Permit CITY TIGARD MECHANICAL PERMIT
Al. EVELOPMENT SERVICES PERMIT #: MEC2005 -00273
r I 13125 SW H all Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/25/2005
PARCEL: 2S112CC -04700
SITE ADDRESS: 15860 SW 80TH AVE ZONING: R -12
SUBDIVISION: BOND PARK NO. 3 LOT: 075 JURISDICTION: TIG
Project Description: Furnace and AC 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: 1 DOMES. INCIN:
GAS 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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
POWELL, BOS & ANEE Description Date Amount
15860 SW 80TH AVE. [MECH] Permit Fee 51251200E $72.50
TIGARD, OR 97224 [TAX] 8% State Surchari 5/25/200f. $5.80
Total $78.30
Phone: 503 670 - 8038
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone: 503 640 - 3607
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 B / Permittee Signature:
CaII 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.
1 0, Ia 002/003
RECEIVED -
Me chap di Permit Application FOR OFFICE USE ONLY
City of Tigard MAY 2 a 20 Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/By' s 04 I G i i - 2005 - -004275
Phone: 503.639,4171 Fax: 503,598 -1960 Plan Review
CITY OF Ile "I tl'i�' (' i1 DswB Other Permit:
Inspection Line: 503.639.4175 -
Internet: www.ci.tigard.or.us BUILD /NG D'•: ' !'-' Date Ready/By: ]uric. El See Pace z rot. � p 77;; " ' NotiFied/Mothod: 77 Supplemonrallefermatlon
4 ,;11 ,,�1 u� � "!," 'ih '6Vi ; tif� ,, :p " nnq ,,,,,::H;',4;071-,..-: r 1 ,. � -,• ' •
1� ,. .,, ,.,, „••,i.; +;, �''Igi . t l� -1_"::; ( + t;d5 'otiy* e.�y Ip � 1N1
dld, t7 + i,,, a ' CdlVllOQ #'AL fiI" .kHEF).CGI $' = USEt CHECKLIST'
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
Demolition
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Other:
y mechanical materials, equipment. labor. overhead, and profit. arg; •
°,'� ,,' '',''.(, ': �tS.T'� 4I.ht'', * -00411 F'C t 1 i.',u , - t: :i:, '.',.41 : „, 1 Value: $
1- and 2-family dwelling ❑ ' „i;'1ltESID �'Y 1V]e1�1T / S�lSTE•1V(S, FEES*
C ommercial /industrial ❑ Accessory building
❑ Multi -family For Spectal ormation use check
[reformation y ❑ Master builder ❑ Other:
Description Qty. Ea. I Total
„'4$ gir1 ;,i ''t,'f; i.,.!5' - ;.Jq ;h SIT1„' !RL`l'tQ RMAiT4(')N :; ANDI ; 4;94'11 O ,.. .., ,. ',!.' ,'a, Heatln /cooling
Job site address: r S`t 6 (- 4- `/ Q Air conditioning or heat pump 1 I =attires sim plan showing placement) 14.00
Ciry /Sratc/ZIP: -- C? s e ek q 3 z?/-r Furnace 100,000 am (duct uets /vent,) 17.90
s/vents 1 14.00
Suite/bldg./apt. no.: (� Furnace 100,000f. BTU (d
Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct .vork 14.00
klydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
(lout heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision:
Lot no,; Pluc /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
t',•, - '"'I''' .' �• , i't: a„ R i ' . . y .. , L •. b '. .'",' 1'i .,: •nt
t'?'!'' > ; 5,y.? 11. - ilin'.i�•T,, 1., ., 'E PTION :OIF.1, : ' ,, r -i • .L 1 ;i ' . .. 1 1 ll l . `' .. .,I,; ; J' • 1 +. water heater 10 00
Gas fireplace 10.00
Flue vent for water heater or gas
