Permit CITY OF TIGARD
MECHANICAL PERMIT
/1:11i ' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00653
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2007
PARCEL: 25111 BA -00900
SITE ADDRESS: 14280 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 029 JURISDICTION: TIC
PROJECT: KARR
Project Description: Install furnace. Oil to gas.
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:
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: 1
Owner: FEES
KARR, GEORGE R EVELYN E Description Date Amount
14280 SW 100TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 11/7/2007 $72.50
[TAX] 8% State Surcha 11/7/2007 $5.80
Total $78.30
Phone: 503- 634 -2566
Contractor:
PREMIER HEATING & AIR CONDITIONING
PO BOX 86295
PORTLAND, OR 97286 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -233 -6566
FAX 503- 239 -4998
Reg #: LIC 96473
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: r
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.
r ...4 05/,4/2005 11:13 FAX 5035981960 CITY OF TIGARD !0001 /003
s
Mechanical Permit A eft 'I ri 44 - ,, ri;)i' 0.1141( t. t St- ()N1,1 ,
City of Tigard y .. ' Received 11 1 01 r Pem y . , --19
13125 SW Hall Blvd., Tigard, OR 97223 Pisa Review
rk mc: 503.639.4171 Fax: 503.5981960 U 0 7 ' ° t .: --1 carols, Other Pr emit
Inspection Linc 503.639.4175 Y .441. A i y Date Re Ready/Br, toxic RI Set N'ajs 3 Air •
Internet www.ci.tigard.orus . i 1�I ;Vigo Method Sappxaaet,tai
ai � � COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
[] New construction V! I i:!' V_ . : tm/replat:cment Mechanical permit fees" art based on the value of the work
[] Demolition ❑ Other: pe lbtmed- Jodieare the value (sounded to the newest dollar) of all
mechami _ materials, equipment, labor, overhead, and pfoftt
CATEGORY OF CONSTRUCIIOIV Value: S
RESIDENTIAL I tQULPh�SNT I S'YST MS FEES"
❑ 1- and 2-family dwelling ❑ Coenmerciel/industrial 0 Accessory building
Q Multi -Eim r ❑ MaSter builder 0 Otter: Fo. sFodat iTk naaaa„ we eh�khss
Dam:intima ] Qty. 1 Ea. I Total
SOB SITE INFORMATION AND LOCATION Bsstingfeeeling
Job Cite lu d en: �,,� Air conditioning or heat pump
(=Ores
I �l l • T 1 V� . Ate vontbowieavi+eemtn0 14.00
City/state/2�: ''" II ,1_, � , 97224 100,000 BTU (dam) 1 14.00 Y �- ,
Suite bldgJapt. no.: I Project name: Furnace 100.000* BTU ( ) 17.90
Oas beat pump 14.00
Cross stare /discctione to job site: Duct wont 14.00
Plydronie het water system 14.00 t
Residential boiler (sadistor or
hytnmc) 1900
- Unit hams (fuel -type, not electric),
in-wall, in -duct, sowed, etc- - 10.00
Subdivision: Lot no.: Plnehhent for Ely of above 10.00
Othc. l 10.00
Tax map/parcel tto.: Other brat a • • names
_ DESCRIPTION OF WORK Water beater 10.00
Oas fireplace 10.00
o P�( Fine wart fba water heater m gas
&Waco 10.00
1.0a liahtcrigas) 10.00
World/pellet 10.00 -
_ , Wood ilreplsoclnse t 10.00
• gPROPERTY OWt ER I 0 TENANT , Chintneyilintehreivart 10.04 , - -
. Crater: _ 10.00
Name: ire - ` a / A 0 , Environmental endue* and vmtit*1loa
Address: _..f, ii 11 • a Range kitchen
t 10 -00
City /State Mara Ti_ i /2 P: �i , Clothes dryermraaust , 10.00
0141 Singla-dar erbium Qbetbrocank,
Pbane ( _, aAs INIFERAI Fax: ( ) , toilet commenter*, 0 tvoma] 8.30
[D {APPLICANT D CONTACT PP.AOON Atticlarawlspece fans 10.00
Business name: Men 10.00
�. — End piles
Contact name: WAD for tae Coact 51.00 for eeh additional 14 C Ad dress: Ftmtt e, .
Gas heat pump
City/State/ZIP: W edluait heater
Phone: ( I gays:: ( ) Water heater _,
E-mail: Fix' epl cs
Range ,
C e i - C•rt7R Bubo=
Business name: p . ...,/ ! a or, QO M dexe' (tom
Oda
s: ,r1 �r • �i. 4 Z� . MECHANICAL. PE FEES -
City eA i1.►..�,� ► ffiriiliajl', &tbtorai 1 Q40
Phone: ^` 140 - / 1 4 i - " /' I . p (zs% o£ rtes)
.4 Maine= permit CCs lie.: "MG State sutc urge (g% ofpetmit lea) iP
TOTAL mazer FEE - r , /
Authorized signature: - 'Ms patrL1t spittle/dos expires if a permit is ant ads , . . 1 i
ff days after h Ass been sculpted Na maptete.
Print name: VI' /'YY \ 5R : irAi
I j -�� b� gas �xb, rrceuexY Building ta ,. s«eiutBo.ra
2'd 096ti86S2OS :01 866176E2 0S d :W0eld LS :ti0 L0e2 -L -PION
CITY OF TIGARD
BUILDING DIVISION PERMIT #: mEc2007-00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2007
A,
Phone: (503) 639-4171 iholi
Inspection Requests (24 Hrs.): (503) 639-4175 U.
INSPECTION WORKSHEET FOR DATE: 11/8/2007 TIME: 7:00AM PAGE: 22
SITE ADDRESS: ' 14280 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 029 TYPE OF USE:
PROJECT NAME: KARR
DESCRIPTION: install furnace. Oil to gas.
OWNER: KARR, GEORGE R EVELYN E, PHONE #: 503-6342466
CONTRACTOR: PREMIER HEATING & AIR CONDITIONING PHONE #: 503-233-6566
Inspection Request Scheduled For: Date: 11/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 069287-01 503-233-6566 N
Corrections/Comments/Instructions:
6 7 7 4.. ,,,e, , . -- z... s i ---,.7-ce-,4i 0 a )--
,17-Aidie.
;AIIP 7
i c , f (.--- ----- .-= / - ,- . .,,,- --
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1 tri‘s 0 PARTIAL APPROVAL rj CANCEL n NO ACCESS
0 FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector:
, Date: i-1 8 — a ? Phone #: (503) 718-
_ .--....„....