Permit CITY TIGARD • MECHANICAL PERMIT
fib DEVELOPMENT SERVICES PERMIT #: MEC2005-00650
R= --' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/12/2005
PARCEL: 1 S134CD -02000
SITE ADDRESS: 12090 SW 118TH AVE ZONING: R -4.5
SUBDIVISION: LERON HEIGHTS NO.3 LOT: 044 JURISDICTION: TIG
Project Description: New gas furnace & venting.
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: 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
CAROL BROWN Description Date Amount
12090 SW 118TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 10/12/20C $72.50
[TAX] 8% State Surcha 10/12/20C $5.80
Total $78.30
Phone: 503- 590 -3019
Contractor:
AAA HEATING & COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Phone: 503- 284 -2173
Reg #: LIC 222
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: .2 A Permittee Signature: , • �, c) v ,0
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.
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Ci�� of Tigard r..., y://17.2 5 �C., o (2s "00 C50
1 3125 • SW Hall Blvd., Tigard, OR 1 9 , ECEI 1 DateB
Plan Review Other Permit: 503.639.4171 Fax: 503.598.1960 �aiRri (/l Date/By:
Inspection Line: 503.639.4175 OCT 12 2005 � i Date Ready /By: furl : El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 1 I ( " Supplemental Information
CITY OF Tic V
��I« ��/ COM MERCIA L FEE* SCHEDULE - USE CHECKLIST
Gk 1 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.
Value: I
CATEGORY: OF EONS TRUCTIOhI RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description i Qty. I Ea. I Total
'' .' JOB; SITE , ,AND .LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: ! ZV q ' a".14.. / / Z 14 4 /a - `. (requires site plan showing placement) 14.00
City/State/ZIP: / f�,�.. '17 2- Z Furnace 100,000 BTU (ducts /vents) 1 14.00 / 4 (
7 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 737;,,,,341-A____ Gas heat pump 14.00
14.00
Cross street/directions to job site:
Duct work
Hydronic hot water system 14.00
�'a et? 12./ j r Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above ` 10.00 16
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
,; Water heater 10.00
r' ' =t";:ri .�:.DESCRIPTIONI�OF'i W.ORIC:�r. -
' ,.... .< ,._. ,.. :._. 10.00
,....... ,.. _. Gas fireplace
‘3,47". / "I 4-Jt.41 e- 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
Chimney/liner /flue /vent 10.00
P ROPERTY OWNER 0: TENANT Other: 10.00
Name: L gi/Lo Environmental exhaust and ventilation
Range hood /other kitchen
Address: / 2 v Q' S 1 „) ) / A. equipment 10.00
, 22 3 Clothes dryer exhaust 10.00
City / State/ZIP: Single -duct exhaust (bathrooms,
Phone: (5D)) S' . 3 6 ) 4 Fax: ( ) toilet compartments, utility rooms) 6.80
CONTACT PERSON Attic /crawlspace fans 10.00
`_ -- rr,;_f:, ® `APLIGAIVT .. �' 10.00
. - , ,. : R Other:
Business name: Fuel p iping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Water heater
Phone: ( ) Fax: ( )
Fireplace
E -mail: Range
CONTRACTO Barbecue
Clothes dryer (gas)
Business name / A r_l® i-2 r 0 h)-z� Oth
Address: e) 1 E t ^ 3 L 0.7 (G I/d " . _ MECHANICAL PERMIT FEES*
City/State/ZI`PP::�� /S' r1 I ' &ie. '3 7A,2 Subtotal
Minimum permit fee ($72.50) 7, ,5'O
Phone: (5 _ d
Fax: ( �� � _ Plan review (25% of permit fee)
CCB lie.: ��_ _ _ State surcharge (8% of permit fee) 5', 8
`�>m! " �° � I TOTAL PERMIT FEE 7. 30
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: 4 a) .. , - Date: 7 a 5 * Fee methodology set by Tri -County Building Industry Service Board
. �n..; u: .,.NP•emitc1t Prrrni 12/03 44 -461 I v02 /COM/WEB)
CITY OF TIGARD Ly41, (I g L�
BUILDING DIVISION - PERMIT #: Ml 2006,00650
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 100 1210
Phone: (503) 639 -4171 :�I�i�1�1�'iIi
Inspection Requests (24 Hrs.): (503) 639 -4175 ;.:�
INSPECTION WORKSHEET FOR DATE: 2/412006 TIME: 7:03AM PAGE: 107
SITE ADDRESS: 12090 SW 118TH AVE CLASS OF WORK:
SUBDIVISION: LERON HEIGHTS NO.3 LO T #: w °— TYPE OF USE:
PROJECT NAME: m
DESCRIPTION: New , furnace & venting.
OWNER: BROWN CAROL PHONE #: 603,690,3019
CONTRACTOR: AAA HEATING & COOLING PHONE #: ::)03-284-21 73
Inspection Request Scheduled For: Date: 2 0d /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 027467 - 01 503590, 3019 'V
Corrections /Comments/ Instructions:
ii/1/"‘ 0 La'4(-) 3 ‘1 /
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[X PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL H CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
411 Az Inspector: Date: � " • Phone #: (503) 718 -
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CITY-CF-TIGARD W IFF
BUILDING DIVISION PERMIT #: ME.C30OS.001360
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/12120()E,
Phone: (503) 639-4171 e llailIgit
Inspection Requests (24 Hrs.): (503) 639-4175 s.1. • '-''. —
INSPECTION WORKSHEET FOR DATE: 213/2006 TIME: 7:02AM PAGE: .62
• ,
SITE ADDRESS: 12090 SW 118TH AVE CLASS OF WORK:
._.
SUBDIVISION: LERON HEIGHTS NO:3 LOT #: 044 TYPE OF USE: .
PROJECT NAME: MOWN
DESCRIPTION: New gas furnace & venting.
OWNER: BROWN, CAROL PHONE #: 60:3 590
CONTRACTOR: AM HEATING & COOLING PHONE #: 603-2842173
Inspection Request Scheduled For: Date: 2/3/2006 Pour Time:
- -
Code # Inspection Description Confirm # Contact # Mess , ge - 5:-
•
699 Mechanical final 026189-01 - 6035903019 'Y -
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Corrections/ComMents/Instructions:.:„ ' , . • . . ,,,,, ,
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[1/ 0 PARTIAL APPROVAL 0 CANCEL NO ACCESS
FAIL [1 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: A
/ Date: - 2--3-0F D Phone #: (503) 718- 2-1--g-S------