Permit C ITY OF TIGARD MECHANICAL PERMIT
" " COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00614
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/1/2006
PARCEL: 2S103BB -09600
SITE ADDRESS: 12045 SW 122ND CT ZONING: R -4.5
SUBDIVISION: YE OLDE WINDMILL LOT: 010 JURISDICTION: TIG
Project Description: Replace 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JANET ANDERSON Description Date Amount
12045 SW 122ND CT
TIGARD, OR 97223 [MECH] Permit Fee 12/1/200E $72.50
[TAX] 8% State Surcha 12/1/200E $5.80
Total $78.30
Phone: 503- 869 -9371
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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: ---- f(„n _\ Permittee Signature: -,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.
R011
.
: FAX ND. : 5035570919 Dec. 01 2006 08:57AM P1
7'
Menia . nical Permit ApEl,ka
rOR OFFICE USE ONLY
City of Tigard . R rrnitNth O _
eceit—i
13125 SW Tia11.131■4, Tigard, OR 97223 MCP IN/E-A.-. _ Dateray; a - - /pCri) 1 1 -c
Phone: • 503.639.4171 Pax: 503.598.1960 Plan Review e 2. i, • /6 -
Dateilay; Other permit
inspection Line: 50313 A Ve t
39.4175 .,_,,
Internet: www.ci.tigard.or.us 1 1 ' .
1 .,hli i N
DEC 0 a'' • --- D.t.Rcady/By:
yuris: 0 Sec Page 2 for ----
Noddod/IvIethol
1 .---- Sudplcraeatal Warm:mon
,..—
, , ,,,_,_ pF TiGARP
• Mailitt; l 'i„:': . **Or• ' 7
4 • !•,-.,.. ,.,.,...-- ,, -_.
^ . 4 :.. • ., . ,. . 1W.1 • S" - •.: ',"•;' ''''', "4• ' AtCIA!"441iMatICL,'SCRED:aidEr4:.:V•SPER•E'CICLIST;'
. New construction Addition/alteration/replacement Mechanical permit fees• 'are bascon the value of the work '-
Demolition 0th performed. Indicate the value (rounded to the nearest dollar) of all
lj]
mechanicalpaterials, et.u..iiptrient, labor, overhead, and profit.
.. „ er
A.:$10.hiltitgei .Wiltit .,:,`: . . ...
Value
51,1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
: $
,.. i :. F!g ' 0 1 Afk . ' 1 ,S4k .. i.0 . 044[ET‘`Z . "fiIitNifS,F.F.,`ES* --1
El Multi-family 0 Master builder 0 Othcr .. .For special inprination use checklist.
---- -- -, —
Descnpu oil I Qty. 1 Ea. 1 Total
,V.;;,,iiii•;iplSilvVIIIIiig' i)rik•Vik,t4,6617646:::kff!. :-.7.. .,.,
1 .." '! H
- 4 ''' " '''',,'' l' ;''• I .. ' ■•■:.' ...,,., :'.'%1 " :......:: OH n g
---...
fob site address: OPIU (.7 ,_-)(-)0 (,) et .. Air conditioning or heat pump L. 14.00
(rcaulles sitc plan ShoVvI318 Onceniefin _
'
City/Stale/ZIP:liklkd q--7),.5z: Furnace 100,000 13TL/ (ducts/vents) .. I . 14.00
f 1 4,60
) .. ,
' ' Furnace 100,000+ BTU (dicuivents/ i7.)0
Suite/bldg./apt, no.: ()
Project name:
_ . • .....
—__, . -
Gas heat pump 14.00
„,.
Cross street/directions to job site:
Duct work 14.00
. ..
— liydranic hot water system 14
____
_.
Residential boiler (radiator or
hydronic) 1 .• .
. — •••, .. ,— Unit heaters (fuel• not electric),
in-wall, in-duct, suspended, ctc, ... 10.00 ..
Rue/vent for any of abor 10,00
Subdivision; Lot no.:
.. ..,„ w ..._ . Other: 10.00
Tax map/parcel no,:
Other fuel appliances
:4.;•,911 r frIliaAfiiiqitl,'Iill—efijtIfiliT77.7. _
r, ..' , FR '".i!•,'''T ,'•. Water heater 10.00
ki •, --!;'• ...-',..''.''',-tn. .- 'll,lje'l'';; ''''
Gas fireplace 10.00
f 1 .I& .. , , ■ 4 _, ,
. IA a ce Flue vent for water 1
:lever O gas
...tirciplaCe , 10,00
-
-- -- - . -- ,. Laughter (gas) 10.00
Wood/pellet stove 10.00
- '' - • ••• -- ...
