Permit `.,' 0 '
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005-00796
I'll 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/5/2005
PARCEL: 1S134DA-05700
SITE ADDRESS: 11315 SW 105TH PL ZONING: R -4.5
SUBDIVISION: NODAK LOT: 005 JURISDICTION: TIG
Project Description: Replace gas furnace, add AC.
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: 1 DOMES. INCIN:
NAT 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
JOLLY Description Date Amount
11315 SW 105TH PLACE [MECH] Permit Fee 12/5/200`. $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 12/5/200` $5.80
Phone: 503 330 - 3440 Total $78.30
Contractor:
BEAVERTON HEATING + A/C INC
5400 SW 170TH AVE REQUIRED ITEMS AND REPORTS
ALOHA, OR 97007
Phone: 503 649 - 1271
Reg #: LIC 118441
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: C.u7 i 0Z
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.
12/02/2005 12:38 FAX 5036486448 BEAVERTON HEATING AC Iii] 002 / 004
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? 11/07/2005 09 : 12 FAX 5035981960 CITY OF TIGARD Lill 0 0 2
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Mechanical Permit .W
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City of Tigard . - -. veil r ..- , ovi
D.tes . _,., 0/7 !.....,-,..: fi , ,
131/5 SW Hall Blvd.. Tigard. OR- 97223 Plan Review
Phone; $03.639.4171 Fax: 503598.1960 DEC 0 2 2005 *
Datvaly: other Pruritic
Inspection Line; 503.639.4175 . .,,r, : 611.- 't I DateRe. , '"'ry: El See Papa for
puma; www.ci.tigard.orais
CITY OF TIGARD NotiliediMethod: ,...W11 Supplemental Intinnapien
' . - • • • - . • — - .0.cw.e. Tr..
' -.:f ;',:;'.:',. T,I4VP)414,7 ' :7, j ' I TM, l 'Al:` , :71.!,, , ;' %. )■ca• - .1 , 41.1';44.' i'gPat` C '''l L1 : 1 : 1 " '' !.'-', 6
cr.bardeal permit fees° arc based on tha value of the work
0 Now conStruction SKAddition/altaration/roplacement
0 Demolition 0 °thin: patented. indicate the value (rounded to tho newest dollar) of an
mechanical materials, - id ..- labor overhead end. oft
, 23/01 0 1i5Gfott .t'oli : k i ' l' i4 1 0 0 ... . . ''',. :' .. ' 7 1. ••■• ',.'. 'i: 01141tVit Value: S
X Jel..' ... ' • ' ' -- • . "N. ' '', . , • ' ';' • • ', • . . • tp..ritiviiiifTe41,'' 45kiREriz'k'7
1- and 2-filmily dwelling 0 Commercial/industrial o Accessory building
)
Multi-family 0 Master build= 0 Other:. . ' sL ' ,#' :- . .L:. - . i! .,
D
Description F nifiwynntion use checklist.
I Qty. 1 Pa. Total
i . .:_f • ' ' ' : . r heat pump
Job site address: I c SU1/4) i 0 '52 -.. ,........ -....;. ptac,320, 1 14,00
% - mace 10t(I00 BTU (drativouto 1 14 1 9 a
City/State/ZIP: My cl i rp P., Q 1 - 1 - 1 , 2--
. , 1•10 1 : . •., rrNISII 17.90
Suite/bldg./apt. no.: Project name: 3 1....,„ _ ,i . 14,00
GAS hen pump
c street/directions to Job site: ' Duet yatk 14_00
----....-
' 11'su.t,tar system 14.00
Residential boiler (radiator or
hydractle) 14.00
Unit hewers (fitel-type, not 'electric).
' - 1 Liz= ptlue saul end ctl
- ----- Flue/vent fbr lour abovo 10.00
Subdivis inn: Lot nth; , . —
Other , 10.00
Tax map/parcel no.: Other fuel appliances
' 4 , w , ,e ' f . *.. t...1.f ..s.,..,-....,a. • • - ' - .4.....t V" -' 7 ;..,;,-. 1: , - c : ..0-, r k!'' . 77+: ,a1 woe:boor 10.00
:: ;IUG :....
- 1CZ!‘ .. ;). , q ,, ,W. .1tWr' 441 P' r 4 ' 1 4} ' . . ' • ..'. .: ;', ' Nat • '
Qas fireplace 10.00
if k ‘I rY4=t b '''- cum o ta Or (%. nue vent for water heater or gas
replace tom
OtAr4 (r& fNIVVIA (. .i. Lx(k-a- O' tktC:-------- Lou Ilene (pas) 10.00
Wood/pellet stove 10.00
---- ...
