Permit C ITY OF TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC2005 -00270
A
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/25/2005
PARCEL: 2S 114AB -03700
SITE ADDRESS: 16530 SW 93RD AVE ZONING: R -4.5
SUBDIVISION: KNEELAND ESTATES LOT: 024 JURISDICTION: TIG
Project Description: Furnace 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: 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
PAINTER, JAMES & SHARON Description Date Amount
16530 SW 93RD. AVE [MECH] Permit Fee 5/25/200. $72.50
TIGARD, OR 97224 [TAX] 8% State SurcharE 5/25/200E $5.80
Phone: 503 869 - 1039 Total $78.30
Contractor:
ADVANCED HEATING & AIR COND
5825 SE FOSTER REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97206
Phone: 503 774 - 0161
Reg #: LIC 98573
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
-
Issued By: 40, /1 �/! Permittee Signature: dims' -4_,f0_ s „
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanica Permit Apl` li IM VV 11�® FOR OFFICE USE ONLY
City f Tigard 7t '"`"c d , d
131 SW Hall Blvd„ Tigard, OR 57223 MAY 2 A 2005 Review a �
r` Ocher P rnuc
P1wnc: 503.639.4171 Fax: 503.591!.1960 f { ; D
Laapoodon Llac: 503.09.4175 ( ,' . I Date RCaayruY: 5 ' Sec !Case a Ter
internee www,ct.'ilgOfd.Dr.u3 CITY OF TIGAF;t.. ` Nuensea Memo, m Suppkmwoui bof•rmaioua
gs_t'1 n� �.nIVISION P
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i:l�c. C 11:$.I:dd , �liti <.. I�, 4 $ ,;. - ' . -
New construction ❑ fldditiaa />>1Leration/top1accrosnt
Mechanical ° ere based on the value of the work
performed, Indicate the value (rounded to Cho nearest done) of all
❑ Dotnolitioo 0 Otltier: rnoehattieet rnaterialu, •• „'- t. tabor, a "erheod, and rnfir
= ., 1. itI,.C': \:In7i.: �,. ,�{�, '�I�• ��j,� I,,:11 a i ';.I,�1l1,r VO1UO:5
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s i.; .;:: ; { +I :! 1 t ±`; •� '! 1fn4.'i1� : :id ":.. ,),, ;,r; .. l. • ,. _ , I : ::.,. .
- 1. , ::.1 1 , ,I: • „,, '0 t �
g 1- and 2 family dwelling ❑ Comrnc v i/indueerial 0 Accessory building lr2 °' � . 1IAL, t t r t ??`1 i w :v . �E
For special inform:140o kW eneCklitr•
I] Muld- family ❑ Master builder ❑ Other: Description ri5ty. I Ea. I Tncil
;I,v....:.• - ,..,. ,. 4 tl)t�dAT LQCS170k. c. }1 : { ,, .,r6 1 u'I :II iit;'p.;,a.i; ".:! hlcatim,/coal7nk - ---...
Job site address: 14,.6-3,0 5 IA) Air conditioning or hest pump
R,� �{ •(�.Q (requites Cie plan fhowily placement) _ 14.00
CityIState/z1'Pt t + f a Op— 91 a Li Fu , ate 100.000 STtI jductslvcnto ' 1 4.00
Suite/bldg./iv, too : I Project came Furnace 100.000+ ETU (dveleiventt) 17,90
Gal heat pump , 14.00 ,
Moss street/di/notions to job site Duct work -- . 14.00 _-
Hydtnnic hot water System 14,00
Residential bo (radiator or
hrdronie) - 14.00
link heaters (fuel -hype, not electric),
. ie.wall, ie -duct, suspended, etc. _ 10.00
Subdivision Lot op Flue/volt for arty of about 10.00
other 1 10 .00
Tax map /pared no.; Other fuel appliances -
y, i lu!� , ; -4 ,, .,'64 1 I f . Wait( �1 10.00
7
:,i $1 `. . ,': : ... ■ 1 . : +1 .•.;:I [ "9 ;:..:� (: -i ! a r $ ; t _ . E N it di l t �,t. r� . g u '. hit °i1:4 `.
