Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00641
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/1/2007
PARCEL: 2 S 104A B -10800
SITE ADDRESS: 13263 SW BENISH ST ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 6 LOT: 137 JURISDICTION: TIG
PROJECT: FIEBICH
Project Description: Gas 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:
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: 1
Owner: FEES
FIEBICH, DAVID G + LAUREN J Description Date Amount
13263 SW BENISH
TIGARD, OR 97223 [MECH] Permit Fee 11/1/2007 $72.50
[TAX] 8% State Surcha 11/1/2007 $5.80
Phone:
Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 - 598 -0718
PRI 503- 620 -5643
Reg #: LIC 66578
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: e 9-7,
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.
NOw' /01 /2007 /THU 01:59 PM _ FAX No, P, 001
Mechanical Permit A' 'Rea '.! E i ) FOR OFFICE USE ONI;h'
Received
City of Tigard Davey: �/ / B i Permit 11 C.,0200 — pit, 13125 SW Hall Blvd., Tigard, OR 4 1, 2 -- " Plan Revises
Phone: 503.639.4171 Fax; 503.598.19t`w0, Ov — 1 i l II' / Lsn .)• t , . Date/By: Other Permit:
Inspection Line; 503.639.4175 IV _NA .!j i i ■
Date Ready/By: Jude: 0 See Page 2 for
Internet: www.citigard.or.us Gay -fi '__U1.' -- Notifed/Method: % Supplemental information
li V L 1 � 1 ®�
; . 7) a (_ , t A , 11„' q , '1 '', s p ti �p,.�.r�f 1.16 ■ 1 t1 �:'�j ,my� �(p' a , . • j"4 ,
77'SiMG' ei w � M . 10 a 3 A l'�bG 0,: !.,, �.: ,y. ' 6 .:` - :. 1 ;; t "' ' 61,1F�.�4rgs :i4i' S�fl J , .� 0 .FA2 *+1s gEri � .i lie4 44:,± . ' s,
❑ New construction C/ 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
Li Demolition ❑ Other: mechanical materials, equipment, labor, overhead ,and s profit.
�,� 4 e a t ) ¢ n5 ;:?j I a , u zr rp f
vlts d+ a ;o` y s, ^' 'a o ! J �:, t 3 ,g u Q, GSc o.'�, ` mar' ° e P 1i� Value: 3rt 7
21 1- and 2- family dwelling ❑ Commercial/industrial ( Accessory building 9 r+
Far special htforniarlon use checklist.
❑ Multi- family ❑ Master builder ❑ Other: -
5'. ar V �s a (3 } . gar Description I Qty. I Ea. I Total
, , „”? P 1r $ , ,§ i o a I " i�_l 11 O ft O 1 15 sl J , . ' i HeaUn cooling
t. � i.�r, ,�, sty, . p � '; �'�� . .�, , t:l - Heating
Job site address: �''�� Air conditioning or heat pump
32 £? S dr eras -..(.� [ (re•sires site .Ian shawin. , lacemenr 14.00
City /State/ZIP: iii $ _p_ O c - '. Furnace 100,000 BTU (ducts /vents) I 14,00 /' µ�
Suite/bidg. /apt, no.; Project Hamer // / Furnace 100,000+ BTU (ducts /vents) 17,90 -
VC° 1 t:',(7 0 /� Gas heat pump 14.00
Cross street/directions to job site; Duct work _ 14,00
" � 54- Residential hot water system _ _ 14,00
50 13 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
Other; 10.00
Tax map /parcel no.: Other fuel a, •[lances
r4EIREPA iF + , ' f r: „T- Water heater 10,00
t ,, r Gas fireplace 10.00
' Rapt / _ a S Flue vent for water heater or gas
fireplace - 10.00
Log lighter (gas) 10.00
Wood/peIlet stove _ 10.00
Wood fireplace /insert 10.00
a tY: � a � � iGuo� d 7,∎ FERIe 9 Wx"ctr u� Chimney /liner/flue/vent 10.00
������ Other: I 10.00
Name: 'QUP rex'1l� t •S i 1 Environmental exhaust and ventilation _ - Address: !J QQ Range hood /other kitchen
r . • t..) _ equipment 10.00
City /State/ZIP: I ,/ ic Y.4 P i.. G i 71 Clothes dryer exhaust 10,00 -
Single -duct exhaust (bathrooms,
Phone: 543 ) .0 r4-' Fax; ( ) toilet compartments, util y rooms) 6,80
,' , ' Attic/crawls ace fans 10.00
a7� " � 5 �.�1 . .,, _� . ,41,.' Other: '� 10.00
Business name: pee.ita t.` 1-4-e_aii 0 5611- 0 Fuel piping ,
Contact name: $5,40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heatjtump
City/State/ZIP: WalUsuspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater _
- Fireplace _
E -mail: Range
IMENS 1Rjg N , y
t ` Mitia:'iJ `�l , a / �t0 d .i�,,,Li'. s i t ; . ' 1:l a%Z,, $arheoue , -
/ � Clothes dryer (gas)
Business name: ( i_ i 14 P 7 f5 Other:
Address.' c/{ �f {1.� //�• �J �y 3' � f ♦� d ai y t t� "te . k,2t ' , , k 4
V �-+V L i ... or l SL :Y I :!V.`C 0.-ai, �,'r. • N 9 , 1 )-4 - time's. ' ,, hair:. 1, l . 9 .�.
City /State /ZIP: / i 9 0
. • iC S ubtotal
R . a 2 - 2--S r
Minimum permit fee ($72.50)
Phone. (S3 4 0 .- J 4, q3 Fax: c ro ; ) ( 1V 6 G ? Plan review (25% of permit fee)
GCB tic.: ( 6 m '3.-e State surcharge (8% of permit fee) - E !
TOTAL PERNLTT FEE .7 Q.3 r ,
Authorized signature: J T his permit application expires if a permit i$ not obtained within 180
days after It has been accepted as complete.
Print name: i n „ 0 f r-ea. mm Date: i t 6 67 * Fcc methodology set by Tri- County Building Industry Service Board
I: 1Buildind iPermitsIMED.PertaitApp.doc IIL/a7 440.4617T(11/02/COMIWE9)
CITY OF TIGARD . - - .•
BUILDING DIVISION PERMIT #: MFC2007- 00641
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/112007
Phone: (503) 639-4171 ' /i rl�
Inspection Requests (24 Hrs.): (503) 639 -4175 .�''I�.. .
INSPECTION WORKSHEET FOR DATE: 1212.7/2007 TIME: 7 :00AM PAGE: 14
SITE ADDRESS: 13263 SW IBENISHST CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 6 LOT #: 137 TYPE OF USE:
PROJECT NAME: FIEBICH
DESCRIPTION: Gas furnace replace. •
OWNER: FIE13ICH, DAVID G + LAUREN J, PHONE #:
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503 - 620.5643
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
699 Mechanical final 06217&01 503.620 -5613 Y
Corrections /Comments/ Instructions:
1/ 692 Gu so-za,e. i I - 7 S'--- ,s 7d A /e.4/ 01-, -e—/ 7-' -/r4ir2 c
❑L—fS ------ PARTIAL APPROVAL fI CANCEL ❑ NO ACCESS
❑ FAIL 7 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
j
Inspector: Date: l2.-- Z7--e7 7 Phone #: (503) 718- 7 2 5 •