITE ADDRESS: 14490 SW 80TH PL ZONING: R -7
SUBDIVISION: WAVERLY MEADOWS LOT: 045 JURISDICTION: TIG
PROJECT: BASTIN
Project Description: Furnace install.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
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
JACK BASTIN Description Date Amount
14490 SW 80TH PL.
TIGARD, OR 97224 [MECH] Permit Fee 7/23/2007 $72.50
[TAX] 8% State Surcha 7/23/2007 $5.80
Total $78.30
Phone: 503- 320 -2568
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 -681 -0793
PRI 503- 620 -5643
Reg #: LIC 66578
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: fa Permittee Signature: cc-la—A_4( 2-
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.
; , /2007 /FRI 03:40 PM FAX No, P. 002
Mechanical Permit Application FOR OFFIICF LIST: ONLY
City of Ti and Rece
Pemtit 1rr : .
g ti - f Dote/By: o� o Ci Pe 7 7 t
13125 SW hall Blvd„ Tigard, OR 97223 It ECC1 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' :v,d ; 1, Date /By: Other Permit:
p
ins ection Line: 503,639.4175 ) i J B y
JUL l c Dote Ready/fly: ee Pent 2 for
Internet. Internet. www.ci.[igard.ar.uS � ® 1, . - Notified/Method Supplemental Lpplemental Innformation
Yµ`e y�" µ,1,o o ff' }��±�✓ q 1k ii a r. r!.6' 7 > ".•, ism' F'AC W11• ar ' 4 . 5 C 0anfiI�i L_
i8 , }�7! r tl•�F� fi,i:�•"`�I"�'f�,�LJ h 1
F ._ t,:. 1 t7. i ax. • ... .
❑ New construction 111 Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Ocher: mechanical materials, equipment, labor, overhead, and profit.
V 7 '�'c"�2�. g ��,�� p S� ` � , n, � 1.0''''', . i L ' n .i....' ' ,3: 5,, rF; iNi '1,1 Value: $
,. ,. „" i..s,* Y '� f .�. t Elii �r't:� -., A « , G4, tilt' o ,,,ii. 0 , ! , .o . r'i .. 'C tr Y '^,�a4�5 a � '�j -. ..�" � ��.- a.r:.a ...�•+cm:
gl- and 2- family dwelling El Commercial/industrial El Accessory building $ `"
For special lrjormatian use checklist.
❑ Multi -family 0 Master builder ❑ Other. Description 1 Qty. 1 Ea. r Total
� -, p yy.�, � 'til i i.115147. .n�. � `*nrr fi r 7 Hui�j..
� ,,., erf `i J b/� I,�`lil.t.: v r-' : , , 0. .tam Nl v� t :11.: i;.le ing/cooIlnP,
r i yF~, . } 4 �Y.41 .+ r.r , §:r .1 d.T4R,l,ri 74,A,..„'
q O �, _ _ V , _ _ _ _ «C'_ Air conditioning or heat pump
14 �
lob site address: S � P(• (requires site plan ahowin�ilacemeat) 14,00
I
City /State/ZIP: Furnace 100,000 BTU (ducts/vents) j 14.00
Furnace 100,000+ BTU (ducts/vents) 17
Suitefbldg. /apLno.: I Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00 _ ,
Iiydronio 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
Subdivision: 1 I of no.: Fluc/vent for any of above 10.00
L Other. 10.00
Tax map /parcel an.: Other
1 f, y p� . Other fuel appliances
7„
` . -Ve �Z e!,,' s r .. ! m11Via "h , D y i r • , D ' G ,,� rrj'7: Water heater 10.00
t It , .l . Z at7 d .Po' E ` T t 1. ' , Ii?: } n IL
Gas fireplace _ 10.00
Flue vent for water heater or as
hA/ fireplace 10.00
" 3' ,.I Lug lighter (gas) 10.00
Wood /pallet stove 10.00 -,
Wood fireplace/insert _ 10,00
a l+t 1 l • " -" t F � iltl 32t 1; ;�,ei +tt Chimne /liner /flue /vent 10.00
i' �t ',> F. it Pf � Y ao_. , [�,G .l �f� : , �X, g► , , • ia }� °: " ' i p`� � � Other: 1 0.00
Name: Bastin, Jack 807351 Environmental exhaust and ventilation
Address: 14490 SW 80 Place Range hood /other kitchen
equipment 10.00
City/State/ZIP: Tigard Or. 97224 Clothes drycr exhaust 10.00
(503)320 -2568 Single - duct exhaust (bathrooms,
Phone: ( ) toilet compartments y rooms) 6,80
R '' ' �Mi,y}s7n�f.n,r r �t} " 7l . - '+ K ` I .,� ' r ef jJ.i t i t ' t 0 D tl � 6.' .' r0 0 ,K r ,:iiiNai Attic /crawlspace fans I0.00
e i9's ? ,AM,rnz7il� 14.3, .�tC J - 1: . i},r ,. '�. .�.... 4 .. t : ^U ' toiii _
Other. __ 10.00
Business name:
Fuel piping
Contact name: 35.40 for first four; $1.00 for each additional
Address: Furnace, etc.