• •.'r •' 10,00
ent ' 1 r - , . "T., � 11 '" ty i .��„ ' U�.: !!•;: I ° a . a .i. . ^.i� ate !
Gas fireplace
'�(,Gr 1. Flue vent for w>ttcl' heater or gas
fireplace 10.00
- Log lig (gas) 10,04 =
Wood/pellet stove 10,00
Wood fi lace/insert 10.00
_ 7 , t;_ r t 1 I ,. F 1 . 11 Chigrurny IincrKludvent
10.00
S =' r -:.. i ; � I i' - `'� • 7 4' 1: ' , '.e ; .ii i.:. i,, a L , ., r - , !i , ' • ) . , • r, , l a � :, . .. o mv tli p 10,00
NAmo: !C . � , • • t En
vi ronmcntal exhaust and rend don .
\1 • i i
Range hood/other kitchen
Address: ' 0 ref I .J.� equipment 10.00
C11y/Statd [ 1 Z11 t f n4rj:� a //# g.. q a 2 f,.� 0,0.11,4 ,shier exhwlt - 1 0.00
I f!t /19 r� 1 5Mgle-duct exhaust (bathrooms,
Phone: Ls f 9 / - � fax •// , 4— f Q toiletc nt1, utili ty morns ) 6,80
U' 1 '� rIlli .i i,l { I I 1 , 1 ' . o ::Iii' V. +l i 11. + ',i� ' d. ? co4'PFEICTi ; P3iR � r '''1':1:x'; :i_ Ataelrraurtcnnre fhns - 10.00
: O ther: 10.00
Busiue S name: 1 -
- # .ii . / ir ter' i Fuel .1.1n:
Contact name; 4 • 65.40 for Grr?s four; $1.00 for Wuh additional
I. A
A
(
ddress: 0 . r Furnace, etc.
• d t" . . i Gas heat +ur119
City/Statc/ZLP: I. I/i �rL.� I� w / - / to Wall/su • dedlumtheater
Phone; Water healer
/- • -- 41 s // Fireplace
E -mail; Range
-I l :'.'I 1 _'L : •. .Jr ryTi .aI� � ” „ '' ' ..t'''' � - •
•' ' i . ; ,: * e ++ I rt}} • T. 1 1 ,Iii.. •• • , ; , ,. i 7 Barbecue
, '-y. �;.:. ; < ,'`1;:�':i _'i: ' : '.:..- ili,� ^ iil:7 .il i.l�'!I . P�:�RY8 1::: •l . ,1, .. • ' � I r �� i�� � 1a;� � •� � L �•�1..i'� , f F? •
Buslncss came: J� � f Clothes dryer (f1�) i .
Other:
( �. �` j/ I• : � 1 � a:' ati •E,;I',I$ �,,. h :
C sty /SterfZIP: e (
Lam/ 97; f(
u6teed f 4
r� Minimum permit foe 1572.50) f,2.� _
Phone: (� ) / Fax: (q, ) — 3 ./
• — Nun review (25% of permit fee)
CCB lk.: Stara dlfrchurSc (KYR of pcir to JCC) .„„4: r4$
TOTAL PE MIT FEE 7 .
Atltlw Ad St ttltirc' ��� .. i _,....116...." V Thir pc -emit applies Gua UKpirei if a permit i• got PtpI . O within 11f
- dap alter It ha. o.au >eeapted as complete.
Print name: 5 h �G� Uate�,. / ,-d - Fec met nodalogy iv by Tri- County Build l neasay Setvict Board
TB Jtid £NI1b3H QDoNdAQ17 T6£1712LL£OS GE. :LT SOBZ /£Z /Se
CITY OF TIGARD
BUILDING DIVISION PERMIT #:#1 re.. 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 lmypuph
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /6 c' ' 12 ' J 13k9( 4' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Ifq rak,t)
Corrections /Comments /Instructions:
K PASS ❑ PARTIAL APPROVAL Li CANCEL El NO ACCESS
El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � Date: t/ 718 -
p Date. / Phone #: (503)