n -2 fir .lace 10.00
J C. '� - Lo li •.ter s 10.00
Woodl•ellet stt ove 10.00
Wood fireplace/insert 10.00
g';l , I i• � .a � • r ra J r ' .'r„ •' ,n y •1.. Chimney /liner /fludvcnt 10 -00
:I : _ j:,. 1 9 : iY,� `.. i ik F� R p L•YZ• . .6 0 . - N{L ' '�y� y1 F x'1 i'I�1 .1 : ,'3 I rft� Es i l y ' , = 4.0:
--- 4:'�+,.. ., ,. '1 v,e, 1.'Sf'72' "..j1. !' IC_:.!..41, ,,c,.p. L'J�1z, ,, ,, ' :t.a- 1, +l ' ii, '. I
l ' Other; 10.00
Name: E &- J 4� e0 t , - Environmental exhaust and ventilation
Address:
m ., � ` Range hood /other kitchen
equipment 10,00
City/State /ZIP: Clothes dryer exhaust 10.00 1
r �� - Single -duct exhaust (bathrooms,
Phone: ( )
�j i F ( ) • toilet compartments, utility rooms) 6.60
r' ` r' 1 AT yi ':a ' �' ' r ' �' r) , '�" "171'',n;r.,t 4 !I „ 1 acc fans 00
' .l ' ' , _ . ' ; G . , A'N T�`k,7 fr,' - d ._ A ., ,, l' R . ;,. , .,:, , 'tTi ,.. PER'SOD� ,.0 . ,' • Attie /crawls p l0.
Business name: ` / Other: I 10,00
U r C- T4'I 17 G ^C-± ( P Fuel piping
Contact name: !, r \d-`- t; C J CI r-c ` $5.40 for first four- $1.00 fo each additional
Address: Furnace, etc.
�C 5�.. i C.L C' C. ` - v:Dt (Z c - :
City/State/ZIP: Gas heat pump
Ci
ry 7 ( r Gl \. GC. , (_ 6. G L 4.. 2_ L 3' Wall/suspended /unit heater
Phone t.' - Fax:: ( t f (, g- ( .. 0 4 `t ? Water heater
E-mail: Fireplace
Ran •e
, 1':le �. 1d + •rl Q J ; t t P zv�� � , - • Ieh, 7.: 1.
•�4r '�..�,;:'.,�; t+l _,;K:l� ��` ':.�,� - n .,t,••,°� I,;r j.,..?",:,',. B rb cue
BtL9iness same: Clothes dryer (gas)
Other
Address: ° il'i+ ;; , i - 1; *dtA1.V'IE74;'1' 12A•ff1i" til'E S..
.City/State/ZIP: Sub [o [al
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCH lie.: L (4 S -- - 9' S' State surcharge (9% of permit fee)
TOTAL PERMIT FEE _ g a
Authorized Signature- . This permit application expires Ira permit is not obtained vithin 160
C L-{ -. -�1- L � '- days a ltar It has been accepted as complete.
Print name: i ,.„0L ,•` Date: S 0 Pr - Rae methodology sae by Tri.County 2t,ilaing Induury Sarvica Board
02, 1, ". A7( Z003/003
•
SITE PLAN
PL
PL
A G PL
PL
/S D fl'"/ 40"
STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
CITY OF OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00273
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2005
Phone: (503) 639 - 4171 �niamrll�lluy�upj�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/6/2005 TIME: 7:12AM PAGE: 65
SITE ADDRESS: 15860 SW 80TH AVE CLASS OF WORK:
SUBDIVISION: BOND PARK NO. 3 LOT #: 075 TYPE OF USE:
PROJECT NAME: POWELL
DESCRIPTION: Furnace and AC install.
OWNER: POWELL, BOS 8, ANEE, PHONE #: 503- 670 -8038
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503 - 640.3607
Inspection Request Scheduled For: Date: 7/6/2005 Pour Time:
Code # Inspection Description . Confirm # Contact # Message
699 Mechanical final 010788 -01 503 - 640.3607 Y
Corrections /Comments /Instructions:
M 1 A/6 R - S 7 'fo -- S'- /‘ 3ze>
FvnCN r4-c -C
Pr (c_._ vna r me A SP M+x
.11
KPASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • ' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 17.
Inspector: Date: v Phone #: (503) 718 -