Permit ids
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CITY TIGARD MECHANICAL PERMIT
°' DEVELOPMENT SERVICES PERMIT #: MEC2006 -00540
' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/3/2006
PARCEL: 2S 103BC -02300
SITE ADDRESS: 12295 SW ALBERTA AVE ZONING: R -4.5
SUBDIVISION: CANOGA PARK LOT: 007 JURISDICTION: TIG
Project Description: Replace furnace
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KAREN CHAVEZ Description Date Amount
12295 SW ALBERTA
TIGARD, OR 97223 [MECH] Permit Fee 11/3/200E $72.50
[TAX] 8% State Surcha 11/3/200E $5.80
Total $78.30
Phone: 503- 332 -6705
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
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: /• ��� ` / ` Permittee Signature:
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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FOR it €11 1 11 ? : R � i " 1 ° i..'t'
. r- Garof Da �� 3 O / Permit No I / /(� — O � •5-1
13125: "S •W •hall Blvd., Tigard, OR 97323., f P;� Raview
Phone: 503 639`4171 Fax: 503.598.] dti i i < 2006 tr , rr � , Date/By: Other Permit:
Inspection Litie: • 503..639.4175 p �� a ' Date Reaa Notified/Me/B : See Pa 2 for
�) T RD l/ _ _., Y Y 5u mental information
Internet: wW%w:ci:tigard:or us . , 5 , t- Notified/Method: Pp
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❑ Ne w-construction I - ' dition/alteration/replacenlent Mechanical permit fees* are based de the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition Daher: mechanical materials, equipment, labor, overhead, and profit.
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Value: $
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- and 2- aniil dwelling Commercial/industrial ❑ Accessory building
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y dlli g ❑ g For special information use checklist.
0 Multi- family •- ❑ Master builder ❑ Oth Description I Qty. j Ea. ' Total
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Iob site address. ir conditioning or heat pump
� L _ A I (requires site plan showing placement) 14.00
City /State/ZIP:: i C l �6) D-3 Furnace 100,000 BTU (aaets/vents) ( 14.00 1 �?, !A
Furnace 100,000+ BTU. (ducts/vents) 17,90
Suite/bldgiapt..no.: Project name: X Gas heat pump 14.00
Cross sheet/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 10.00 ,(Q ,GO
Other: 10.00
Tax chap /parcel no.: Other fuel appliances
i i , ^ ry '= Water heater 10.00
mot:. ;
Gas fireplace 10.00
/ o ` Flue vent for water heater or gas
fireplace 10.00
Log lighter (g 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
,_ u L ti Chimney/liner /flue/vent 10.00
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Name:' / ,/ U -
_Other: Environmental exhaust and ventilation
Address:.. Range hood/other kitchen
4.„ in , A - . equipment _ 10.00
City/State/ZIP: 4.. A 1 4 ) d-a 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
: 3 r - D� Fax: ) toilet compartments, utili roams) 6
Phone
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.14'.:::; £ "� j £) t £ � t i t t {. Y �'1 S Y N � � R65�' f S 4 ti'E ". Attic/crawlspace fans 10.00
.,..i, S � �t .. to F' ac. ff �stdi�
10.00
Business name; . Other:
1• A - 4 ✓� A Fuel piping
Contact 'name: At in a. IA 'lla $540 for first four; $1.00 for each additional
Address: ' Pomace, cte.
r . t 4II . 1t Z Gas heat pump
City /State/ZIP: ii ai r / Wall/suspended/unit heater
Water heater
Phone :. C50 t -A .. d V , Fax: : ( ) Fireplace
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Business name:
' Clothes dryer(gas)
• Other:
Address: ri b a: 1
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City/State/ZIP: _ a ubtotal Dq i .:_
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:Phone: ( ). Fax: ( ) Minimum permit fee ($72.50) R--,
Plan review (25% of permit fee)
CCB. lic. : 8 State surcharge (8% of permit fee) f=j
TOTAL PERMIT � i.
This permit application expires if a permit is not obtained within 180
Authorized signature:
Nri p. 1 „_ ✓ days after it has been accepted as complete.
Print name: . . , 4 r Date: ( it ' Fee methodology set by Tri-County Building Industry Service Board
i1 B uildiopnmitaMEC-PemtitApp.doc 12/03 4404617T(11/02/COM/WEB)
Z00 /T0012 XVd CV:FT 9002/ZO/TT
CITY OF TIGARD .. -.op-
. BUILDING DIVISION PERMIT #: MEC2006-00540
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2006
Phone: (503) 639-4171
.„..rilil p
Inspection Requests (24 Hrs.): (503) 639-4175 t
INSPECTION WORKSHEET FOR DATE: 11130/2006 TIME: 7:00AM PAGE: 82 .
SITE ADDRESS: 12295 SW ALBERTA AVE CLASS OF WORK:
SUBDIVISION: CANOGA PARK LOT #: 007 TYPE OF USE:
PROJECT NAME: CHEVEZ
DESCRIPTION: Replace furnace
OWNER: CHAVEZ, KAREN PHONE #: 50.332.5706
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503-281-0752
Inspection Request Scheduled For: Date: 11/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 040382-01 503-521-1146 N
Corrections /Comments/ Instructions:
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- 744; e S n PARTIAL APPROVAL 0 CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: /./ ei G. Phone #: (503) 718
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