Permit CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00691
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/28/2007
PARCEL: 25111 CD - 05200
SITE ADDRESS: 15965 SW BRENTWOOD CT ZONING: R -
SUBDIVISION: SUMMERFIELD NO.9 LOT: 511 JURISDICTION: TIG
PROJECT: NELSON
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
BARBARA NELSON Description Date Amount
15965 SW BRENTWOOD CT
TIGARD, OR 97223 [TAX] 8% State Surcha 11/28/200 $5.80
[MECH] Permit Fee 11/28/200 $72.50
Total $78.30
Phone: 503- 670 -7541
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO ST.
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503-234-0611
FAX 503 -234 -0439
Reg #: LIC 161085
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.
,.. 4. , '
Mechanical Permit A e i lication
•
C of Tigard ol; (/I I It l 1 NI ONI 1
•
g �� 1 # ' a Received
13125 SW Hail Blvd., Tigard, OR'' _x. Dat ; I a G' p Permit N. ,
Phone: 503.639.4171 Fax. 503.598 1960 Plan Review ', 7 -O O •
Inspection Line: 503.639.4175 �� 7 % �� I / `""`'n+'; I DatelBy: Other Permit:
Internet: www ci 503.639 cus
CITY OF , Dace Ready/fly: tuns:
�� { U ®� �I�AiI® Notified/Method: � Supplemental to See Page 2 for
Information
- r ...
.w
New construction ® Addition/alteration/replacement Mechanical
permit fees' are based on the value of the work
❑ Demolition Other: performed. Indicate the value (rounded to the nearest dollar) of all
` $ arr mechanical materials, equipment, labor, overhead, and profit.
:.
Value: S
,
- i - and 2 family dwelling 0 Commercial/industrial t k "' '^ ' � t n .
0 building
❑ Multi family ❑ Master builder
For 1 °
❑Other ,3 r
;�� �� to � t a r special information u se checklist.
.», a' . r'�-Rr" y,. a u _ , t Description
P e nl�ttt l tie a .:, l e Qty. Ea. Total
�
. u 4s
Y " " ) "ea"
Job site address !' C L > L . ,
{ r� ` ` r •+ .1 _
Air conditioning or heat pump ,
City /State /ZIP: �C (requires site plain showing placement) 14
C ;. ' -. � i G_ ? Li Furnace 100,000 BTU (ducts vents) i I4.00
Suite/bldg. /apt. no.: -,' Furnace 100,000+ BTU (ducts vents) 1790
Project name:
,t,;(::(,.. i _ i.'` i'1 Gas heat pump
Cross street/directions to job site: 14.00
Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
- Unit heaters (fuel -type, not electric),
imwall, in -duct, suspended, etc. 10.00
Subdivision: Flue/vent for any above of b
Lot no.: 10.00
Tax map /parcel no.: Other: 10.00
l i : ° sr , i:xiw`'1�� % Other fuel appliances
....•�[ K i *p ..*• E " ' ': ;z}... � , V . ; 3 .e•� ;..r.0 r ,. s
`/ - t..., r rp;, a ';;A,+ i - r'+'f. ^� ',5 t�ti;??�.5'sS•4;' Water heater
f 1 i Fjr „+, 0.00
- -? t - ?- 1 ..; ) l',' Gas fireplace
.'�. a, 11-, -. 10.00
Hue vent for water heater or gas
•
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fire
,< ::n, . - - fireplace/
insert c' .;' "'s ;,ki i'r kAd/. .,. 1 . k N.a _ .1 P insert 10.00
3 a:�•),:r .. .. h , ; ;_.� `.. .x� ;!'�i Chimney
:u �_,xa.. ;rs.ir %t ,. y1 fl...rt s v %r. /liner /flue /vent
„ , t . - t, 1, v .; Other: 10.00
Environmental exhaust and ventilation
Address: ' _ , a - „ ✓ \` ` 1 (' j` Range hood/other kitchen
City /State /Z1P: i, ( `-' (.1.„....f..... a ui m
`\ - t.'> 9 p cnt 10.00
`'D Clothes Phone: .... ,. ( „� I - /` _.. .._ dryer exhaust
('` >,: ;) .1-L3 . - .' - : / Fax: ( )
Single-duct exhaust (bathrooms,
10.00
"' is =aa; >r:rW gle - d e. laust bathooms,
r
i..' _ -,, t- rip:' °; +r:? s r* aa,r,; toilet compartments,
a:e % — x t , fix °sa axs-es F P utility rooms)
tl ";:?�.,��'w ...}''�,. "4.�:T"� [� _ '�. ,.,�,,:.�..m�y...n.a4•�y,atert ?a AnIC/ 6.8�
„;�����,.��„�gitM�s3, crawlspace fans
Business name: 10.00
Other: 10.00
Contact name: Fuel piping
Address: $5.40 for first four; SL00 for each additional
Furnace, etc.
City /State /Z..IP: Gas heat pump
Phone: ( ) Wall /suspended/unit heater
Fax. ' ( ) Water heater
E-mail: Fireplace • a.,.. - ,;•;' ,, ..•;. : •-; , ;', , ,-- ; ", Range • :.4.... , "^ ! � v. s 1 r'.X`•' r a • A pr. �`X4":9x f.(& 1 A', t *:1 ! .y ti - 4
Business name: Sunset Heating and Cooling ° t «.aaa -'. Barbe
Clothes dryer (gas)
Address: 0607 SW Idaho Street Other.
City /State/ZIP: Portland, OR 97239 y
Phone: (503) 234-0611 Subtotal
Fax: (503) 234-0439 Minimum permit fee ($72,50) r = - . f::71._:'
• CCB1ic.:161085
Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:. _. , - TOTAL PERt1tIT FEE "?
_ - ' ` ' . ;?...
This permit application expires a s permit is not obtained it • 180
� obtained within 180
Print name: Sh)nuna D'Ambtosia
Date: days after it has been accepted p
V / ; % �' ; P ed as complete.
�, = • F ee methodology set by Tri County Building Industry Service Board
;AB e -Perm App sloe 12/03
44 0 -4617T (t I /02/COM/WEa)
a* 01 eLO:TT LO LZ AO
CITY OF TIGARD
BUILDING DIVISION PERMIT #: r, FC200' _0063)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171 IiuIil
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 12/27t20Q7 TIME: 7 :00AM PAGE: 65
I SITE ADDRESS: 15965 SW BRENTWOOD CT CLASS OF WORK:
SUBDIVISION: SUMMERFELD NO.9 LOT #: F,1•j TYPE OF USE:
PROJECT NAME: NELSON
e DESCRIPTION: Gas fu replace
OWNER: NELSON, BARBARA PHONE #: 6O367t1.7641
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503-234-0611
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 062163 -01 503.670.7541 N
Corrections/Comments/Instructions:
_ oz. ; t � o,� 5 - 4-2-173 ,/-09 J / go - v 9
/ /r,_ cJ.4- "as> ,4t -r--2 , A P' ' ' -.2v
PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL p CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: />Z— Z7 —rT( Phone #: (503) 718 - 75JCI — ------