Permit ,! V
t ' CITY OF TIGARD MECHANICAL PERMIT
l l DEVELOPMENT SERVICES PERMIT #: MEC2005 -00820
�'I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/14/2005
PARCEL: 2S103DC -01900
SITE ADDRESS: 13890 SW 114TH AVE ZONING: R -4.5
SUBDIVISION: VIEWMOUNT LOT: 007 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
• FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
TED CLARK Description Date Amount
13890 SW 114TH AVE [MECH] Permit Fee 12/14/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 12/14/20C $5.80
Phone: 503- 860 -4209 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
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 fo ru - ..opted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throu OAR 952 - 001 -.100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 800 - 332 -2344.
Is ed By: Permittee Si • W /,
Call 503 - 639 -4175 by 7:00 a.m. for inspections tha •usines • ay.
his permit card shall be kept in a conspicuous place on the j• • site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. .
mt,h . ,. 1 Perm A FPEPFll VE I
. anica ermit pp lea on° , j i / FOft OFFICE USE ONLY
City of Tid Received / 3 615' '1411/ lyfeelec.75--eredet
13125 SW Hall Blv Tigard, OR 97223 DEC 13 2005A Dale/By:
Plan Review , Permit No :
Phone: 503 639.4171 Fax: 503.598.1.960 0:her Fermi:
Inspection Line: 503.639.4175 CITY OF TIGAF -LtNili Date/By:
Date Ready/By
J:4,...a e See Page 2 to-
Internet: wwwici.tigard.or.us BUILDING DIVISION Notified/Method: / . Supplemental Information
" ' . ....."- , :i " :?t:; ; e . ..',: . : '. 1 . i i ..flkt .. : 7 .'. '''.'•Mg:..Q,yo,fw -., ,,.....:.::.,:: cEi4.etAi.;*p . 's'engt) mu - USE. CIIE.CKLIS9
New cons:rurtion dd lam/alteration/replacement
Mechanical per fees are based or the value nf the work EJ 1,A
performed. Indicate the value (rotr.ded to the nearest dollar) of :
0 Demol:tion 0 Other: mechanical materials, equipment, labor, overhead, and pro n1
t ' i .,- k . .';' ..7, j; ,0 : 0. ... 44 * •°610; '° °trai4E !/ 4 ':' '.. ....' '' Y ' ' . '''.;''. . 'Li! .:: -S Value: $
..la011iASITIAL E,Q1:1TP1MENT/ SYSTEMS FEES*
I- and 2-family dwelling Commercial/industrial 0 Accessory building . . ,.,..,,.• ,•••, • - •
For special information use checiclis;.
0 Multi E Master builder 0 Other:
Description [ Qty. I Ea _ Total
- .. •:. T .Q!-.§. F . 1 !:PIPPWAiTi'. 4 :1P 1 :•:ANR-T:'°eA s PIP.N. :: •1: ,..• :•:.- ';':: • , .• Heating:cooling _.
Air conditior.ing or heat pump
Job site address: / ' if 70 ,,-,-- z„); /, (requires site ?lac showing placement) 14.00
City/StateiZIP: Furnace 100,000 BTU (thicts/vents) 7 14.00
Furnace 100,000+ BTU (sluctsivents:, / 17.90
Suite/bldg./apt. no.: 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
hvdronic) 14.00
Unit heaters rfuel-type, not eleciric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water heater 10.00
1 '!" . ' 110 *::. 5 Ai±gIc . l'Z ? :• 124i ' 4 :'' .. 1 11 ::::APY"§eC. F g.01qq:9tYY9Y1S . ' 3 4 . ).. - . - z ..- -.4 1, :' . .;:•.:4; .i.j
Gas fireplace 10.00
,6„...e-i ../..t....--9 ,... ..:e„,...e.<",-1.,-; ...., ...e_....) Flue vent for water heater or gas
fireplace ,
, 10.00
4
Log ligh:er (gas) 10.00
woodipellet stove 10.00
Wood fireplace/insert 10.00 ,
- ;-',, ,. ;,sn , i.0 , 1 3,.liOvilieliiO40 , ; ; , ? : . ? .;_ t o,:,,,..) .....74,: t o : . :,;,1, .4 .3, - . - 4 .0 4 „ . . 4Nt:; ..,: ,: , •;:.,..;. . ,: ,• ; .,.:::.,. Chimney/liner/flue/vent 10.00
Name: Z?"'G Environmental exhaust and ventilation _
Range hood/other kitchen
Address:
equipment 10 00
City/State/Z1P: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone:(5//) "4 wo, Fax: ( ) toilet compartments, utility rooms) 6.80
ii:Aniciti.,:ii41 Attic/crawlspace fans 10.00
Other: I 0.00
Business name:
Fuel piping
Contact name: / 4 , d - /2 / $5.40 for first four; $1.00 for each additional
Furnace, etc. .
Address:
Gas heat pump
City/StEeiZIP: Wall/suspended/unit heater
Water heater
Plione )b,,V Fax: : ( ) .5?( e..2,
Fireplace
E-mail:
Range
-1-- : , :•resii■Viiii6ii4k . '' , . ,- ;;"! : ' , lit l e:: - ' ' ,•;:.'.'''';'' -.:. , '4 .''''..:‘ Barbecue
.A. :■"-.'- 3 .:'7 , ''',":ti'd-.> ':i ,,.'..: . .:*'...',.. :"- - ', P ....;...■. .. ' 4 t ', . 1 , 4' ':: '-.,--'.----:.,•,".": ''; - ',:,--:•• i::.•:,-, • Clothes dryer (2,as) i
Business name: . 4 ".. 6 /et ,' ,/-4 -rn,../4., ...o.- C i
el. i d 4,4 Other: !
Address: Ao• 6py, c , 3 4 , .3 5 4g0iikliac.4-1gRkif..
City/State/ZIP: ' Subtotal
77 4- AL ef,.._. ?24...:2,,,..3
Minmnum permit fee ;$72.50)
Phone: . % t ; ) 4 a ,./ zzlc , Fax ) ..... Er oa 74 ,
Plan review (25% of pe+rnit fee)
COB lie.: 7 , 0,5 7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: e t , • - , - 7 2 . - / - e - - e - - , C 1 2 : 9 ' 1 - 4 1 1 , " This permit application exp ir eS if a permit is not obtained w, thin 18
days after lt has been accepted as complete.
Print name: 1 C44 4 .t,/e I D are' / --z:5"" • Fee methudolcgy set by iTi-Coenti Building Indus:re Ser..e.-.: Boa:
L'ItmidinoTortints\MEC.PernitAn due 11'33
Z .C1 ' OLZ0869C09 6u!iesH equinioo e Z9:60 90 9 L oea
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200 00820
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 21 1412005
Phone: (503) 639 -4171 �'�NN�Iic�p i�l�
Inspection Requests (24 Hrs.): (503) 639 -4175 ° __..
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7 :06AM PAGE: 80
SITE ADDRESS: 13850 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: VIE\MvIOUNT LOT #: 07 TYPE OF USE:
PROJECT NAME: CLARK
DESCRIPTION: Replace as furnace.
OWNER: CLARK, TED PHONE #: 503 - 6604209
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503.6242704
Inspection Request Scheduled For: Date: /2/1612005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 023587 -01 503 -624 -2704 N
Corrections /Comments/ Instructions:
/7110 Zeci ' 5 72_2.33
r
c r. .1. ......,
A PASS I I PARTIAL APPROVAL . 0 CANCEL III NO ACCESS
I FAIL — CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: i 44 Date: 1/2-' #: (503) 718- `Z2O