Permit S �� .
r CITY OP TIGARD MECHANICAL PERMIT
� a DEVELOPMENT SERVICES PERMIT #: MEC2005 -00779
Ag - �ef 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/23/2005
PARCEL: 2S115AD -04600
SITE ADDRESS: 16674 SW 108TH AVE ZONING: R - 4.5
SUBDIVISION: DOVER LANDING LOT: 029 JURISDICTION: TIG
Project Description: Reconnect furnace /replace.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
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:
Owner: FEES
MARK MACDONALD Description Date Amount
16674 SW 108TH AVE [MECH] Permit Fee 11/23/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 11/23/20( $5.80
Phone: 503- 684 -8316 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone: 503 640 - 3607
Reg #: LIC 66578
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- 8073a2 2344. -
•
Issue( By: / I / I Perm
� Sis .
Call 503 - 639 -4175 by 7:00 a.m. for inspections • business day.
This permit card shall be kept in a conspicuous place on t ° 'ob site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11/22/2005 12:30 FAX 0002/002
, r
Mechanic Permit_ Ap plicat1o FOR OFFICE USE ONLY
City of Ti and V E Received pannitNa.: }.�
! Data/Sy; // m /lee, 7 -
13 t25 SW Hall Blvd., Tigard, OR 972 3 plan Review
Phone: 503.639,4171 Fax: 503.593.1960 //'grit+ • tt• r\ Dutc/By, Ocher Permit:
p
Ina ection zinc: 503.639.4175 if ; .j i
R a a BM El See Page 2 far
Internet: vnuw.Ci,tigard.or.us NOV VU U 2 ZOO ' `r" N kid/lvl Supplemental Information
CITY OF TIGAan _
;a M ' E P1Y0 ;: , ____._ C ";FEF. * „ SC'EIED
5', ., ', :r ' m'',.i; � :.I _..).0 8 ' ;a ik ll ULE — USEICRECICUST
[l New construction ❑ Addition /alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
' ' '''1l ° ; ' I ~'l : ' lc, ! CATEGO_.X :O 'CONSTRtfCTION ',1: ' , I Value; 5
`j'1- and 2 dwelling ❑ Commercial/industrial , ' "RDSTD> N,T PQfG 1VLE�IT /SYSTEMS FEES*
y g ❑ Accessory building '
For,tpecial information use checklist.
Master b uilder ❑Other:
❑ Multi- family Q Description
Qty T Ea, I Total •
" '(i' r., +i',; ' "'s08 SITFai`YN,x*IifidgiO ,ANp LOCA'TIOC „ �'' IIoacinp/cooling
Job ( site address- I t t '4-4 J) r 4 [ Z- Air conditioning or heat pump
C' _ ` (requires Site plan $how,nq placement) 14.00
City/Scale/ZIP: • y. 01 , Furnace 100,000 BTU (duets/vents) 1
Furnace 100,000+ BTU tdue4/ventsi 17 90
Suite/bldg, /apt, no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: DUCE work _ T 11 00
Hydronic hot water stern 14.00 I
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fusel -type, not electric).
in -wall, in - duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00 �
Other: _ 10.00
Tax map /parcel no.: . Other fuel a lice
ans
• ', �Fa- ' " if_ :'_. ;'r13SGFtIPTION OR;V,RK y a.`.:
” Water heater 10.00
Gas fireplace 10,00
Flue vent for water heater or oas
(I fireplace 10,00
"-,-.t..„ , /Ag-f.C41-C-E. Log lighter (gam 10.00
_ Wood /pellet stove 10.00
Wood nreplacc/inscrt . 10,00 I
/,. , „ Chimney/liner/cue/vent 10,00
' ' ,,;I l'lfRRO ERTd „OWNgFRI;` a "' • ` .:w4: ?- .. ; : r NANT;,�u ..' I
„';` .. O t h er: t 10.00
Name; j2^-14. fl/L--e- 06 ify a _e_4 Environmental exhaurttand ventilation ,
Address: Range hood /other kitchen
equipment 10,00
City /State /ZIP: Clothes dryer exhaust 10.00 1
Single -duct exhaust (bathrooms. I
Phone: ( ) 1„ p L 4 _. ,e3 r (0 Fax: ( ) toilet compartments, utility rooms) 6,30 1
'.', ' :rj" f 1;;t. ' III,'iiPRI.,16ANTI. h. , 'y; ° CONTACT .PERSON . Attic /crawlsp fans t0 00
name:
Other: __ Business ca 10.00
t < C C c a 1-` 1 f - (c.- ( f '� Fuel piping
Contact name: -1 r‘G � �_ t c',_ C.-' (.', 1,4" y1 / 55.40 for first four; S -00 (Ur e ach a dditional
Address: C Furnace, etc.
S ( L (: �' 6� v ' r 7 t 2 Gas heat pump I
City/State /ZIP: 1 `�,;,_ L i < ' / -- L L Wall /suspended /unit heater
Phone: (St j 6..„ ) � L v J _ , ( , 6 - I Fax::(.') / ( 5 - ( - __C , 4 ' �? . Water heater •
Fireplace
.
E -mail: + Range -
' ^' -` .,:;: �; r' „;;' '.?, f n : .' ` • r I !;, CO11,T :,0, TOR '' ' . ' 9' +' I .,;,• barbecue -
, ..
Business name: L - — '.� .; , clothes dryer (gad ,
? .a-1 L (ice Other:
i
Address: 4i :;r'. ; , ;114GIiANICAX, RERMITEEES•
City /S tate/ZIP: Subtotal
Phone: Minimum permit tee ($72.50)
( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: LL (c: S-- State surcharge (B% of permit fee)
TOTAL PERMIT FEE 0
Authorized signature: C•-r•-4C � � +• 7 . L Thie permit oppticacloa expire' If n permit Ira not obtained wlchln 180
days after It has been accepted as cemplere.
• Fee methodology set by Tri- County Building Indus Service Board
print name: -1 vzii,-e,.,..,. _I I S C. r
Date: VA • / B y u c7
CITY OF TIGARD
BUILDING DIVISION -- - f PERMIT #: MEC2005-00779
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/23/2005
Phone: (503) 639 -4171 / AA 9mt gl$ii.i
Inspection Requests (24 Hrs.): (503) 639 -4175 : _ = . : .W "J..
INSPECTION WORKSHEET FOR DATE: 12/8/2005 TIME: 7 :0OAM PAGE: 42
SITE ADDRESS: 16674 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOVER LANDING LOT #: 029 TYPE OF USE:
PROJECT NAME: MCDONALD
DESCRIPTION: Reconnect furnacefreplace.
OWNER: MACDONALD, MARK PHONE #: 503.684 -8316
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503 -640 °3607
Inspection Request Scheduled For: Date: 1218/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 023062 -01 503-640-3607 Y
Corrections /Comments /Instructions: RV\
6 --- ) . 7A - 1 \ =v( - -,...s. C i-a_c__
.,
■
,, .
/ s .
g ...P.ASS, PARTIAL APPROVAL n CANCEL n NO ACCESS
I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: IA C/ Date: ) Z11/6 Phone #: (503) 718-