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Permit C ITY OF TIGARD RD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00064 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/1/2007 PARCEL: 2 S 114 B B -13 500 SITE ADDRESS: 16448 SW 104TH AVE ZONING: R -12 SUBDIVISION: SWANSONS GLEN NO.2 LOT: 076 JURISDICTION: TIG Project Description: Replace gas 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: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: UNITS: UNS: FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: > 10000 cfm: Owner: FEES CURT & MARY BELLE ST DENIS Description Date Amount 16448 SW 104TH AVE TIGARD, OR 97224 [MECH] Permit Fee 2/1/2007 $72.50 [TAX] 8% State Surcha 2/1/2007 $5.80 Total $78.30 Phone: 503- 624 -1781 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 By: ` S /� 42 Permittee Signature: \ n,, _ 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. f Mechanical Permit Application volt OFFIt(r. us": CINI.I 14 City of Tigard , Dal cd J / © 1' 1`-� Permit r,.°.6 2 ! • 13125 SW Hall Blvd., Tigard, OR 9722 \ Dafe/B /(fib `- t'x �� t� ��Q(1 � / i Plan Review Phone: 503.639.4171 Fax: 503.59$$ , .. , Date/By: Other Pertnit: Tic ;AitD Inspection Line: 503.639.4175 U `to�� Date Ready/By: luris: El See Page 1 for Internet: www.tigard or.gov V�‘ -- Notified/Method: Supplemental Information 0 .TYPE OF WO &' : +a " Iv. COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ttOn keplacement Mechanical permit fees* are based on the value of the work ID New construction [1] AdditioNaltera performed. Indicate the value (rounded so the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit_ CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT l SYSTEMS FEES* ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building El Multi-family For special information use checklist. y ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORM / 5 � ATION AND LOCATION Heating/cooling Job site address; . I / ! ,,_. Aiq conditionin or heat pump i U f G ,o� (re site plan showin placetnenl) 14.00 City /State/ZIP: /6 /tie Furnace 100,000 BTU (ducts /vents) • f 14.00 { Suite /bldg.lapt. no.: { Project name: Furnace 100,000+ BTU (duets/vents) - ! 17.90 1 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) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: : Flue/vent for any of above 14 Other: 10.00 Tax map /parcel no.: A_/ / Z--/075 — 135oa Other fuel appliances DESCRIPTION OF WORK Water heater • 10.00 • • - Gas fireplace 10.00 _ t ._ • /• _ - Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 IA'oodipcllet stove 10.00 • Wood fireplace/insert 10 PROPERTY OWNER ❑ T ENANT Chimney /linerifluelvent 10.00 . Name: - Other: 10.00 tinrY *vMI.[1i' G�/��r Environmental exhaust and ventilation Address: f & g.u_ 6 �, n u, 'n ^ e r S Range hood/other kitchen ¢ equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 • � 1 Single -duct exhaust (bathrooms, Phone: 67 / V Fax: ( ) toilet compartments, utility rooms) _ 6.80 ❑ APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans 10.00 Business name: Other: 10.00 J � q Fuel Contact name :• /7'1 CJ t /� piping $5.40 for first four; $1.00 for each additional Address: Furnace, etc. City /State/ZIP: Gas heat pump ' Wall/suspended/unit heater Phone: c 3 I ) L/ — �� 0 f I Fax:: f 3 S - •_ 0 - a Water heater j E- mail: /d / Fireplace Range • CONTRACTOR Barbecue Bus iness name: ^' J/ I ' Clothes dryer (gas) Address: Other: c.,"" City /State/ZIP: D • MECHANICAL PERMIT FEES* /r • orz. 9 7 a — � / Subtotal ' Phone: (57)3 j_ .. —,)---20 ! 0 I FaY: J /5—„fJ -3 5 9 , - 0 ^0 Minimum permit fee ($72.50) i CCD lie.: rp 1, f Plan review (259 /0 of permit fee) Stasc surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 136 J days after it has been accepted as complete. 1 Print name: / ,47/ l Date: .�j 1 ' Fee methodology set by Tri•County Hai:dine Industry Ser,ioz Bosrd �l f c7,21,4,./10 C I I:\ uildtnglPemits 'J.EC- petmit.4ppdoc 04/96105 440- 4617r(I1/02/LOM/WEB) Z 0LZ0 869 - 009 ONLLV2H VI91Nf1100 n60:60 LO 1•0 qe CITY OF TIGARD BUILDING DIVISION . ; PERMIT #: MEC2007 -00064 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21//2007 Phone: (503) 639 -4171 i �nN�� 1ii 11'(I t• Inspection Requests (24 Hrs.): (503) 639 -4175 '.:. INSPECTION WORKSHEET FOR DATE: . 3/21/2007 TIME: 7:02AM PAGE: 55 SITE ADDRESS: 16448 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN NO.2 LOT #: 076 TYPE OF USE: PROJECT NAME: DENIS DESCRIPTION: Replace gas furnace. OWNER: ST DENIS, CURT & MARY BELLE PHONE #: 503-624-1701 CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 -624 -2704 Inspection Request Scheduled For: Date: 3/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 045011 -01 503-624-2704 Y Corrections /Comments /Instructions: , 1 / 1 V H/P . f/ ...e„„ . .._./ PASS ❑ PARTIAL APPROVAL El CANCEL n NO ACCESS i AIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: IL Date: � I Phone #: (503) 718 - .;-..: , '- CITY OF TIGARD . ••• BUILDING DIVISION PERMIT #: mm 007-00064 13125 SW Hall Blvd., Tigard, OR 97223 '' DATE ISSUED: 2/1/2007 ' Phone: (503) 639 -4171 , m��b , Eli" Inspection Requests (24 Hrs.): (503) 639 -4175 J �_�.. INSPECTION WORKSHEET FOR DATE: 2/2812007 TIME: 7 :02AM PAGE: 7g SITE ADDRESS: 16448 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN NO.2 LOT #: 076 TYPE OF USE: PROJECT NAME: DENIS DESCRIPTION: Replace gas furnace. OWNER: ST DENIS, CURT & MARY BELLE PHONE #: 503°6241781 CONTRACTOR: COLUMBIA HEATING & COOLING INC - PHONE #: 503-624-2704 Inspection Request Scheduled For: Date: 2/213/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 043836-0/ 503- 624 -2704 Y Corrections /Comments /Instructions: 5iff,e -/r' --va r G ts/ - - 4 S /._( -,_') I e'I-4. 3 PA n PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Date: -6 ? Phone #: (503) 718 - 2.46