Permit CIT OF TIGARD MECHANICAL PERMIT
i I DEVELOPMENT SERVICES PERMIT #: MEC2006 -00342
'' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/25/2006
PARCEL: 1S133DD-10000
SITE ADDRESS: 11774 SW 125TH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 137 JURISDICTION: TIG
Project Description: Install furnace and AC.
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: 1 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:
Owner: FEES
GARSTECK, CHRISTI NE Description Date Amount
11774 SW 125TH CT
TIGARD, OR 97223 [MECH] Permit Fee 7/25/200€ $72.50
[TAX] 8% State Surcha 7/25/200€ $5.80
Total $78.30
Phone: 503- 347 -9841
Contractor:
EASTSIDE HEATING + AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 774 -3281
FAX 503- 774 -3057
Reg #: LIC 3258
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: K ‘ht . _ �! Permittee Signature: I.:4 r •
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.
Jul, 25 06 10:31a Fax e . er 503 - 774 -3057 p.2
ix ", ' 1 Y /
Mecha P A i l �' a>� j1 • FOR OFF (SF O\i,1'
` • �
city of 'Tiffard Received / ' `
Y Lee .� ..
13125 SW Hall Blvd, Tigard, OR 972.23 UL 25 23 c p� R cvi r
Phone: 503.639.4171 Fax: 503.598.196 200& , Date/By: ahaPere°t: Date/By:
Inspection Line: 503.639.4175 t _ 1 f I Date B t� '� �. ► ill Set Page t fur
Internet. www.a.tigard.or•us O F I L Notified/Method: :1 1 �> Supplemental Information
BT Trl" fiT1\Tr niat rr r i►
+`17. <;:> # ti)::TYPE OF �- . ;fie_ :;:::y . c .- E,-. - .,.:, ;. :::; COMMSIiCIAI.:.ly1FL� iSCSFDVL IJSE._GRECictist :
, °
❑ 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
D Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
:, r ;.'..4 - ;z ITEGORY.'_OF CO &= r t i , ;:i; >.`; `. 3:K Value: S
- >'::. RID ?! - EQIl1Y I4
EBtlEN FJ SYS 1 FEES""=;;'_ r
] - and 2 family dwelling El Commercial/ ndustrial El Accessory building .. ' `' ". ' .. TMS
Far special information use checklist.
Cl Multi - family ❑ Master builder ❑ Other.
Description 1 Qty. Ea Total
;:' = JOB `7NFORl Y(ATION;:'AN D [.00ATtOP[::��:.. ,. �' t" 4 Hezting/coalia
Job site address: ` l t 714 I ] f y
Air conditioning or heat pump ) t 1 4 -
fre wires site an showing ailment 14.00 `
City/State/ZIP:---T-t. 9 OL"r_ / n K 9 -- r i 'S Furnace 100,000 BTU (ducts/vents) t 14.00 ] Li, 00
Furnace 100,000 -STU (ducts/vents) 17.90
Suite/bldg. /apt no.: Project name: C IS L i - 1 -7 ( s-4P! pump 1� Gas heat um 14.00
Cross street/directions to job site: Duct work 14.00
Hvdronic hot water system 14.00
Residential boiler (radiator or
hydron ic) 14.00
Unit heaters (fuel -type, not electric),
in -wa11, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.1)0
Tax map /parcel no.: Other fuel appliances
rY: T'_ .: 5+r c ,:i 10.00
,��' c . _ � r "_� ; s ;:. i " ,i : t � water heater
'' -�`�- - y ,a' � _ � DFSCRIe770N OR � WORK : �`��
t /' . Gas fireplace 10.00
n �fk- I L ( a S -'f ( -r r7 el rip C(_ r) (i. Flue vent for water heater or gas
_'' fireplace 10.00
Log lighter (gas) 10.00
'Wood/pellet stove ( 10.00
I Wood fireplace/insert I 10.00
1 ,,,.:... _ ,:, _ Chimney /liner / flu elvent 10.00
T - %' PROPEI Y;OWNER - fir - ,.. Tk ?' -1 TlEr r `- ;a"•:. . _ -
Other. i 10.00
Name: (h � f C ,_-1----'k---f--e r E nvironmental exhaust and ventilation
Address: C! Range hood/otha kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( 3) .1.„1 7 _ (is-Li ! Fax: ( ) toilet compartments. utility rooms) 6.80
(`; %; :-4•D .PPE,thki-r °f :` r=•.: ° :' x -': - - ` ,CONVTACI: PERSOlY . :. !: ; Attie/crawlspace fans 10.00
Business name: ] ' ( r
Other: 10.00
G.t%Z�� t C_} t? �YP(k�-H ,,-- C t +- ,c6 )- rG t') Fuel piping
Contact name: e A t' $5.40 for first four, 51.06 for each additional
Furnace. etc. .
