Permit C ITY OF `TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00635
•
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/12/2006
PARCEL: 2S 103RD -06200
SITE ADDRESS: 12664 SW 116TH AVE ZONING: R -4.5
SUBDIVISION: HUNTER'S GLEN LOT: 018 JURISDICTION: TIG
Project Description: Install 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:
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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
RON GENIVCH Description Date Amount
12664 SW 116TH AVE
TIGARD, OR 97224 [TAX] 8% State Surcha 12/12/20C $5.80
[MECH] Permit Fee 12/12/20( $72.50
Total $78.30
Phone: 503 - 522 -8759
Contractor:
OREGON HEATING & AC(125185)
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815(SEE OHAC,
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: 5 Permittee Signature: B cp e
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.
Dec 12 06 08:51a MS Rentals, Inc. 503 - 537 -2172 p.1
o
Mechanical Permit Applicatign FOR OFFICE USE ONLY
City of Tigard [t / -wry
`J g ,. 1 Datc/B eceived _ ' -/ - d 6 /`/ Permit No. D0 t V d 1
13125 SW Hall Blvd., Tigard, OR 97223 RECEIV .I ,1' Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 I '1 Date. /By:
Inspection Line: 503.639.4175 ti; "j , Dale ReadyiQy: Tuns: 8 See Page 2 for
Internet: www.ci.tigard.or.us DEC 1 2 2..A.,-, Notified/Method: . Supplemental Information
CITY OF TIGARD . /
' YP�
T((, ISIFIVOIVISION COMMERCIAL FEE* SCHEDULE. - USE CHECKLIST
❑ 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.
. CATEGORY OF CONSTRUCTION Value: $
• RESIDENTIAL EQUIPMENT / SYSTEMS FEES* •
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
[I] Multi - family ❑ Master builder ❑ Other Description Qty. Ea. Total
- • JOB SITE ,INFORMATION. AND LOCATION Heating/cooling
Job site address: l a t y t Air conditioning or heat pump
rp� St+�3 116 k (requires site plan showing placement) 14.00
City/State /ZIP: 71 w . t F .A t o9R Q a at4 Furnace 100,000 BTU (ducts/vents) 1 14.00
Furnace 100,000+ BTU (ducts %vents) 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
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 1 10.00
Other. 10.00 ,
Tax map /parcel no.: Other fuel appliances
r
DESCRIPTION OF WO
a er ea e
Gas fireplace 10.00
K V AC Flue vent for water heater or gas
fireplace 10.00
`11R .sl-011 - f nose_ Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
.. PROPE NER '
Chimney/liner/flue/vent 10 00 • X ••RTY ;OW :; • .. : ❑ .TENANT .. 10.00
Ot her: -
Name: `Ron Ey. t ll\I c h Environmental exhaust and ventilation
Range hood/other kitchen
Address: j , ! f h Ave, equipment 10.00
City/State /ZIP: , ` a � Q r< Q—I a2 Li Clothes dryer exhaust 10.00
t Single -duct exhaust (bathrooms,
Phone: (565) 5 _s-759 Fax: ( ) toilet compartments, utility rooms) 6.80
-.. r cra
- ❑APPLICANT . `. `::. ,❑ CONTACT . PERSON . ; Att c w space ans
Other: 10.00
Business name: Oregon Heating and Air Conditioning Fuel r m
P g
Contact name: Rathel $5.40 for first four; 51.00 for each additional
Address: PO Box 397 Furnace, etc.
Gas heat pump
City/State /ZIP: Dundee OR 97115 Wall /suspendediunit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2712 Water heater
Fireplace
E -mail: rashelle@oregonhcating.eom Range
CONTRACTOR Barbecue
Business name: Oregon Heating and Air Conditioning Clothes dryer (gas)
Other.
Address: PO Box 397 MECHANICAL PERMIT FEES*
City/State /ZIP: Dundee OR 97115 Subtotal
0
Phone: (503) 538 -2953 Fax: (503) 537 -2712 Minimum permit fee ($72.50) , a, s
Plan review (25% of permit fee)
CCB tic.: 11$'S [ i al a .2 State surcharge (8% of permit fee) 5. go
TOTAL PERMIT FEE ']g. SO
Authorized signature: This permit application expires if a permit is not obtained within 180
.L, days after it has been accepted as complete.
Print name: Fa L , �, Date: l a_ I , a _ ' Fee methodology set by Tri -County Building Industry Service Board
:'. BuildingW nn
ermin\MBC- Peit4pp.doc 12103 V 440 -4617T (1 r /02:COM.WEB)
1
■
CITY OF11GARD _-
BUILDING DIVISION PERMIT #: MEC2006-00635
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/12/2006
Phone: (503) 639 -4171 � �190 , j1
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_'
INSPECTION WORKSHEET FOR DATE: 1/1912007 TIME: 7 :01AM PAGE: 31
SITE ADDRESS: 12664 SW 116TH AVE CLASS OF WORK:
SUBDIVISION: HUNTER'S GLEN LOT #: 018 TYPE OF USE:
PROJECT NAME: GENIVCH
DESCRIPTION: Install furnace,
OWNER: GENIVCH, RON PHONE #: 503.532 -8769
CONTRACTOR: OREGON HEATING & AC(126185) - PHONE #: 503 -638 -2653
Inspection Request Scheduled For: Date: 1/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
899 Mechanical final 042297 -01 503- 5313.2963 Y
Corrections/Comments/Instructions:
..CD EL G - er72i4'/.y L 41.4. i.n."0, -- .4A - ‘4CZ S -//1 4 5'2 4y2/0i.ey-/,4 C4, 2 7"
1-1 ASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
Li FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: . Date: /'-- 7 q — C> Phone #: (503) 718- Z1--S
•