Permit CITY OF TIGARD
MECHANICAL PERMIT
j DEVELOPMENT SERVICES PERMIT #: MEC2006 -10002
��11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/14/2006
PARCEL: 2S111 CB -05100
SITE ADDRESS: 15165 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: PP1997 -058 LOT: 001 JURISDICTION: TIG
Project Description: Replace furnace.
CLASS OF WORK: OTR 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:
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
GREG BLAIS Description Date Amount
15165 SW 100TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 2/14/200E $72.50
[TAX] 8% State Surcha 21141200E $5.80
Total $78.30
Phone: 503- 639 -9820
Contractor:
OREGON HEATING + NC INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PM 503 -538 -2953
FAX 503 -537 -2172
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: _z , �' Permittee Signature: � e eT
Call 503 - 6394175 by 7:00 a.m. for inspections that business da .
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.
( i eb 13 06 11 :41a`ils, Inc. 503 -537 -2172 p.2
p � 6 ,�
Mechanical Permit Appli c ti`s FOR OFFICE USE ONLY - . ,r
�0 �D I Receved �G f`. Petmn Na C U ✓i,4ae i
. - City of Thar �\Gp. e ived f �
13125 SW Halt Blvd., Tigard, OR 97223 � OF w \ s,. Clan Review tither
?e Permit
Phone: 503.639.4171 Fax: 503.598.14W G D 1 I Date!By:
Inspection Line: 503.639.4175 �� ,�. r Date Ready /By: Avis. El See Page z for
Internet: www.ci.tigard.or.us Notified-Method: ..V r Supplemental Information
F . ':: : ; : :: 7.:,;- . - : = :. _:..,, :- _::, •TXPE 'OF .WORX - ', : : : : . : :, : ::: ;. : : : :, :.i',. :... :. :: :. CO[ISMERCat.. : E *.BC:11L ) : :1.1 L - hick TST..
Mechanical permit fees* are based on the value of the work ,
❑ New construction 1 Addition!alterationirepiacement I performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
i ` ES* -
.. EATEGO,12�r : OF ' CONSTRUCTION, .:; -.'t- ::.- ° :: '_ -
7 ` :; . : :';. :.' "' � , - SIDUNfL4LEQ ;IPMENT /,SYSTEMS'
[2' 1- and 2- family dwelling ❑ Cornmerciallindustna] ❑ Accessory building For special inform ion use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
` > ' .-; JOB: SITE .`TIVFMRR7ATT0?N., A.?tD LOGa.TI0N . - r ,_; : : :_`' .`1 .;`.' :- :'. Hearing/cooIing
(� ' Air conditioning or heat pump „ 1
Job site address: 1 1 6 ( 1 , --- 7� (� 1 0 � (seauires site plan showing placement) 14.00 , i
« 11 (� , ,] Ftirnace 100,000 BTU (ducts,'vents) I4.00 i 't
City/State/ZEE': - f �j,,� I ' -k� -� Furnace 100,000 - BTU (ducts /wens) . I 17.90
Suite/bldg. /apt- no.: ( I Project name: Gas heat pump 14.00
Cross street/directions to job site:
Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or '
hydronic) 1 1 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: 1 Lot no.: _
Other I 10.00 I
Tax map /parcel no.: Other fuel appliances
-.. .. -- :.,.,.. e e
er 1
Watrhat
:
- - _- _,..... .,..., .... fireplace ..._ .. :..- .... :; :.� : :., : :. :.. ... Gas
n 1 p '.1 ^4. 1 L I _ Flue vent for water heater or gas
_ _ l - - fireplace 10.00
ki Log lighter (gas) 10.00
Wood/pellet stove 10.00
10.00
l� " Wood fireplace /insert
V :
_:,__:. , ..... ...._ ...,. _..,,..,, _ __ ITT` y erlflue/vent oth, ,.� - -. Ch• ne
r_: -. .. --.- . , 10.00
Name: C • OA '
- Environmental exhaust and ventilation
/ f��, Range hood /other kitchen
Address: i ' Ati� QJ la. equipment + 10.00
City /State /ZLP: 1 ,/l Clothes dryer exhaust - 10.00
Single -duct exhaust (bathrooms,
Phone - 1 V ( Fax: (a ': ) toilet comica*_anents, utility rooms) 6.80 •,
yls�.� (if,
c e fa n.
wl ac
c I000
i•. tc to sp
°...p ?..'.. ®s ?COl�'TAC �P�50i`i: � : ic's:
Att /
Other 1 10.00
:.,lid' ... :.,.,.. ...... � :' �
Business nametfrd °� - �U C LA Fuel piping
Contact name: l � C r �� �1 $5.40 for first four; $1.00 for each additional
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L �
I 6- 0 )
Furnace, etc. I
Address: _ �' -
�' r Ga s beat pump
Wall/suspended/unit heater l
City /StateiZIP: p fj Q� W ater neater
Phone( �) S ( 4 Fax:: ( y 3� 1 � �2 Fireplace • .
E -mail: v �9� ) /1 Range -
'.; :: r' ' 1 2.1 Barbee
c
P CT012-
. Business I '' Clo lies dy (gas) l
Business name: \ \\ / / '4-- ..}1..): .. 'U , Other:
Address: r)
City /State /ZIP: 1'1 /r � C j l n �,� Subtotal I 1
Y � E/v 41 _ �7 17.7--
Minimumpermit fee ($72.50)
Phone: 6 -) - (C�'/ Fax 3 (�; l Plan review (25% of permit fee)
/
GCB tic.: 2. State surcha.ge (8% of permit fee) �•
TOTAL PERMIT FEE '1,S -�
This permit application expires if a permit is not obtained wrthin 180
Authorized s ature: ) . , / days after it has been accepted as complete.
ICESIN F AIMEL ° J1 u FA Date: '/ i Feeesethodelo� sot byTzi-CounyBuilding Industry Service Board
. . . - ........ autd617r 111/01JC @A'W°_B\
CITY OF TIGARD ,_ , ,' �-
BUILDING DIVISION PERMIT #: �• r . lcg
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: / 1�11f1��
Phone: (503) 639 -4171 u ,dy���i l 1111'
Inspection Requests (24 Hrs.): (503) 639 -4175 1_.. /
INSPECTION WORKSHEET FOR DATE: 3/71/2006 TIME: 7:02Am PAGE: 66
SITE ADDRESS: 15165 3 100TH AVE CLASS OF WORK:
SUBDIVISION: ppi997_€ 68 LOT #: o01 TYPE OF USE:
PROJECT NAME: BoAIs
DESCRIPTION: Replace furnace. I �Jl/0 r
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OWNER: I3LAIS, GREG PHONE #: 503 -- 639 -9820
CONTRACTOR: OREGON HEATING 4. Ale INC PHONE #: 50 , ,53 - ; 9 5
Inspection Request Scheduled For: Date 2121/2001 Pour Time:
Code # Inspection Description Confirm # Contact # ssage e9
699 • Met:tiariical final 02720"1 - 01 5O3 - 53B - 2963 V
Corrections /Comments /Instructions:
•
•
,_ .
, __.
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ci4 PASS 1 1 PARTIAL APPROVAL . - ❑ CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ "ADDITIONAL FEES ASSESSED
Inspector: Date: ?/ ®6 Phone #: 503 718- (2-4 2-4(