Permit C ITY OF TIGARD MECHANICAL PERMIT
l& SERVICES PERMIT #: MEC2006 -00344
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/26/2006
PARCEL: 2S111 DB -04900
SITE ADDRESS: 15207 SW ALDERBROOK PL ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 411 JURISDICTION: TIG
Project Description: Replace gas furnace, install A/C.
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: 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
NORM HENKLEMAN Description Date Amount
15207 SW ALDERBROOK PL
TIGARD, OR 97223 [MECH] Permit Fee 7/26/200E $72.50
[TAX] 8% State Surcha 7/26/200E $5.80
Total $78.30
Phone: 503- 684 -4486
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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: .+�����./� y Permittee Signature: _ 1 Q1�
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 Permit A,,p lication FOR OFFICE ISE ONLY
C %By: of Tigard Ca i , D, 4 permit N.. /C.t 2DO, D0 Vc
1315 3125 SW Flail Blvd., Tigard, OR 9 223. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit.
Date/By: •
Inspection Line: 5C3.639.4175
AA; -
I Date Readye3y. l i / B1 S ec P 2 for
Internet: www ei.tigard.or.uS q, JUL 2 6 2086 Notified/Method. -51 Suppleteeaal Information
Cir1t P �J 111 `III
OA �' Alit} COMh1EACIAL FEE" SCHEDEILE —USE CHECKLIST
El New construction f� � � �}� i i - Q /r gent Mechanical permit fees' are based on the value of the %tuck
q ?l performed. Indicate the value rounded to the nearest dollar) ot'all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and prorit.
CATEGORY OF CONSTRUCTION Value: $
.-1- RESIDENTIAL EQUIPMENT; SYSTEMS FEES*
and 2- family dwelling ❑❑ Commercial/industrial ❑ Accessory building —
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. I ha I This]
JOB SITE INFORMATION AND LOCATION Heating/cooling
/ 7 /� / p
Job site address: /J (r�t� �� L � Air conditioning g or heat p n
/ ( (requires sire plan showing diacritical) / 14.00 •
City /StatelZlP: Furnace 100,000 BTU (ducts/vents) i 14.00
r
Suite /bldg. /apt. no.: Project name:
Furnace 100,000+ BTU tductsvents) 17 (./0
I Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronie hot water system 14 00
Residential boiler (radiator or
hydronic) 14.(0)
Una heaters (fuel -type, not electric)_
in -wall, in -duct, suspended, etc. I 10.00
Subdivision: Lot no : _ Flue/vent for any of above 10 00
Other 10.00
J Fax map /parcel no.:
Other fuel appliances
1
DESCRIPTION OF WORK Water heater 10,00 I
Gas fireplace 10.00
�/ C �� .. 1- /!`7GL G Flue vent for water heater or gas ,
— . _ f► f , /1 `� + P replace t lr.U(
�<� I Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 1 0.00
iROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 13.00
y�� f� ) Other: 10.00
N
•
ame: . /( � r - i I �f•Ai !�
✓' �� � rd Environmental exhaust arid ventilation
Address: Range hood /other kitchen
equipment t 10.00
City/Stale /ZIP: Clothes dryer exhaust 10.00
3 % Pi/ �r/ no=:' ( ) Single -duct exhaust I bathrooms,
Phon • ) (> 7 Fax: toilet compartments, utilay rooms] 6.80
❑ APPLICANT ,t CONTACT PERSON Attic /crawlspace fans . 10.00
Business name: Other: 10.00
Fuel piping
Contact name: 4 � M /
a b/ first 55.40 for four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump 1
City/State/ZIP: Wall/suspended/unit heater
Phone 7 2 ) / j �l7oy� Fax: n � ) � � � v i Water heater
! f Fireplace
IC- taail:
Range •
CONTRACTOR Barbecue
Business name: / ei / Clothes dryer ]gas; ^~
/ � b! G A'd y 1•C' (.06),/,.,,,y, Other:
Address: P. Vy 34 C ` MECHANICAL PERMIT FEES
CityiState/ZlY: � '� � �� �,� Subtotal I I
Phone: I: {, J) / 7 ,/ 0 77 6 , c f F 2 . ) .5---g / / . /) Plan Minimum permit tee (572.50) 1 ;
CCt3 ti t' �} `F f v ; )
%TJ 7 Bbl Plan review ,25 �a of permit fee)
7Z;, 3, </ i State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: Tilts permit application expires if a permit is riot obtained within 1 M
days after it has been accepted as complete.
Print name :"4 /,,7 O Jh ail: 7� 6, , /p4 * Fee methodology set by Tai County Builds :tg Industry Sen'tce Baud
i •.nuilding PvmIApp doe 12:03 ,. 440 -46 Tr (} 1/OZ'COM/N'EB)
Z 0L30969C09 buReeH eigwlnpo eb1:61. 90 93 Inf
ar
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
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I
ADDRESS: 7f �1ao
e 0LZ0969C09 BuReeH elgwnlo0 e9 6: L. I. 90 9Z In!
CITY OF TIGARD
BUILDING DIVISION 7 PERMIT #: MECat f) -003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/'26/2006
Phone: (503) 639-4171 � a ��l�4Ii ,
5
Inspection Requests (24 Hrs.): (503) 639 -41 1.1..
INSPECTION WORKSHEET FOR DATE: 8/4/2006 TIME: 7:04AM PAGE: i01
SITE ADDRESS: 15207 SW ALDERBROOK PL CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO .7 LOT #: 411 TYPE OF USE:
PROJECT NAME: HENKLEMAN
DESCRIPTION: R ep l ace gas furnace, install A/C.
OWNER: HENKLEMAN, NORM PHONE #: 503 - 684 -4486
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 - 6242704
Inspection Request Scheduled For: Date: 8/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
698 Mechanical final 034345 -01. 503- 624 -2704 N
Corrections /Comments /Instructions:
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/4 i I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector.: Date: /(-‘ 7O 6 Phone #: (503) 718- 2--(12Y