Permit CITY OF TIGARD MECHANICAL PERMIT
r l DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00088
� ' c - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/4/2005
PARCEL: 2 S 102 D B - 04200
SITE ADDRESS: 13181 SW CHELSEA LP
SUBDIVISION: CHELSEA HILL ZONING: R -
BLOCK: LOT: 019 JURISDICTION: TIG
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:
LPG 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:
Remarks: Furnace replacement.
Owner: FEES
PRUETT,1DAN Description Date Amount
13181 SW CHELSEA LOOP [MECH] Permit Fee 3/4/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 3/4/2005 $5.80
Phone: 503- 968 -2239 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 - 557 - 2220
Reg #: LIC 72623
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 rujs or direct questions to OUNC by calling (503)246 -6699.
Issued By: .( � A Permittee Signature: />7 if (V 4/
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next 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.
Mar 02 05 09:5a TriCounty Temp Cntrol 5035570919 p.1
•Mechanica. Permit Applic.ci
4 *JECEI'ff - .) - ..--. -• - -- ..° . ..
....... ...:. .. ... . . . ..
FOR OFFICE USE ONLY . • . " ' .
,.. -----
City 0,i'Tigar'ti • Received
OR 97223 . /
Date/By: 0/ 0 d..)D Permit No.: (\./\ &_C....„)...005 -- 0,00.
13125 Hall Blvd., Tigard,
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 MAR �4 4 ! k 43 !&!1; Other Permit:
.. s ,, f Date/By:
Inspection Line: 503.639.4175
„JIM. IL, Date Ready/By: 1,..i.i / Cs, _ > See Page 2 for
Internet: www.ci.tigard.or.us
CITY TIC.ii-N.R.I.
N• - - , °tined/Method: / Supplemental Information
OF
1
TYPE , ...-..........-,• . . -.:.,..,„..........-...-,' F... . --T1§4CHECICLLST -
ID New construction X Addition/alterationirepl acement Mechanical permit fees. are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
E Demolition 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
: -. -'• ,-• -.-- •-'. - , -•,,,, ---i • ...-i•-',..:•'. - GATEGORY:'OF'':CONSTRUCTION:'' •'•-•'-'1r ''- %. - -..-, -- '-':~:•.T Value: S
RE
1 and 2 dwelling 1:1 Commercial/industrial 0 Accessory building ,:.'...;:.
For special information use checklist. •
0 Multi 0 Master builder 0 Other:
Description Qty. I Ea. Total
.['...;:.:.':....;:'-:::.,•::;•'.7..7.7...]-,':::.;,'i...':)...013'0_TONFORMATIOI■f:...;ANH: t66;:iior'i. . i.-.,,:,: '...-...::-,',. .,:: • ,.. , HeatinWcooling
Job site address: 1 IVAN ditisca. Loop Ail' co requirenditioning or heat pup
(s site Man showing placemment) 1
14.00
:
City/State/ZIP: i cr/223 Furnace 100,000 BTU (ducts/vents) ( ..: 14.00
Furnace 100,000+ BTU (ducts/vems) 17.90
Suite/bldg./apt. no.: Project name: •
Gas heat pump 14.00
•
Cross street/directions to job site: ..
• Duct work 14.00 1
/ .• Hydronic hot water system I 14.00
I Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. , 10.00 .
Flue/vent for any of above 10.00
Subdivision: Lot no
' Other: _ 10.00
Tax map/parcel no.:
Other fuel appliances
f!!:: .• : . :: : : : ---... 1 ' . -,,,, .: - .. : ;!: : ; .: :: :- ;:n. , ".: .'- :.. ' ;:, 1 , - 7 : 4EireTIbSi: --- .0,.*Oiik21;: . : , : , :,i -- Jl .i ;:i;:,t...;:71 ,.-- : : :'" : - - .: ';. Wa ter beat i 10.00
P O - tirria-(f , Gas fireplace
Flue vent for water heater or gas 10.00 . •
fireplace 10.00
Log lighter (gas) 10.00
Woodlpellet stove 10.00
Wood fireplace/insert 10.00
, . ... ' "..
I
1:, c
ii;',1: ,-.::,,, ,,I J .in - :. Chimney/liner/flue/vent 10.00
Other: I 10.00
Name: Pritett
Environmental exhaust and ventilation .
Range hood/other kitchen
.•
Address: earytej
equipment I 10.00 I .
City/State/ZIP: Clothes dryer exhaust 10.00
Fax: ( )
Phone: 02) 6 tIg?) - 226.1
Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
0- .. . -
a ''''!"-:.: : ' 2, t , ' ,..7, ;; ,-7 ., : : :,., : . :ry'dit , i ,. .pfei6kii§oN. - . -- ::.: , .:; .,: : , : , Attic/crawlspace fans 1 0.00
Other: I 10.00
Business name: Tr! Cowiti iciTip (61111 I , Fuel piping
Contact name: ) i/fl
t Nasty\ $5.40 for first four; $1.00 for each additional
Address: ( 6 0 la( kai 05 Rivoc-d)ricr) Furnace, etc. ,
Gas heat Dump
City/State/Z1P: erteen Ci Ili C Q q 704,3 Wall/suspended/unit heater
Phone: (te) 557-2290 Fax: : (52) 557__ciiq Water heater
i
Fireplace
E-mail:
Range
, ::':I.c:. ' '.*:.• -:.•::',:: ,',.-',... ..._: -,. Bar becue
Business name: In ca Ray Contr-o) I Clothes dryer (gas)
I Other: nn _ .... .... .1
Address: , c ' :4 • C ' 6 vti fl ..:c..I:::.
.„ •
City/State/ZT: orecol 0 ak q ilb Subtotal
Phone: (aS) 55 Fax: (605 65-7.-m161 I Minimum permit fee ($72.50)
Plan review (25% of permit fee.)
CCB lie.: 721
State surcharge (8% of permit fee) -
. /
Authorized si a
gnture: 4. -274,°'-g------- TOTAL PERMIT FEE
if
This permit a permit is not ob ed within 1S0
complete
2 41 16
Print name: ,bi A/W 6 4 Date: ' 5 - Fce methodology set by Tr-County Building Inclusmy Service Board
i ABuilding Term= \ MEC. PermitApp. doc 12/03 440 .- (11102/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC20000088
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/4/2005
Phone: (503) 639- 4171 mrr' � u � A Inspection Requests (24 Hrs.): (503) 639 -4175 ' ..
INSPECTION WORKSHEET FOR DATE: 3/17/2005 • TIME: 7:13AM - PAGE: 99
SITE ADDRESS: 13181 SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 019 TYPE OF USE:
PROJECT NAME: PRUETT
DESCRIPTION: Furnace replacement.
OWNER: PRUE.I I , DAN, PHONE #: 503- 968 -2239
CONTRACTOR: TR! COUNTY TEMP CONTROL PHONE #: 503-557 -2220
Inspection Request Scheduled For: Date: 3/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 002022 -01 503 -6 57 -2220 Y
Corrections /Comments /Instructions: `
M 110 miwry-
' r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
e C
Inspector: _ Date: 1 ! OS Phone #: (503) 718 -