Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00575
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/21/2008
PARCEL: 25111 DD -13800
SITE ADDRESS: 15682 SW 87TH AVE ZONING: R -7
SUBDIVISION: MILLMONT PARK LOT: 015 JURISDICTION: TIG
PROJECT: TROXEL
Project Description: Gas furnace installation.
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:
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
HEATHER TROXEL Description Date Amount
15682 SW 87TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 11/21/20C $72.50
[TAX] 12% State Surch 11/21/20C $8.70
Phone: 503 -598 -0543
Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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:
+e:,,,tot‘l°
Permittee Signature: iG �Coj'�G/
Call �5 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.
Mechanical Permit Application �*.C FOR OFFICE I SE °NI.1
City of Tigard 13125 SW Hal Blvd ,Tigard, OR G� 1 , R° PermitNc:
D
inspection P l an y Revew I i ig li 8' 75
pp Phone: 503.639.41177 1 Fax: 503.59.1 c 460 t, * r .f Other Permit: •
( � � . y
TIGAR) i
: i Line: 503.639.4175 �. ' 1`V� , Re
, - ,a Juno: Ed See Page far
Internet: www.tigarc- or.gov �, ` .tilled/Method: /' Supplemental Information •
TYPE OF WORK `` L« ` COMMERCIAL :FEE" SCHEDULE — LSE CHECKLIST •
C New constriction � t'fldditio /a)teratio ` replacement Mechanical permit arc �v
ptt foes• arc based on the value of the or'.;
performed. Indicate the value (rounded to the nearest do' Ear) of all
❑ Dtt molition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value. S
• r "`'''' RESWENTLIL EQUIPMENT / SYSTEMS FEES*
- and 2-family dwelling g ❑ Commercial/industrial ❑ Accessory building For special information tar crccklist.
0 Multi-family ❑ Master builder ❑ Other: Description I Qty. Ea- } Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: j r Air conditioning or heat pum
���dr .. 4,3 ` (requires site War. showing placement) I • 14.00 •
City /State /ZIP: Furnace 100,000 BTU (du�'vents) I 14.00 1 t Jv
uiteibldg /apt. no.: P n ame: ,,1 Furnace 100,000+ BTU (duets/vents) I'.90
S
Tr Ux�i' Gas heat pump 1 4.'.10
Cross street/directions to job site: Ductwork 14.00
Hydronic hot water system I4, 60 _
_ ?i r.— „_.agr ± -!. ;_fir Residential boiler (radiator or .
hydnmic) t 4 -00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. : 10.00
Subdivision: . Lot no.: Flue/vent for any of above j 10.00 , + __,
_- Other: I 10 -00
Tax mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
' Gas fireplace 1 0.00
- t) Ia � _Q 9�._ e - ei�+ a_ , Flue vent for water heater or gas
fl y fireplace 10.00
Log lighter (gas) 10.00
Wood/pelletstove 10.00
Wood fireplace/insert 10.00.
l,d"PROPERTY OWNER I 0 TENANT Chimney /liner /flue/vent 10.00 Other. - 10.00
Name: 966 J ` / :�; t'k,.. / Environmental exhaust and ventilation ^_ •
Address: !! Range hood /other kitchen I
equipment 10.00 ; _
City /State/L1P: Clothes dryer exhaust 10.00
�
3 "� Single -duct exhaust (bathrooms,
Phone:) J " W. — 3 Fax: ( toilet compartments, utility rooms) 1 6.80
❑ APPLICA.NT ❑ CONTACT PERSON Atticfcrawlspace fans 10.00
Business name: Other 10.00 a
/ Fuel piping
Contact name,7 R j L y SS.4o for first four; SLIM for each additional
Address: ! ! Furnace, etc. 1
1 1 Gas heat pump
City /State/ZIP: Wall/suspended/unit heater 1.
Phone: c"D3 )i3- - ,"7 Fax: :93 )S S'- d D. -2 v Water heater
Fireplace I
E -mail: Range 1
CONTRACTOR Barbecue • •
1 wn /44-/-4)-*/ 1- O , / � Clothes d (gas) -
Business Marne n b' 9 x
Other: 1
Address: J Q 3 p X .23 6, 3 9/ MECHANICAL PERMIT FEES
•
City /State/2IP: 61 4 ,,� ( 2 - . / Subtotal 1
Phone: (, 1() ( Fax: 1 Minimum permit fee (572.50] 7,2.5v �� ' J O ' y �4 Plan review (25% of permit fee)
CCB tic,: 7 b 3 S 9 ' State surcharge (12 %ofpermit fee) ; V 70
TOTAL PERMIT FEE SSl Ka
! This perm application minims U permit is not obtained witai" INet
Authorized signature:
044, o J ( days after it bas been accepted as complete.
4 Print name: ,.C (1 L - 6� (Date: , ' Fee methodology set by Tri- County Building Industy Service Beard
Z'd OLZO 969 DNILV]H vis nioo 40: l.0 20 I•Z AoN
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I Ec-)00 40i,7 ;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2I/2008
Phone: (503) 639 - 4171 "'� ��y�u�IIP! i '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 124'212000 TIME: 7 :00AM PAGE: 18
SITE ADDRESS: 16682 SW 137TH AVE CLASS OF WORK:
SUBDIVISION: MII.I MON T PARK LOT #: 01 ?.a TYPE OF USE:
PROJECT NAME: fROXEL
DESCRIPTION: Gas furnace installation.
OWNER: 1 °ROXEL, I lf_AiFil^Ie PHONE #: 503,598,0M3
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503.€24_:2/()4
Inspection Request Scheduled For: Date: 12/712004 Pour Time:
Code # Inspection Description Confirm # Contact # Message
698 Mechanical final 070678 -01 603 -698 -0543 N
Corrections/Comments/Instructions:
`20 E L.Ec 1 c_44..._ b.c.fr-ou.Uiz-- 44 ow S M6439- c G: iG�-1,r—
ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
H FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: / —Z G P Phone #: (503) 718- �4-4.1
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