Permit 3 'ir n��;a CITY OF TIGAR
ill ;, �`�r MECHANICAL PERMIT
`` ` COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00725
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/13/2007
PARCEL: 2 S 102 D B -04400
SITE ADDRESS: 13205 SW CHELSEA LP ZONING: R -12
SUBDIVISION: CHELSEA HILL LOT: 021 JURISDICTION: TIG
PROJECT: SENESTRARO
Project Description: Gas furnace replacement.
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
SENESTRARO, DEBRA C Description Date Amount
13205 SW CHELSEA LP
TIGARD, OR 97223 [MECH] Permit Fee 12/13/20C $72.50
[TAX] 8% State Surcha 12/13/20C $5.80
Phone: 503- 624 -6532 Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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: a i / ,' / % ,,4" Permittee Signature: 44/ x ' CA1 11
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.
y �E �, 2 07 02 :42p RECEIVED p2
Mechanical Permit App • tin .FOR•OFFICE� ; ONLY
City of Tigard U 1 ' 2007 Received T�(� /, 1
Date/B}- 3 / p / a fern:' /•� XJ-i- 00 ---7.- 1 3125 SW Hall Blvd., TigarJ, OR 97223 CITY or r,GNau Review
/ r >
Phone: 503.639.4171 Fax: 503.598.196 ' Da t e
p,�� Other Permit
Inspection Linn. 503.639.417= BUILDING DIVIS t',. �, � Date Read /B .17'
Internet: wvnv- ci.tigarel.or.us / �, / ^' Y Y H See Page 2 for
// J i Notified /Method: Supplemental Information
. • TYPE OF "WORK A'X, COMMERCIAL FEE* SCHEDULE — .'USE - CHECKLIST
❑ New construction Addition/alteration/ :c a , ' Z \ , ' Mechanical permit fees* are based on the value atilt work
/ 0 / performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor
,overhead, and profit.
CATEGORY •OF ..CONSTRUCTION Value: $
1 -and 2 -famil dweliin ". RESIDENTIAL EQUIPMENTJ:SYSTEMS "FIFES*
IT
y g ❑ Co mmercial /industrial ❑ A building
Multi -Tamil For special,nformo tan use cliecl lisr.
y ❑ Master builder ❑ Other: Description P I Qty. Fa. Total
JOB SITE INFORMATION AND - - . LOCATION
Heating cooling
Job site address: 5�` v
f ! l
� t /tFZ �, A � Air conditioning or heat pump
� Ji��- fFtC(e�r l (requires sueplan shewingplacement) 14.00
City/State /ZIP: CC_ 77 z Z L . Furnace 100.000 BTU ((filaments) r 14.00
Suiteibld�.' t. no.: Furnace 100,000+ BTU (ductsivents) 17.90
o ap Project name: Cress beat trr=
P 14.00
Cross street/directions to job site: Duct work 14.0C
Hydronic hot water system 1 4 . 00
Residential boiler (radiator or
hydmnic) 14.00
Unit heaters (fuel-type, not electric),
in -wall, m -duct. suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 1 10.00
Tax mapiparcel no.: Other fuel appliances
• • • DESCRIRTION=OF 'WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
) r k_-- a fireplace 10.00
Log lighter (gas) 10.00
�^` Wood/pellet stove 10.00
Wood fireplace insert 10.00
P ROPERTY :OWNER . Chimney /finer /flue /vent 10.00
.
( ❑ TENAN"I
Name: ,�/ ,/>> n �d ,l_,� i ^ 1 � " Other. 10.00
�>,,�:.� d'�r � �U Environmental exhaust and ventilation
Address: � Range hood'other kitchen
City/State /ZIP: 4 7 7 .0 equipment 10.00
Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) u� Li_ r„(,5 L. Fax: ( ) toilet compartmems, utility rooms) 6.80
. APPLICANT i.:: • ❑ CONTACT `PERSON : ••Atticicrawlsaace fans 1 10.00 -
Business name: Other 10.00
Fuel piping
Contact name: $S.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail:
Fireplace
Range
CONTRACTOR : ' Barbecue
Business name: 14 // Y r Clothes dryer(gas) I
Other. I
Address: p/ f�!` Z � . MECHANICAL PERMIT FEES *"
City/State'ZIP: (! ,- if � L/ °/ 705 Subtotal
Phone: (55) 2 (,,, ( G —( 24ic) F at: (5t) Z., 7 pe rmit — 3L7 Minimum fee (S72.50) 72...00
Plan review (25% of permit fee) n
CCB lie.: / bV State surcharge (8% of permit fee) —
TOTAL PERMIT FEE
� N
Authorized signature: j This permit application expires if a permit is not obtaine M
e 4 _ days after it has been accepted as complete.
Print name: ! jC4,_ / ' yo ,t✓ Date: ` Fee methodology set b.• Tri- Counry Building Industry Service Beard
i 'Bmldwq' PermitApp dot 12)03 445 -061rr (1 tioz /COnvwes)
CITY OF TIGARD �� .
BUILDING DIVISION
1 L ! 1 PERMIT #: MEC2007 007 5
13125 SW Hall Blvd., Tigard, OR 97223 �� � - DATE ISSUED: 12/13/2011/
Phone: (503) 639 -4171 pi � h4Puy�pp l
Inspection Requests (24 Hrs.): (503) 639 -4175 6^r ILI / v0o _7 _ 06 aS
INSPECTION WORKSHEET FOR DATE: 1/412008 TIME: 7:01AM PAGE: 43
SITE ADDRESS: 1320' SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: SFIdESTRAF2O
DESCRIPTION: Gas furnace replacement.
OWNER: SE3NI: STRARO, DEBRA C, PHONE #: 503 -G24 -6532
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266 -1248
Inspection Request Scheduled For: Date: 1/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
589 Mechanical final 06256B -01 UAL
so-266-1249 Y 9-0
Corrections /Comments /Instructions:
•
7
\1 ( \Art
1\4- Va . f r�
V
I PASS ❑ PARTIAL APPROVAL n CANCEL XN0 ACCESS
X FAIL CALL FOR I SPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 4 _ Phone #: (503) 718-