Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00151
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/21/2007
PARCEL: 1 S134DB -01700
SITE ADDRESS: 11200 SW 115TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HUFFORD
Project Description: Furnace.
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: 0 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
ANNETTE HUFFORD Description Date Amount
11200 SW 115TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 3/21/20W $72.50
[TAX] 8% State Surcha 3/21/20W $5.80
Total $78.30
Phone: 503 -524 -9191
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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: t ve� i J Permittee Signature: / J • ,'
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.
Mar .19 07 04:23p Oregon Heating & A/C 503 - 537 -2172 p.1
Mechanical Permit Applicati'aa' ='(f , H. FOR .OFFICE USE ONLY
City of Ti
a , ' R'ec ge
aarh t e L --- /(' Permit No.:
s ` Date /By: D U V . k/ 15
13125 SW Hall Blvd'., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 A p. .' te, 7 Date /By:
Inspection Line: 503.639.4175 `" 1 . A I' ' I Date Ready / By: lens: H See Page 2 for
- Internet: www.ci.tigard.or.us '�"
Notified Method: Supplemental -Information
w
. TYPE O
- COMMERCIAL FEE* SCHEDULE : =' OE CHECKLIST ;
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • CATEGORY: OF CONSTRUCTION • ''
®1 a . . •
RESIDEN'L7AL EQUIPMENT /. S3YSTEMS FEES* `.- •
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family El Master builder ❑ Other: Description Qty. Ea. J Total
. •
JOB S ITE INFOR.NWiolt. AND LOCATION Heating/cooling
Air conditioning or heat pump
Yob site address: ' (_`: L 7_3c._ j j f 5 T h 1 Ave._ (requires site plan showing placement) 14.00
City/State /ZIP: �I lCt Cr, Furnace 100,000 BTU (ducts /vents) i 14.00
Ci ( t
JJ Furnace 100,000+ BTU (duets/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 I 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
er
,,- ,: - •... DE . ` . -; :" .'!.r:::::,;::::: . :: : : , i s' ° ` . 10.00
at eater
Gas fireplace
rti; .— {u rn CI Ce Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
run
; y iner /flue /vent 10.00
: PO
RPERTY OWNER r: •: ,.,;' '..' , , ] TENANT O t h er. 10.00
Name Environmental exhaust and ventilation
t'\�l�'1 �1� �1t�CC1�r� 4 u �Q
UU Range hood/other kitchen
Address: t C,C, ' i c 15-\-\,-, , \,-, [\\J equipment 10.00
City/State/ZEE': ---T\ �— l Clothes dryer exhaust 10.00
� 1 `�� Single -duct exhaust (bathrooms,
Phone: (`jj j) y 3t) — c i1 9 / Fax: ( ) toilet compartments, utility rooms) 6.80
,, :. : • ::::.,:.;,:n i ' ` : :. - Attic /crawlspace fans 10.00
APPL' I . . : .::...: ..:..:..' , . . . .. . ❑ CONTA P = . .:;' . ,
Other: 10.00 -
Business name: Oregon Heating and Air Conditioning Fuel piping
Contact name: 1 - 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address: PO Box 397
Gas heat pump ,
City/State /ZIP: Dundee OR 97115 WaWsuspended/ttnit heater
Phone: (503) 538 -2953 I Fax: : (503) 537 -2712 Water heater
Fireplace
E -mail: rashelleriboregonheating.com Range
•::.: ...'.:. RACTOR c;'t Barbecue
` CONT
Business name: Oregon Heating and Air Conditioning Clothes dryer (gas)
Other:
Address: PO Box 397 MECHANICAL PEE . ` ; ,:.
City/State /ZIP: Dundee OR 97115 Subtotal u A -) ' -
Phone: (503) 538 -2953 Fax: (503) 537 -2712 M perm fee ($72.50)
Plan review (25% of permit fee)
CCB tic.: 1 /7", / -)C: State surcharge (8% of permit fee)
` TOTAL PERMIT FEE - 7 ', .3c;
/ < This permit application expires if a permit is not obtained within 180
Authorized signature: ,;�d 4w. L. ' c ( p , days after it has been accepted as complete.
Print name: j i 3, )1 x : 1 IC / j y (. y,
V Date: - eATI * Fee methodology set by Tri- County Building industry Service Board
i? B \e M
uildingPmits\EC- PnmitApp.doc 12/03 - 440 , 1617T (I 1 /02 /COM WEB)
. -
CITY OF TIGARD _ ,!-- f
BUILDING DIVISION PERMIT #: MEC2007.00151
13125 SW Hall Blvd., Tigard, OR 97223 a __• DATE ISSUED: 3/21/2007
Phone: (503) 639 -4171 :78 /04 olIN� J1
�
Inspection Requests (24 Hrs.): (503) 639 -4175 � /
INSPECTION WORKSHEET FOR DATE: 4/9/2007 TIME: 7:01AM PAGE: 48
SITE ADDRESS: 11200 SW 115TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HUFFORD
• DESCRIPTION: Furnace.
OWNER: HUFFORD, ANNETTE PHONE #: 503 - 524 -9191
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 -538- 2953
Inspection Request Scheduled For: Date: 4/912007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 046173-01 503"538-2953 Y '!/ 0
Corrections /Comments /Instructions: .
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•
7 x : 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
C 7 Inspector: Date: G ° Phone #: (503) 718-