•
Address:
Gas heat pump
City/State/ZIP: Wall/suspendedhmit heater •
Phone: Fax :: ( O ) Water heater
( 3) � 7L(.���1 J 3 771- /- �Ck,� -7 Fireplace
E -mail: i? n ra. Q e- 1 A Q hu (.`4 -1 (6 rr-1 Range .
-3r -: ' r1r 4.:WCONFRACTOR. ` �'i`•`',a: - r : -. 4' : . z Barbecue
�/ { � Clothes dryer (gas)
Business name:
l ll > ! P{� tA.'Yl 1' 1 1' n Other'
Address: .
7.� �' , S� -c 1--1 1-1 C C r� R. :P-, I Iv A '�
n>�c>HAxIt'ATp1ex]r_>ES*:,;; ; .:.:.. ;
City /State/ZIP: I l 2 - � Subtotal
pc) Y � l G1 -✓� Gi _ ti) ` Minimum permit fee ($72.50) '7� _ 5v
Phone. ( 3Z) - T7�_ �� Fax. (f ) 2) 7 7t�'_�G; 7 Plan review (25 %ofpermit fee)
CCB 1ic.: 3 ,, - State surcharge (8 %ofpermit fee) 5 , `
G � I. TOTAL PERMIT FEE 7,s so
Authorized signa4rre G �iYI! G
This permit application expires if a permit is not obtained within Ise
( • days after it has been actrptcd as complete
Print name:_ •p /IA_ ( f �, ,stn k Bate: 7/ /l („r l r) Fee methodology set by Tit-County Building Industry Service Board
i:lBuitdin -Aerm itApp.doc I2/n3 440 -46 ITT (II /02./C OM/WEB)
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INSTALLATION ADDRESS: // Li S
PROPERTY LINE ?�
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CITY OF TIGARD ;--
BUILDING DIVISION / PERMIT #: MEC200G.003342
13125 SW Hall Blvd., Tigard, OR 97223 , " DATE ISSUED: 712610006
Phone: (503) 639 -4171 '4p� iO4( I /r
Inspection Requests (24 Hrs.): (503) 639 -4175 1.1.
INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7:04Am PAGE: 105
SITE ADDRESS: 11774 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 137 TYPE OF USE:
PROJECT NAME: GARSTOCK
DESCRIPTION: Install furnace and AC.
OWNER: CARSTECK, CHRISTI NE, PHONE #: 503-347 -9841
CONTRACTOR: EASTSIDE HEATING + AIR CONDITIONING PHONE #: 503.774.3281
Inspection Request Scheduled For: Date: 8412006 Pour Time:
Code # Inspection Description Confirm # Contact # ► - ge �v
699 Mechanical final 034193 - 01 503 - 7743281 Y
Corrections /Comments /Instructions:
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) // ' . SS ❑ PARTIAL APPROVAL ` n CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date:�k - / / 0 Phone #: (503) 718- - 2-4 2-1