. Wood fireplace/insert 10.00
EP
Chinincy/lloer/fluelyent 10.00
. ... , .'/Www*::!';' - ',' ',". .i.:.;i . ..41'..;.... '4 VitplAVW
10.00
Name: .lo Ill Environmental ezhaait Pad 'n06.4601
4.-.
Address: ‘ i -/ t Range hoodtother kitchen
equipment 30.00
City/State/ZIP: 1 1
- • s, „. r , 1.,li Clothes dryer exhaust 10.00
Slitgle-chict exhaust (bathrooms,
Phone: ( 1, 0 - 4 b Pax; ( ) toilet comporjulonts, utility rESOM) 6.80
—
, ;''`.°:;. -:, . 7,- ." s .7rialiNkiat; i‘: vi:? 'AV. i pilittOt4;00 -. Att1C/Ctaw15ptieG Ems )0,00
:';,...;:;:?.,i,".. =&,4s. .:1•"11`'''''wm - . n ' . ' • -`.'• -.• • r - . , 4. ,....... -, othrz 10.00
Business name: ... e e x y " t tkrg ru) b'. l Fuel piping
Contact mune; t‘ yy b t AA, el
k . 55.40 fbr first four; 51.00 fur each additional
Fu et_uaz
L i T S. :c _ sis l__________ I 51-03'0 4N-
Chut heat pinny
City/State/ZIP; A 1 .. ,. • 4t • , Wall/wsnoodednialt heater _...
Phone: (99, ) i - -. )-1-- Fax: : (s )6 • - , q ( w heater
, Firoplisce
E-mail: n ./...11.. , 1,...p jgc_________.___,_._
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. 00:41, Plc ., , 0.. '. • • 13arbeecie
y.*.4:.....:,.q Y ' : ...r ''.. 7 ' 1 `! " ' ' • . • . :.• • ., _ —
Clothco (ans)
Business nat
— Other
Arkin:1SC .1...„..: .Sfq">*•11.t.* .. RttiFb%
...
Ctty/State/IIP: Subtotal -
---....-,...--- Minimumfmmit fee (S72.50) 31,,,c151
phone! ( ) I Fa ( ) Plan review (25% of permit feo) ' --
CCB lie.: 1 \ < IA 4 I so" surcharge (8% ofpermit foe)
TOTAL PER.Mrr FEE IA( _
)
This permit application alum Ira permi t is not obtained withift 1110
Authorized signatute; r:-..0 j\ days altar it los boat ACCepted As complete.
Print mune! 4.4 V kmt.A.,,..r (co irn oat. 1 ?..1 . . ) 4 0 g o F me set b Tn„c Building Industry service Board
i:\BABEiniptershs44E.C.PasehApp.doc 12/03 44o•Ai17T two:Kowa/Fa)
12/02/2005 12:38 FAX 5036496446 BEAVERTON HEATING AC U1003 /004
Beaverton Heating & A/C, Inc.
Alt FULL SERVICE: GAS • NC • ELECTRIC ■ HEAT PUMP • CONVERSIONS • ADD -ONS 'lc/ EXISTING SYSTEMS
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5400 S.W 170th Avenue • Aloha, Oregon 97007 ■ (503) 649 -1271 • (503) 649 -6446 fax • CC8# 118441
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BUILDING DIVISION PERMIT #: MEC2005-00796
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/512005
Phone: (503) 639-4171 Ate),
Inspection Requests (24Hm.):(5U3)638'4175
INSPECTION WORKSHEET FOR DATE: 12/14K2008 TIME: 7:01AM PAGE: 55
SITE ADDRESS: 11315EW105TMpL CLASS OF WORK:
SUBDIVISION: NODAK LOT #: 005 TYPE OF USE:
PROJECT NAME: JOLLY
DESCRIPTION: Repkce gas furnace, add AC.
OWNER: JOLLY, PHONE #: 503-330-3440
CONTRACTOR: EEAVERTON HEATING + NC INC PHONE it: 503-6491271
Inspection Request Scheduled For: Date: 12/14K2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 023404-02 503-649~1271 \" As/A
Corrections/Comments/Instructions:
E:
APASS "17TAR,T CANCEL n NOAC{�ESS
��
I | 7(AIL FOR INSPECTION ADDITIONAL FEES ASSESSED
12-iy. �l . |na pector' �' Oate: L� Phong #: (503) 718-
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