Permit CIT OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00140
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/18/2008
PARCEL: 25111 DD -07200
SITE ADDRESS: 15795 SW 88TH AVE ZONING: R -4.5
SUBDIVISION: STRATFORD LOT: 070 JURISDICTION: TIG
PROJECT: SASAKI
Project Description: Replacing gas furnace.
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: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
VALERIE SASAKI Description Date Amount
15795 SW 88TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 3/18/200€ $72.50
[TAX] 12% State Surch 3/18/200€ $8.70
Phone: 503- 866 -5708
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 B g �Q� �^
y• Permittee Signature:
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.
t
Mechanical Permit .A nplication v�O FOR Of FR E 1 •I :ONL1
V Pannit No
City of Tigard GO D 3 /b C)� �7 T / cu P`l0
13125 SW Hall Blvd., Tigard, O Q Plan Review Other Permit
n-
Phone: 503.639.4171 Fax: 50 98.1960 1 D 10 DtuelBy:
Inspection Line: 503,639.4175
1; t \ P� O Date Ready/B runs' 131 See Page 2 for
T1!i U Internet: www Tigard- or.gov Of 1 ` OP S O N Notified/Method: Supplemental Information
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TYPE OF COMMERCIAL FEE* SCHEDULE - USECHPCKLIST
A Mechanical permit fees` are based on the value of the work
❑ Now construction Additionlal performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other , mechanical materials. equipment, labor, overhead, and profit
Value: $
CATEGORY OF CONSTRUCTION • •
RESIDENTIAL EQUIPMENT ! SYSTEMS FEES*
y f l- and 2- family dwelling ❑ Commercial/industrial El Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other Description , Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling
Air conditioning or heat pump
Job site address: ,:j id r (requires site plan *Wing placement) 14.00
City /State/ZIP: 1 /"''�' Il I 9 ' 7 )'- Fu 100,000 BTU (ducts/vents) l 14.00 /N• t!() _
Furnace 100,000+ BTU (duetsivents) 17.90
Suite/bldg. /apt. no.: Project name: .SG 3c i (; Gas heat pump 14.00
Cross street/directions to job site: Duct work 14
14ydronic hot water system 14.00
• Residential boiler (radiator or
- hydronic) 14.00
L; nit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. , 10.00
Flue/vent for any of above 10.00
Subdivision: Lot DO" Other 10.00
Tax map /parcel no.: Other fuel appliances _
DESCRIPTION OF -WORK . Water heater 10.00
Gas fireplace . 10.00 '
4e/74 ' e d5 / °" � ,, e ., Flue vent for water heater or gas
/ 7 fireplace 10.00
Log lighter (gas) 10.00 .
Wood/pellet stove
10.00
Wood fireplace/insert 10.00
Chimney/Iinerlflue/vent 10.00
. tGPROPERTY OWNER i ' ❑ TENANT Other 10.00
j f}� 4,
Name: fZ_ / ( /e14\-C-- Environmental exhaust and ventilation
! Range hood/other kitchen
Address: equipment 10.00
Clothes dryer exhaust 10.00
City /State2IP: Single -duct exhaust (bathrooms,
PhoneSp j) " 4 57 e V Fax: ( ) toilet compartments, utility rooms) , 6.80
❑ APPLICANT ❑ CONTACT PERSON AttieJerawts ace fans 10.00
Other: 10,00
Business name: — Fuel piping
Contact nantej R 1 a $5.40 for first four; $1.00 for each additional
!. _ !w ° Furnace, etc. l
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
v Water heater ,
Phone:?] )6 D Fax: : ) ty Fireplace
E -mail: Range
. CONTRACTOR Barbecue
(2 a b/ a. N a i (
l � fir clothes dryer () —
Business name: t IA C Other.
Address: q W 0 X .2-3 0 3 9 (� -
MECHANICAL PERMIT FEES'" •
n Subtotal
City /Statc/ZlP: G rJ tL v /2_, - .2. Minimum permit fee (572,50) • 7�,` 1)
Phone: (.S11) t!' 2- L I - •'" - % I Fax: 5b3 ) S — & - 7b Plan review (25% of permit fee)
7 § 3 S ! p a
CCB lie,: / S tate surcharge (12% of permit fee) V x-,70
1 TOTAL PERMIT FEE » l
Authorized signature:
t7 G AG �/^�1, ' / This permit application expires if a permit is not obtained within ISO
/ " ' f`/ days after it has been accepted as complete.
4Y/
Print name: P-( / i Date: 5 "t I • Fee methodology set by Tri -County Building industry Service Board
__ _ .. . .....,r, 1 440- 461.7 (I1ro2/COMnves)
Z OLZO ONI±V3H viEmnioo BZ•7 :60 90 9t JBW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ME 0200 3 00140
13125 SW Hall Blvd., Tigard OR 97223 DATE ISSUED: :3 /ie/Not>
Phone: (503) 639 -4171 w , ' , -
Inspection Requests (24 Hrs.): (503) 639 -4175 __ �
INSPECTION WORKSHEET FOR DATE: 4/28/2008 TIME: 7 :07AM PAGE: 19
SITE ADDRESS: 1&795 `;W 881Th1 AVE: CLASS OF WORK:
SUBDIVISION: STRATI f F ?I:) LOT #: 070 TYPE OF USE:
PROJECT NAME: SASAKI
DESCRIPTION: Replacing gas furnace.
OWNER: SASAKI, VAI..ERI €:•. PHONE #: 503 -8666 /08
CONTRACTOR: COLUMBIA HEALING & COOLING INC PHONE #: €ii3:'624 -2704
Inspection Request Scheduled For: Date: 4/28/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanic al final 068811 -01 ,i0` - 624-2704 Y
Corrections /Comments /Instructions:
If& E / GAL- LA.L"„iv /L 444 t " S — /5 4-3F , Aecg Gz i?G�f
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 7/ Date:4 - S Phone #: (503) 718 - 4