Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -10022
4 . 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/9/2006
PARCEL: 2S109AD -02300
SITE ADDRESS: 12963 SW BIRDSVIEW ST ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT: 015 JURISDICTION: TIG
Project Description: GAS FURNACE REPLACEMENT
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:
Owner: FEES
JIM LAHM Description Date Amount
12963 SW BIRDSVIEW ST
TIGARD, OR 97224 [MECH] Permit Fee 4/1/2006 $72.50
[TAX] 8% State Surcha 4/1/2006 $5.80
Total $78.30
Phone: 206 - 620 -3595 •
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503- 692 -1565
Reg #: LIC 5193
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: ¢���.� Permittee Signature: L$/,Kl -GC.� lf n,
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 ca oa FOR OFFICE u ONLY
City of Tigard "
Received,
4 / •Permit No
13125 SW Hall Blvd, Tigard,' OR 97223 MAR 9 2006 r i>+ • •&-. so,
Phone: 503.639.4171 Fax: 503.598.1960 Plan Revie
Datday:
Other Permit:
Inspection Line: 503.639A175 ae �TY PJ
• Internet: www.ci.tigard.or.us Bj7IT� e� g ° Vy I V rFT2- 7-1-11.1'. RY thod: H See Page Z for
1 F � Notif� Supp lemental Information
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1 ;a: -:, ._ ..,'a.. t Zi' a.o'4 �'•i krz '11 3'�.�.'
❑ New construction • '. r " t� :ddition/alteration/ieplacement Meohanrcal permit fees' are based e val
n the ue of the ' or
_k
• perfoinied. Indicate the value (rounded tothe nearest dollaryof all
❑ Demolition ' ®Other •
mechanical materials, equipment; labor, o`veiliead; and protit; .'-•
7 "E 0 '
,- , •'?.l 5 +^+- e-", `,.){�i�.' 5 f -" u. 's(�.�Y�> t :.. aa a Valle: +'
`ir . �i �:b sE^ . t rst:.:.•71S. s.. '77tE e :k - �* :I .v.a K t : k.
.. r ..L'R ..viac�.. ..�� u n. �� ✓_.5,.,. ,. 4 K\ 4 ` jj'' \ '�* _ .{� .
r, 1- and 2- family _ .al/indust :: a i1 ��l` lt"5 Jd lg �!J'I.r t` `ir �W i.�+ ,.fi t -
iri dwelling . -.0 Cotnmerctnal El Accessory building * - `t =w . _ ... r_.. ,_. {..: _ r�
. ❑ Multi family ❑ Master builder 0 Other For special information use c
,' 2"gc" `�r'x -z � r a '. t "'' `au�x v �,2 a ^+, ' ", Descripfloa I • Q6 I Ea. I TOtal
S
i * , 1.4 .) �, Lttt.[e a .. � .. ) t > - .k' Q A ' t 4 ' " rz`K`3 5
.a..u c�� r. '
, Heating/cooling
Job site address: /Z 3 _ S�J P � V/ - Air conditioning or heat pump
�J 2 S� (requires site plan showing placement) 14.00
City/State/ZIP: 17 *e o T /1� 97-1Z-3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldgJapt. no.: '� I Project name: Furnace 100,000+ BTU (ducts/vents) 17.90' .
Gas heat pump 14.00
Cross street/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: l Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
w W AV _ ,- . �• n ' i?l ieQ16 t 's` x r ?� ° " W. " Waterheater 10.00
/ �j u �q r Gas fireplace 10.00
( LA/4 r' F6 0 V E ink-1E S Fri C a JIB G 6,1( Flue vent for water heater or gas
/`t p L' Pe -A-G!S W 1 / (0 /f A? f S J�j2 kli1 Ll fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
it
Wood fireplace/insert 10.00
'' � `R�Y Chimney/liner /flue/vent 10.00
a �+��
s i .$ 4- .,'. ' '- .`-�s k - 4 a - = ', 1.3 Other: 10.00
Name:
�/ 6_4>9 Environmental exhaust and ventilation
Address: /2 7 (' 3 Sc) !J p / L)5 Vi'(,/ 5'T- Range hood/other kitchen
equipment 10.00
City/State/ZIP: T(rAR or, 17 - 'L-
2 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
- z �` - ' � 1 S. .. p , y � Aitidcrawispace fans 10.00
Business name: jh � / , Other: 10.00
A ,,,,(mot/ / t_C l n.l /G- ,6L Fuel piping
Contact name: � � /. R. y Pe' (►L4 2 $5.40 for first four; 51.00 for each additional
Address: O Furnace, etc. J
/ 3. 51..„) Tt.. T l l,J ,lZ i� .
Gas heat pump
City/State/ZIP: 277,,,A l._ i / . �., q.e (� 2 ' . Wall/suspended/unit heater
Phone: (57/ ea, , / 48 71 l Fax: : ( 3 ) (..0e? / ..... / g -91 Water heater
E -mail:
Fireplace
� �ssc x �. Range
'
F i+ - �^ r . . '` - "' {" fr? ..W4 , _IIt r� - �. _ PSIT `° IV RI-.'57 � '7 .
as ;,..a Barbecue
>?,..ISe'•,.at -„ s`r.- .._,,.a....��r. we'r•� �� '�sY•..,�fia"e -'._ e.�r �r1
Business name: Age �i4), 1?G� Clothes dryer (gas)
Address: ;� ,,,,,
_ ,„..„..„....,:....,....,.....„,„.„, ,..„........,,......,.._:„„...::::,,,.............„,„
City/State/ZIP: 11 C � _ Subtotal
Phone: ( ) Fax: ( ) i, ; Minimum permit fee ($72.50)
S-7 Plan review (25% of permit fee)
CCB lie.: J S surcharge (8% of permit fee) .
? TOTAL PERMIT FEE
Authorized signature: ��� J / ibis pormk>appticatlon espties lra permit is not ebtainea within 190
_ .-. _ . days after has been accepted u campletc
l • F......elw
n_ --� - l G i..in.... wee . Tr:_/`r.....w R..:Iel:r..r r..A,..÷.., .C......4,.. A....a
CITY OFt TIGARD
BUILDING DIVISION • „ PERMIT #:fl 2 tG fOO l2.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Aksh l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIM PAGE:
SITE ADDRESS: / I3/ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #.(D c) '7q3- -6b2 -7
CONTRACTOR: 7pGg_ PHONE #:
Inspection Request Scheduled For: Date: Li - l -- C( Pour Time:
Code # Inspection Description Confirm # Contact # Message
6q9
Corrections /Comments /Instructions:
•
\ ■9 ____ ,
rI
I '
C
rt PASS n PARTIAL APPROVAL . ❑ CANCEL ❑ NO ACCESS
FAIL • CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718