Wood fireplace/insert _ 10.00
I /liner/flue/yen t 10.00
. .0 46 'iii:ot Witi,' ..•,,.,,, ,. :! - :.,, , V , Efr:T.0:21;*..;:::. ,, J: ,. ;!..!7:;,i . . : : , ::; Ch-rrin-5Y -
f,,... ' • ! , , , ,, ,1- •• , .. - , v -rvl",- -.., 'r ',,•••• l :1.1 .'•'• "I''':• - ';'•"•:•,,,•••'" ;.:‘' • -. *:.'.. , ''''''•"' : r Other: 10.00
Name: \..._ ajapi ,/.8.(LcDr) ........ Environmental exhaustand ventila inn .. _....,
Range hood/other kitchen
Address:
equipment - 10.00
City/State/ZTP: Clothes dryer exhaust - 10.00
, .., . . - .... - .. -
- Single exhaust (bathrooms,
'
Phone. • . ) 4r OP • - ' Fax: ( ) toilet comertments, utility rooms) 6.80
— -
A%,-,Tilifiltiof:,:7",J .$ „.;:,„.,; ,., Attic/crawlspacc fans 10.00 -.......
10,00
Business name: Tr) Cavrty Temp (Ovrti I Fuel ' ,
-,...., .. •
---
Contact name:
55.40 for first four; $1.00 for each additional
-„,....
„ ... .
Furnace, etc. _
Address: 0 I O E3 - .[. -- aCkairn(15 RAZTUYNC)
Gas heat pump
...
cit cnion ci -N 0K) _ 6(70 — 45 Wall/suspended/unit
-
Phone: (t0 ) 5 -; )9D Fax : (52 ) 5 1 q (5
.,. ,. War het E-mail: Fireplace _.... ..,„
,
Range __
• ' - .'it;- , ' , v
tenpoor „ 1 11 j) Barbecue .‘‘,.. •
Business name: TO (0( in v fay Cn-rti-ri ...c,lothos dryer (gas)
• ,
Address: t?)i50 G, (106Saat5 i)vr \r-C, L17 gOrNit:ii
sub(otAl
cityisrateJzfp, cm n 014 g c.. 2-
., , ...
,.......,
Minimum permit fee ($72.50) -
phone; (r_1,. .- - 22 2r=r I 63x ( 6. .5'7.-(1.1'1 ,.
Plan review (25% of permit fee)
-
_. . ,
CC Iic.: '7
..._ State surcharge OM of permit fee)
...-.
,., -. -- .._
TOTA_L PERMIT PPE
Authorized signature: 4 ,,c ., /k , ,. /7?(/, ,L7C7,e...-_.-___ Thli permit apiflicetion expires Its permit is net obtained within IRO
days Ater it hag been accepted AS complete,
,_..
—
Print name: . piat-Le m t o ,,,) Date: A- (, $ 0 • Fee inntnodology !;et by Tr-County Building Industry Service Rnard
CITY OFTIGARD
BUILDING DIVISION
PERMIT #: MEC2066-00614
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211/2006
Phone: (503) 639-4171 a nollmati I
Inspection Requests (24 Hrs.): (503) 639-4175 _Ji I
INSPECTION WORKSHEET FOR DATE: 1/1212007 TIME: 7:04AM PAGE: 30
SITE ADDRESS: 12045 SW 122ND CT CLASS OF WORK:
SUBDIVISION: YE C)LDE WINDMILL LOT #: 010 TYPE OF USE:
PROJECT NAME: ANDERSON
DESCRIPTION: Replace furnace.
OWNER: ANDERSON, JANET PHONE #: 503-059.8371
CONTRACTOR: TR! couNre TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 1112/2007 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
699 Mechanical final 042063-01 503-557-2220
Corrections/Comments/Instructions:
CL6, crgiegi- totA/1/14 11/4-25Z- . q 4 " . " 5 0 7 91 6tel Ge-/ (j 72-0-'rir"
i4X
ASS PARTIAL APPROVAL El CANCEL I I NO ACCESS
I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: / Date: — /) 7 Phone #: (503) 718-
_ . .