Permit CITY TIGARD MECHANICAL PERMIT
" COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00350
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/14/2007
PARCEL: 2S 104AA -11200
SITE ADDRESS: 12345 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 131 JURISDICTION: TIG
PROJECT: PEZZOTTI
Project Description: Furnace replace.
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:
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
JEFF PEZZOTTI Description Date Amount
12345 SW 128TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 6/14/2007 $72.50
[TAX] 8% State Surcha 6/14/2007 $5.80
Total $78.30
Phone: 503- 702 -8969
Contractor:
COST PLUS HEATING + AIR
7132 N FESSENDEN ST
PORTLAND, OR 97203 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 286 -2009
FAX 503- 286 -6552
Reg #: LIC 47978
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.
/ L A jo_s_.
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Issued By: it Permittee Signature: �,L,� L _ _
I _-
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.
Mechanical P��rJpj i s I OR or l lc I; t Sl u l
City of Tigard Date I . P ermit No.
II tY g DaWBy. o , 3.
Ill 13125 SW Hall Blvd, Tigard, O 224 A n , Plan Review
. Phone: 503.639.4171 Fax: 5 .19.6 L V U r Date/By. Other Permit:
. G A 1 11 Inspection Line: 503.639.4175 Date Ready/By: Jolts:,. '. See rage 2',for
Internet: , www.tigard vf OF IlOARD Notified/Method !r- - . SapplemefitalInformation
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Mechanical permit fees* are based on the value of the work'.
❑ New construction Addifion/alteration/replacement performed.Indicate:the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical, materials, eq(iipment;labor, overhead, and profit.
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1 -and 2- family dwelling El Commercial/industrial ❑ Accessory building
For, specutl.wformalron use checklist.
❑ Multi - family ❑ Master builder r❑ Other: Description I Qty. I Ea. 1 Total
ih�"r^ �"' -. 1 t bs i 4 F k. '& d i A ce1 U t N b,, E a v t S . Heatin COOIin -
irG ..,.»n i.•� ��i4i�.,1 �_�•3? ...ht,r"3Sa? - :'"�Zu��t�^~ � .3%�a> � S fi . � �)'° ( •C F { Y tom � �
Job site address. Z3 YS 5 c i ., H Air conditioning or heat pump
(requires, site plan showing placement) 14.00
City /State/ZIP: -77y /d alt 4 ? 72 2_3 Furnace 100,000 BTU, (ducts/vents) t .. 14.00 /V
Furnace 100 000+ BTU (ducts/vents) . 17.90
Suite/bldg. /apt. no.: I Project name: Gas lieat.pump 14.00
Cross street /directions to job site . Duct work 14>00
Hydronic hot water system 14.00
. • Residential boiler (radiator. or
. -hVdronic) r • .14.00 ' :
;Unit.beaters;(fitel=type, not electric), •
• in -wall, in -duct, suspended, etc. .10.00. ,.
Flue/vent for any of above e " 10.00 1 L! •
Subdivision: 1 Lot no.: 10.00
Other: •
Tax map/parcel no.: • Other fuel appliances
d' z n g * ra t o r s .` a A '" , r - N r , Water heater ' ` 10:00'
,fir 11A1:ri i � e t � �' 0 m � s " - . k? x (t uw.' l G t l' `
d l L ���Ia { ., .r.xc�s "a cz.r. a,...
,
Gas fireplace 10.00
64-s 4.j IC-CAA-Zeta - Flue vent for water heater or gas .
fireplace 10.00
Log lighter (gas) . .10.00
' Wood/pellet stove . 10.00
Wood flreplace/insert . 10.00 •
e - , ',. ' �t` } t� r a °" 0 Fr , .,Kg li7r;1 .� ONS., giwA Chimney/liner /flue/vent 10.00
'` a' := 3 i ti .' a a .t. - :.0 ti glldl` i :LZt .�,..i.:, dac a ' :.aig:Ift. other 10.00
Name: 2" �c_� pc.'Z, -, Z04-44 # Environmental exhaust and ventilation
R'an a hood/other kitchen
Address: i 23(/ 3" 5'i, �, . ( ' L• �3 equi ment . . . ` . 10.00
City/State/ZIP: - 1 7 75-0-11 (rn. 972x3 Clothes dryer exhaust : .10.00
. . Single -duct exhaust (bathrooms,
Phone: (5i ) 752.- WO Fax ( ) toilet compartments, utility rooms) . 6.80
r r r "� j, ��' K r �s t} ' r ' � � a z Attic/crawls ce fans • 10:00
�u./ �... k`' �#.aw a_zu.t rraw x .. :. cu., .. <r f' b gym . - 10.00
Business name: Fuel-piping
Contact name: S' s'A,a~ $5.40 for first four; $1.00 for each additional
• Furnace etc.
Address: Gas heat pump •
City/State/ZIP: Wall/suspended/unit heater
Phone: (3 7E1 - c), v I Fax: : ( ) . . Water heater
Fireplace
E -mail: Range
vs"a1 °' a : : ::07 :::zp0'i" `iS ° x 4 ; rt , ; , 5, i 44:' Barbecue Clothes dryer (gas)
Business name: a
7/ +rm i, . / , - _ � - ,/� Other: y��
7 ` /` ' .5� T . . {' ' 1-4. r'I 14 + �41,14,.-:•,: ` . •' ��' at�r •Y°in�' $: 44 X34 S 3 . :
' tii "- -I ,S rtt
Address: ces7 e� emu,., f.s.�zn. „a3m wa3 ar t..5v a" . .s _gym. x :
City / State/ZIP: T d O't'-LQ a / Qie_. q 72 Subtotal
// Minimum permit fee ($72.50) 7L s'
Phone: (j" ) z. 4 - 200 Fax: (JD) ) - (o , -6S _ _ Plan review (25 %.ofpermit fee)
CCB lic.: Lr /�l7 e Me /u NOW State surcharge (8% of permit fee)
. TOTAL PERMIT FEE 753 3 s
Authorized signaturei4 c,/F�� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: .Sin, , Sift je n^) Date: • • Fee methodology set byTri- Courity'Building Industry Service Board
I: Building \Pertniu\MEC- PermitApp.doc 04 /06/06 440 01/02/C014/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00350
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611412007
Phone: (503) 639 -4171 �,u�b'����Ofl���
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'!+i _..
INSPECTION WORKSHEET FOR DATE: 7/13/2007 TIME: 7:00AM PAGE: 64
SITE ADDRESS: 12345 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 131 TYPE OF USE:
PROJECT NAME: PEZZOTTI
DESCRIPTION: Furnace replace.
OWNER: PEZZOTTI, JEFF PHONE #: 503 - 702 -8969
CONTRACTOR: COST PLUS HEATING + AIR PHONE #: 503.2062009
Inspection Request Scheduled For: Date: 7/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # M age
699 Mechanical final 0551860 503- 781 -9090 Y
Corrections /Comments /Instructions:
C �f
■Ae' k S
Cd2
Ire PASS I I PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: M • Date: — 7//3/0 1 7 Phone #: (503) 718
.