Permit Air
CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00748
II I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/8/2005
PARCEL: 1 S136CB -04800
SITE ADDRESS: 10830 SW 83RD AVE ZONING: R -4.5
SUBDIVISION: STEVE + HUGHIE'S PLACE LOT: 020 JURISDICTION: TIG
Project Description: Furnace replacement.
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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ROB WEST Description Date Amount
10830 SW 83RD AVE [MECH] Permit Fee 11/8/200f. $72.50
TIGARD, OR 97223 [TAX] 8% State SurcharE 11/8/200f. $5.80
Phone: 503 639 - 6936 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 - 538 - 2953
Reg #: LIC 125815
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: , Permittee Signature: B74
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Nov 08 53a 503- 537 -2172 p. 1
Mechanical Permit Application D FOR OFFICE USE ONLY
City (''� Pe rmit No.: •
City of T i g ard > .0 ' A Received I I/Q 6 4 IY1G62.acg 7 47
13125 SW Hall Blvd., Tigard, OR 972 Plan Review '
Phone: 503.639.4171 Fax: 503.598.1 60 Q z; , Date/By: Other Permit
Inspection Line: 503.639.4175 (k 2 U :•1 ( � Date Read /B J 0 See Page 2 for
t Ready /By:
Internet: www.ci.tigard_onus Notified/Method: ( / Supplemental Information
.. :::,.. .. -- - I
: _ :: -< .r: "f A � : '�195�., _�:CON�'IERC�..ATi��F�E 3C HEDU LE USE-C$E,C3Q�TS'1''�
❑ New construction [ X Ad di h �n/ 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.
4
. -_:.. ,.,. . ,. - _ . , TEGORI"_OE :C. _ • ,,'.; ; S) �N�'•EIAL :ZQ[JI I ? ME NT : /S]zSTEMS. F E ES" � ,, °:; : ',
[ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Fa. I Total
. „, , OB S I TE; 1NhURifi1' l' IOiV'�i1ND ;,`' :OC:A'CIOPT: ° - HeatinpJcoolinR
Job site address: 1 3 0 &v g 3 rd Aiq conditioning or heat pump
(y (requires site plan showing placement) 14.00
City/State/ZIP: T50, 0, r d Furnace 100,000 BTU (ducts/vents) 14.00 _�s { •U 1
Furnace 100,000+ BTU (ducrshents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump I 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
Subdivision Lot no.: Flue/vent for any of above 10.00
• Other. I 10.00 ,
Tax map /parcel no.: Other fuel appliances
r: t
. -r >: g arr.: r r ti ` ...,, � Water heater 10.00
I
.. .. . ,t J.<,: ii, ",. u (
_ x.ib S'CRIPIIOi i W�ILTf l:r:: c ; 1' -;: :l,::
_u,
Gas fireplace 10.00
F Q p (KQ, 93f) J U t r nG C( Flue vent for waterheater or gas fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert , 10.00
{ - '+i;'� * '•' .,._ aryw+:i;!i - � �iF.7f ^'j::• - :;: iir'3:eti5� Chimney/Liner /flurJvent 10.00
V sr' PR�PEl7T b «7�TEIt , :,. li . ` • .. " _ St t !? ..i ..... - Other. I 10.00
Name: 0 L3.Q Environmental exhaust and ventilation
Address: 9 3Q SO'--) S rlc Range hood /other kitchen
j (
_ equipment 10.00
City /State /ZIP: I � � Cf 1 �t�o2.3 Clothes dryer exhaust
Single -duct exhaust (bathrooms, 10.00
Phone: ( 4 3i -(c 3(0 fax: ( ) toilet compartments, utility rooms) 6.80
t .:i::,.:...�,.! ; ,,,t ; .' -•. - i cjT :7 - -- - - Attic /crawl ace fans
� � � .•s v � ' r t 5 :.' :. t �`� >;`C,OI�A'�f.CT ` �EILSO1�T t ' ., .. r 10.00 �
Business nam0/ie � 10.00
�t/ r w� Fuel piping
Contact name: lJ (1 r)-g3-e-) $5.40 for first four; $1.00 for each additional
Furnace. etc.
Address: Pt) .
"` q• Jr) Gas heat
JJJ �} � pump
City/State /ZIP: ��!A V_ , n t S Walllsuspended/tmit heater
Phone( 3) • 5r�g aY ` Fax:�� `l 3-7 Zl --2 Water heater
JJ v Fireplace
E -mail: Range
... ; : . , _.: ....._ , ...,:. ..._:. • Barbecue
/� n J��/ LAW dryer (gas)
Business name:
Y .� .� / t- 0i �`i' • W , other.
Address: ..
• z/ � 'I
� i :� - :;'�;,, �: <MECI41vTGAI:iP�131y11T F'EE$'i
City/State/ZIP: / 1 I U tl V 1 I f, S f ;
6�� (J 4 1 Minimum permit fee ($72.50) I CI a rj C!
Phone: < � 9 /� ' ► t'l r F a , r�� I f�ti Z Plan review (25% of permit fee)
CCB lie.: .1. 6 " permit surcharge (8% of peit fee) 5.8O
TOTAL PERMIT FEE rk 3C)
K n� n This permit application expires if a permit is not obtained wi him 180
Authorized sinature: 111 (l l� ` L., days after It has been accepted as complete.
Print name: v'h,r,�"'i.�, d /�`� 071 '{, , D ate: • Fee methodology set by Tri -County Building industry Service Board
�(b r
ifaa sildmeTermitstiitEC- Pemitapp.doc 12)03 440.4617) (t 11D2JCOM'WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005x00748
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2005
Phone: (503) .639 -4171 i 1
Inspection Requests (24 Hrs.): (503) 639 -4175 �' d ;; F_
INSPECTION WORKSHEET FOR DATE: 12/19/2005 TIME: 7:01AM PAGE: 45
. SITE ADDRESS: 10830 SW 83RD AVE CLASS OF WORK:
SUBDIVISION: STEVE + HUGHES PLACE LOT #: 020 TYPE OF USE:
PROJECT NAME: WEST
DESCRIPTION: Furnace replacement.
OWNER: WEST, ROB PHONE #: 503-639 -6936. •
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503.538 -2953
Inspection Request Scheduled For: Date: 12119112005 Pour Time:
Code # Inspection Description Confirm # Contact # essage
699 , Mechanical final 023647 -.01 503- 538 -2953 Y
Corrections /Comments/ Instructions:
•
•
•
j. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (� Date: �l Phone #: (503) 718- ,2-4