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Permit 4 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00050 TIGARD DATE ISSUED: 2/3/2009 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136CB -01500 SITE ADDRESS: 11125 SW 82ND AVE ZONING: R SUBDIVISION: RANCH VALLEY LOT: 011 JURISDICTION: TIG PROJECT: CURTIS Project Description: Install gas furnace. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: 0 VENT SYSTEMS: 1 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES GENE & NANCY CURTIS Description Date Amount 11125 SW 82ND TIGARD, OR 97223 [MECH] Permit Fee 2/2/2009 $72.50 [TAX] 12% State Surchai 2/2/2009 $8.70 Phone: Total $81.20 Contractor: D & R HEATING & AIR CONDITIONING PO BOX 1292 CANBY, OR 97013 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 678 -2517 FAX 503- 678 -2097 Reg #: LIC 84489 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 OU NC by calling 503.246.6699 or 1.800.332.2344. Is ued By: - A, I Permittee Sign -, ure: JA 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. Feb 02 09 02:07p DR Heating 503 - 678 -2097 p.1 Mechanical Permit A • • lieu ().i FOR OFFICE USE ONLY City of Tigard Dat eivea atd . By: � � � • . a , Permit No.: L. 2.0 09 (\(1 • 0 , III • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �"vv a Phone: 503.639.4171 Fax: 503,598.P j.,' 1 9 2 Q DatdBy- Other Permit: 7t `, It �� Inspection Line: 503.639.4175 Date Ready/By: ENIII ®See Page 2 for Internet: www.tigard- or.gov ITY OF A ,� + D Notified/Method: Supplemental Information s' u ©``I' SION COMIVI IRCJAL FEE" SCHEDULE. USE CHECKLIST . Q New construction ® Additionialteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF _ CONSTRUC770N • Value: $ ® I- and 2- family dwelling ❑ Commercial/industrial :RESIDENTIAL EQUIT"MENI' 1- SYSTEMS FEES* Q Accessory building ❑ Multi - family 1=1 Master builder 0 Otber: For special information use checklist Description Qty. I Ea. 1 Total ' - JOB SITE -INFORMATION AND LOCATION Reating/cooling „� Air conditioning or heat pump Job site address: 11125 SW 82 Ave. (requires site plan showing placement) 14.00 City/State/ZEP: Portland, OR 97223 Furnace 100,000 BTU (ducts/vents) . 1 14.00. 14.00 Furnace 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 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wan, in- duct, suspended. etc. 14.00 Flueivent for any of above 1 6.80 6.80 Subdivision: I Lot no.: Other 10.00 J Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK .. Water heater 10.00 Gas fireplace 10.00 Gas furnace installation. Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 1 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 -D PROPERTY OWNER.. ..I: .::. _ 0- • N:1,:. Chimney/liner/finely Chimney/l' 10.00 Other. 10.00 I Name: Gene Curtis Environmental exhaust and ventilation Address: 11125 SW 82n Ave Range hood /other kitchen equipment 10.00 City/State/ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, . Phone: (503)860 -2866 Fax: ( ) toilet compartments, utility rooms) 6.80 0. APPLICANT • . - . 0 - CONTACT: PERSON : . fans Attic/crawlspace 10.0 0 Other: , Business name: I) & R Heating & Air Conditioning - Fuel piping Contact name: Lisa Delzer Cox $5.40 for first four: $1.00 for each additional Address: P. O. Box 1292 Furnace etc. Gas heatpump City/State /ZiP: Canby, OR 97013 Wall/suspended/unit heater Phone: (503) 678 -2517 I Fax: : (503) 678 -2097 Water heater • Fireplace E-mail: drheataelisa.a)centurytelnet Range - CONTRACTOR •.. . Barbecue Business name: SAME Clothes dryer (gas) Other: 1 1 Address: SAME MECRAPRCAL PERNIIT•FEFSq_ - ' . . City /State/ZIP: Subtotal ' 20.80 Phone: ( ) Fax: ( ) ' Minimum permit fee ($72 . 7 Plan review (25% of permit fee) CCB lie.: 84489 n State surcharge (12% of permit fee) 8.70 , I N , TOTAL PERM]T FEE 81.20 Authorized signature: ( far i � I` !,,,vvy- 111c7� / / / /I,/ ! / /1 Q This permit application expires if a permit is not obtained within 180 days after k has been accepted as complete. CITY OF TIGARD ill B • UILDING DIVISION PERMIT #: MEC2009-00050 13125 SW Hall Blvd., Tigard, OR 97223 °' DATE ISSUED: 2/312009 Phone: (503) 639 -4171 �1�'r91"" �'I�I Inspection Requests (24 Hrs.): (503) 639-4175 ° `:_. INSPECTION WORKSHEET FOR DATE: 21 131 ° +Q9 TIME: 7 :0OAM PAGE: 12 SITE ADDRESS: 11125 SW 132ND AVE CLASS OF WORK: SUBDIVISION: RANCH.VALLEY LOT #: Q11 TYPE OF USE: PROJECT NAME: CURTIS DESCRIPTION: install gas furnace. OWNER: CURTIS, GENE & NANCY PHONE #: CONTRACTOR: 0 & R HEATING & AIR CONDITIONING PHONE #: 503 - 678.2517 Inspection Request Scheduled For Date: 2/13/2009 Pour Time: • Code # Inspection Description Confirm # Contact # Mes%=•- 699 Mechanical final 080521 -01 503 -673 -2517 - Ed. Corrections /Comments /Instructions: • `�! / PAssT n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS V/Ir ■ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4L51_4_0 Pho ne #: (503) 718 2-0 .. _