Permit 111 41 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00017
TIGARD DATE ISSUED: 1/12/2009
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104CC - 07200
SITE ADDRESS: 13515 SW ASCENSION DR ZONING: R -
SUBDIVISION: HILLSHIRE WOODS LOT: 016 JURISDICTION: TIG
PROJECT: PAYNE
Project Description: Replace gas furnace with like kind.
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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
CHERYL PAYNE Description Date Amount
13515 SWASCENSION DR
TIGARD, OR 97223 [MECH] Permit Fee 1/12/200. $72.50
[TAX] 12% State Surchai 1/12/20a $8.70
Phone: 503- 524 -4241
Total $81.20
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 848 -3838
FAX 503- 356 -9002
Reg #: LIC 43124
This permit is issued subject to the regulations contained in the Tigard Munidpal 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 OU NC by
calling 503,246.6699 or 1.800.332.2344.
Issued By: CZ aef 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.
JAWS 17:00 FROM :GAROKEN ENERGY CO. IN 5033569002 TO: 5035981960 P.3
Mechanical Permit Appl s IV (tilt tit tlrl, l i (.ill
City of Tigard Received - o 7
DatcB / f o9 � Permit No.:. e e _
II • 13125 SW Hall Blvd., Tigard, OR 972zA N 0 21 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit.
I lc A it L . 0 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: ® See Page 2 for
Internet: www.tigardror.gov Notified/Method: W, Supplemental Information
. BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead; and profit.
CATEGORY OF CONSTRUCTION Value: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty, J Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ) 3 �I sw �S Air conditioning or heat pump
L Q r] S' ll ln ,) (requires site plan shuwiui{ placement) 14.00
City/State /ZIP: , I ya `12- D ? /3 1 ." -- Furnace 100,000 BTU (ducts/vents) / 14.00
" Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: PQ-c_ Q_ Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
rU �, 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. 14.00
Subdivision: Lot no.: Flue/vent for any of above / 6.80
. Other. 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
(,moo 0 � S. `` S t " LA-,( v∎G c-e.. Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
_
�( � Other: 10.00
(.
Name: -ter d-1 ., . Environmental exhaust and ventilation
Address: e�
Range kitchen 10,00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (570"))) 5 L 4-4 a- ( Fax; ( ) toilet compartments. utility rooms) 6.80
0 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: �/ Other: , 10.00
n w ` ov, Fuel piping -
Contact name: 55.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax :. ( ) Water heater
Fireplace
E -mail: 'M'v4.p,.. e- V.c�v t za n . "r Range
CONTRACTOR Barbecue
Business name: (-29, GXO y to A ) Clothes dryer (gas)
�C �/►� 1 Other:
Address: -.S..//, S l •a A MECHANICAL PERMIT FEES*
City/ State/ZIP: (.i )�Y, �(� ��. r Subtotal
Phone: (51 $ U� _� .� Fax }tF- � r� Minimum permit fee (572.50) 7,
3 7 3 )356„ v+, Plan review (25% of permit fee)
CCB lie.: 4 --6 `a L State surcharge (12% of permit fee)
TOTAL PERMIT FEE s ( ,'
Authorized signs \ �� Tbis permit application expires if a permit is not obtained within 180
1 --mac ____q l D days after it has been accepted as complete.
� 0,,, p cYACit -1.- 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2009- 00017
13125 SW Hall Blvd., Tigard, OR 97223
n Ai A■ DATE ISSUED: 1/12P009
Phone: (503) 639-4171 .0 4zo ollits
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 1/28/1009' /
TIME: 7:01AM PAGE: 16
SITE ADDRESS: 13616 SW ASCENSION DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE WOODS LOT #: 016 TYPE OF USE:
PROJECT NAME: PAYNE
DESCRIPTION: Replace as fur
with like kind.
OWNER: PAYNE, CHERYL PHONE #: 603
CONTRACTOR: GAROKEN ENERGY COMPANY PHONE #: 503_848.3838
Inspection Request Scheduled For: Date: 1/28 Pour Time:
Code # Inspection Description Confirm # Contact # Mess. • -
698 Mechanical final 080064.01 W3-624-4241 9 FA
Corrections/Comments/Instructions: q :00 Avut
m i t v off__ t _A-Ggz_____
i , PASS E PARTIAL APPROVAL I I CANCEL fl NO ACCESS
FAIL ' CALL FOR INSPECTION
7
--- 0 ADDITIONAL FEES ASSESSED
Inspector: .■.....___ Date: / .ig/07 Phone #: (503) 718- Z-4
r
. _. „
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for H �c . 9.0og -00017 REQUIRED ON GREEN INSPECTION CARD.
✓ ,.: - Code:. ; :Ins`;ecuon'Descri` ton : +'., , '- ; ..f: PASS.Daie ".:;;.B ' ✓`:, Code.f :.Inspecfioin =Description`;- .. ?PASS`Dat`e,.`.'';:By-
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG-Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceding cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 1- Iydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
•
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - , Plumbing Permit
915 Fire alarm rough-in 305 1 lumbvng underslab
310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm dram
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary, sewer
498 Grading final 595 Misc. i pcction:
499 Final inspection 599 Final inspection
I: \ Building \Forms \inspCard- AOP- Blank.doc 02/02/07
r • : ., i
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00017
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2009
PARCEL: 2S 104CC -07200
SITE ADDRESS: 13515 SW ASCENSION DR ZONING: R -7
SUBDIVISION: HILLSHIRE WOODS LOT: 016 JURISDICTION: TIG
PROJECT: PAYNE
Project Description: Replace gas furnace with like kind.
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: 1
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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm:
OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
CHERYL PAYNE Description Date Amount
13515 SWASCENSION DR
TIGARD, OR 97223 [MECH] Permit Fee 1/12/20. $72.50
[TAX] 12% State Surchai 1/12/20. $8.70
Phone: 503 - 524 - 4241 .
Total $81.20.
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE "'2
BEAVERTON, OR 97006 REQUIRED ITEMS AND REPORTS ,
Contact #: PRI 503-848-3838
FAX 503 - 356 -9002
Reg #: LIC 43124 t`
iii
4
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. , 4 "0,
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 OU NC by
calling 503.246.6699 or 1.800.332.2344. Web
a.
Issued By: pL a46_04_41 Permittee Signature: f > le)—�
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.