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Permit N I1 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00516 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/29/2007 PARCEL: 2S103BB -01400 SITE ADDRESS: 12476 SW BROOK CT ZONING: R -4.5 SUBDIVISION: BROOKWAY LOT: 014 JURISDICTION: TIG PROJECT: ZAGORODNEY Project Description: Replace existing gas furnace. 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 DAVID ZAGORODNEY Description Date Amount KATHLEEN P 12476 SW BROOK COURT [MECH] Permit Fee 8/29/2007 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcha 8/29/2007 $5.80 Total $78.30 Phone: 503- 590 -9992 Contractor: HEAT RELIEF CO 13122 NE DAVID CIR # 800 PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -261 -9915 FAX 503 - 261 -9814 Reg #: LIC 122424 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 L / Permittee Signature: S12,C, . / Call 503.639.4175 by 7:00 a.m. for inspections that business da 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. Aug 28 2007 12:46PM HEAT RELIEF Heating & Coo 503 261 9814 p.1 Mechanical Permit Applicatie C VED rc ►I: oFFK:t.: USE ONLY City of Tigard V 4 Received Date/B Y- ? 2,9 0R' 5 Lk3 Permit No.: H 1c200 QOS 16 i .. 13 t25 SW Hail Blvd., Tigard, OR 97223 14 Phone: 503.639.4171 Fax: 503.598.1960A G 2 8 2007 Play Review Date/By: Other Permit: T I C A R'D inspection Line: 503.639.4175 Date Ready /By: Juris: El See Page 2 for Internet www.tigarc- or.gov CIT q O,‘ .Y IGA Notified/Method: -77 Supplemental Information BUILDING DIVISION - 'e: tit: M - i r 4':ti - - - - ,.. ` ,its :' -% °:�r.. :.i'i {, - ° , ❑ 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 ❑ Demolitior, ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • i j x "�:� /y ;;��, 1 }t a: : ,: Value: S .. - - i:i517tt1icIS:.�llitr: g} :7ta.. yt., zC • 1 u.4.6::4,._.. _3!,..- f ?Jir:;�yyytiz,`.�.. ... ."^. it - ,r.....; ;7�`AP,2l^� ?::._.....�... _... 91;? ,• 5 i L S fi : ' - #' Carr and ^ <- family dwelling ❑ Commercial/industrial ~ 0 Accessory building �' " N i , �;.: ° + ,, id`i'' °� '_••'-. - ❑ Multi - family ❑ Master builder ❑ Other: For special information c ec 1 s e in o on use h klist Description ty. Fa. i' uta ..... �;: a.,'�•���:`.'�'� =�.W," t , ;�, ,;:py Heating/cooling lob site address: 1 at� ec ` Air conditioning or heat pump dl ) dcOO ' . C-Ot-'�-r� (requires site plan showing placement) 14.00 City /State /ZIP: ----. k e- tc..c-d I O 142._ t� -- a - Furnace 100,000 BTU (dretsia.ents) 1 14 00 � oo Furnace 100,000+ BTU (ducts/vents) 17.90 Suite /bldg /apt. no.: Project name: Gas heat pump 14.00 Cross streetldirections to job site: Duct work 14.00 - Hydronic hot water system 14.00 Residential boiler (radiator or hydrnic) 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 appliances • i.:,'.X'i .xe e• ;:lY_ y, } y,,,i�.�sti g.}.; ! :?4 }v au:?�-'�•.- ''- ,P; ,i1�:. ,', '� - -' I y r u� t l.. t¢' , .• 9.'' :q M . r-� i l l i l li1 p_' .rn Water heater 1�.UU „ , . i P <: � Y.'^. .,. - .:.. ,,, eila fi - w: ffiI> ��7+`•�C }2Sii'T4�:.:; ,.3t'�t m Y��� _� ^ ,- T � y q l^ Gas fi rep la c e gas 10.00 Flue vent ent or water heater or as fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 _ y. t„ a =t>, �s A - }:,;;. _•;'- Chimtte yllinerftlue/vent 10.00 ,.:•.- .,, - . ..:.. :.:....:::_, r- _: -:..� ".,,- •..� *_....,........,. ter• ...................... _..,.., ... ..,...,:: "__...- '.......�_.._...,,.,.. Otl _ 10.00 Name: � k,i ` \--') 2.fAcy©c ©d 42,, Environmental exhaust and ventilation Address: 11 _, Range hood/other kitchen equipment 10.00 City /State /ZIP: Clothes dryer exhaust 1 10.00 Phone: (S'�) s9 0 q Q C'f Fax: ( ) toilet con partments utility rooms) 6.80 Fax Pho �' '4.'!t t: T1'ti' «': L'.1tY':tt} Y:^iNY':i' - r (4 .:t„ {,,,:a,:; : Attic crawls ace mans 10.00 a. ... n . t m.c4;:i'4 .:? 1 ...._r = _ a Other: 10.00 Business name: Fuel piping Contact name: 55.40 for first four; 51.00 for each additional _ Address: Furnace, etc. Gas heat pump 1 _ City /State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater 1 Fireplace E -mail: - t ,,( Range - Barbecue • Business name. Clothes dryer (gas) Other: Address: ` l a �.f ig \i � 0 `� Q . Aq 0(il . a .ECHi l'CA4L: PEliellT City /State/ZlP: '7 ` - .o - t p9-.., Gt 7 - 0 Subtotal - 14,00 �\ _ 1 Minimum permit fee (57250) Phone: ( e 3) a co ! _ (1C- l s ax: (r�- 3) 4 c ` - S , L f Plan review (25% of permit fee) 2. O CCB tic.: , _.1 - 1 / State surcharge (8% of permit fee) S,SU TOTAL PERMIT FEE . iy ( . SO Authorized sigpature: This permit armtica lino expires if a permit is not etixelnad within !tin �' . , ' ' r� days after it has been accepter( as complete. Print name: "f-`t `.y._\, `/e j rct ti e. \ S c f Date: • Fee methodology set by TO-County Hoilding Industry Seiviec Board I' tt?ni I tt inq \Pei ni i EC -P ennitApp.dne 04/06/06 440- 4617T( I I talICOM/WEBI • CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007-00516 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/10/2007 TIME: 7:00AM PAGE: 32 SITE ADDRESS: 12476 SW BROOK CT CLASS OF WORK: SUBDIVISION: SROOKWAY LOT #: 014 TYPE OF USE: PROJECT NAME: ZAGORODNEY DESCRIPTION: Replace existing gas furnace. OWNER: ZAGORODNEY, DAVID PHONE #: 503- 590.9992 CONTRACTOR: HEAT RELIEF CO PHONE #: 503-261 - 9915 Inspection Request Scheduled For: Date: 9/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 055386 -01 603- 590.9992 N Corrections/ Comments /Instructions: c G1YG .L / .I.AII3.L /- i 5 - /35'96 q 4247,/a/ PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I I FAIL [ I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: C 1 �l� ? Phone #: (503) 718- 7 4.45