.- _ Gas heat pump
City /State /ZIP: Wall /suspended/unit heater .
Phone: ( ) Fax :: ( ) Water heater
Fireplace
E -mail: � Range _
� , f .„' �, W�a..S 's"a „�:€ . -' rp : p �s +( t �k3 � fit A ..� ' ' . H arbecue
Clothes drycr (gas)
Business name: ' L - i - ' �i
Other:
/� n - , /� / _ '�rr;•� L.44,.'.', � �y�� ��
Address :" �6 b s-,., s-,., 1 +�V . C _ �i for t ,i} rr " - L t i � r ;7 x fs�k4fTf4 ,. %j;: ,-
City /State /ZIP: Ti GZ. ,i # o - - Z 2-5 Subtotal I
Phone; _ to F ax: (S o ) - Plan review ( 25 % of permit fee) G
Minimum permit fee ($72.50) 4
(s-7).) -- ) 472 o ( 43 (p f 1 - 6 "4- q
CCE lic.: ( P C C 3 - e State surcharge (8% of permit fee) / a 7
4 TOTAL PERMIT FEE 'r
Authorized signature: (3 This permit application expires If a permit is not obtained within ID
�; days after It has been accepted na complete.
Print name: f 0 f �,` Datc; 7 f?-C / 0 1) * Fee methodology set by Tri- County Building Indrairy Scrvice Board
l:rµildingWarmitdtgGAertlulApp ,doe 1 2/03 44D (11/02/COMME13)
CITY OF
BUILDIN tIVISION PERMIT #: MEC2007- 00449
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/23/2007
Phone: (503) 639 -4171 i r�� ,�i�l°
Inspection Requests (24 Hrs.): (503) 639 -4175 'III
INSPECTION WORKSHEET FOR DATE: 8115/2007 TIME: 7:OOAM PAGE: 57
SITE ADDRESS: 14490 SW BOTH PL CLASS OF WORK:
SUBDIVISION: WAVERLY MEADOWS LOT #: 045 TYPE OF USE:
PROJECT NAME: BASTIN
DESCRIPTION: Furnace install.
OWNER: BASTIN, JACK PHONE #: 503- 320 -2568
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503 - 620.5643
Inspection Request Scheduled For: Date: 8/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 053905 -01 503- 320 -2568 N
Corrections /Comments / Instructions: •
Orill L6 • 0 ✓- ..:!- -% 5 / - i 2ia ." GL -= et„, - ;/zrzr.- - .ate
kg.iii • 1/' _./� -A Jr " AP i - • .., 6 - Lek, - r/ ( /d' -
��L�,./-
/^
l PASS ❑ PARTIAL APPROVAL ❑ CANCEL 1 NO ACCESS
1 FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
7'(
Inspector: ! • Date: s`-�f Phone #: (503) 718 - Z