Permit / •
— 7 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00056
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/31/2008
PARCEL: 2 S 10 3 B D -07 900
SITE ADDRESS: 12554 SW 115TH AVE ZONING: R -4.5
SUBDIVISION: HUNTER'S GLEN LOT: 035 JURISDICTION: TIG
PROJECT: MILES
Project Description: furnace replacement
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: 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ALICE MILES Description Date Amount
12554 SW 115TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 1/31/200E $72.50
[TAX] 12% State Surch 1/31/200E $8.70
Phone: 503- 579 -4950
Total $81.20
Contractor:
PYRAMID HEATING
PO BOX 1502
SANDY, OR 97055 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 786 -9522
FAX 503- 786 -3432
Reg #: LIC 59382
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By .. . _� < j ._ Permittee Signature: 9,7/7--.4.7011/'
Call 1 .639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
From :PYiMID_HEATING 5037863432 01/31/2008 11:01 #019 P.002
Mechanical Permit Appli .. ,.1 , •,mii r()R t>hFicr. T1st: ()r1,I. •
• City f Ti D R : et 7 �� ��
� and ` � -.-. D eei ete/B y : d � (� �� Permit No,; � vI/'E/lJ1 "". j ,, t
Blvd., Tigard, . ---- " I3125 SW Hall Blvd Tiard OR 97223 11 .1 41 \J 3 1� E J O O 8 Te Plan Review Other Permit:
women Line: 503.639.4175 u- Dato/By'
I i(:,nItI�. Internet: www.tigard- or.gov CITY Of fIGARD Notf� �to d, Supplemental nt Information
3UILDINGOIVI.SION
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❑New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead and profit.
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Value:$
® 1- and 2- family dwelling 12 Commercial/industrial ❑ Accessory building {' TiE IDETVTlk,L1EQ PIS / §7.,,g i:MS I;EEfis, i
For special Information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. 1 Ea. Total
ne,aiiiiFii( :1+r •„ ,,,,
,,.JOB I fFORMAT'ON;�ANI) )CA'TT(N .,t.�, 1, '. . , . ..Heatn�p/coollnR - -- ----- ..._...
Job site address: 1 �SS4 S� S - A Ave r U-E. Air ass site conditioning or heat pump
( lcquinssite showing placement) 14.00
City /State/ZIP: Te - ,tb OIL 9 . Furnace 100,000 BTU ducts/vents 14,00
1 , Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no,: Project name: ` Y ! t Gas heat pump 14.00
Cross street/directions to job site: Duct work • 14.00
Hydronie 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 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
i 1 1 1, D, , , „ +ON R WORK
,.n � � 1 flit If 1 )11 , CCyy++p� 11 . 1 (V l,. ��, :, „�, :� Water heater 10.00
� � .... ,.., E.11il31F"t I � - J V (( f i , I:,I ,l, , �' 1 .:
1 ?-t• Gas fireplace 10.00
act €k fl r!. 1. A r . ' O - . a a e Flue vent for water heater or gas
C Aft115`l 0 '! ► '11.1) S • fireplace 10.00 •
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
ll 1 :In 1,' **Y,�i* 0- : ;iltiRl il'ri I , .,• .. lil Chimney/liner/flue/vent _
10 00
Name: „
r� I ► " -
Na c M - - per: 10.00
e' Environmental exhaust and ventilation
Address: 12.SS4 S W , l s i, Aye . Range hood/other kitchen
equipment 10.00
City / State/ZIP: 1 (qn Y( i O �► 22 � Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (93) S49 Q..,_ 4 n Fax: ( ) toilet compartments, utility rooms) 6.80
APP.L Y 1 , C!01NT CT k OTT Attic /crawispace fans 10.00
Other: 10.00
Business name: Tit, $ , on 4. k4 KC., • /hp l k t 1. • ill; I..1 I f Fuel piping
Contact name: eLvk j ,j-.j a $5.40 for first four; $1.00 for each additional
Address: ' TA 8 \C. 1 Sd Furnace, etc.
Gas heat pump
City/ State/ZIP: ct 0 re 9 -4 WalVauspended/unitheater
Phone: p/ 1' Water heater
(So) g�-.Q a IF. :: ) I110 `3 Y 3.1 Fireplace
E-mail: �',,WktZ,rtn '.Q1'� 4�
„ : A�'t
la , C , ' ' CTQB 1!lP iy'4� Range
Barbecue
Business name: ) • Clothes dryer (gas) ,_
Y ! 11..' . 1 .A 0 O a_
' Other:
x 11 ,
�Q 1 ' l ��� •.. .,, M�GtI C 1r , ItM 1;, &*
City/State/ZIP: c r l A O jt CI 6 . A � A
t5' Subtotal (4 , 00
Phone: (�j } 1 Fax: ( -• Minimum permit fee ($72.50) 1 , SI
Flan review (25% of permit fee)
CCB lie.: 5C 3 % �. , State surcharge (8% of permit fee) q.
/� TOTAL PERMIT FEE R 1 . �. d
Authorized signature: �^+„'1 V�� ` , - CIS This perndt application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: 17 ts4` HAfiS A A Date: ) S t , () , . Fee methodology sot by Id-County Building Industry Service Board
:\Building1Pmaias1 MEC.PermitApp.doc 04/06/06 4 40 -4617T (11 /02 /COM/w6B)
CITY Of TIGARD
BUILDING DIVISION PERMIT #: MFC2008 00055
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/20081
Phone: (503) 639 - 4171 °d4pu u�fl1 �'�
Inspection Requests (24 Hrs.): (503) 639-4175 671
INSPECTION WORKSHEET FOR DATE: 2/13/1008 TIME: 7 :01AM PAGE:
SITE ADDRESS: 12EM SI 115TH AVE CLASS OF WORK:
SUBDIVISION: HUNTERS GLEN LOT #: 035 TYPE OF USE:
PROJECT NAME: MILES
DESCRIPTION: furnace replacement
OWNER: MILES, ALICE PHONE #: 603..57 84950
4950
CONTRACTOR: PYRAMID HEATING PHONE #: 503 - 786 -9522
Inspection Request Scheduled For: Date: 2113/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical Final 064972-01 503 - 786.9522 Y'
Corrections /Comments /Instructions:
/ 4,4 *- 3 - / 3 S' - 7 9 ri, yue�/ '
6 / gag:, �
(l/PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: 5 // d Phone #: (503) 718 - LQ?,--/