Permit 1 4 CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00840
DEVELOPMENT
SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/27/2005
PARCEL: 2S 114BA -14100
SITE ADDRESS: 16240 SW COPPER CREEK DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 4 LOT: 106 JURISDICTION: TIG
Project Description: Replace ghas 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:
Owner: FEES
CANNON, STEPHAN F AND Description Date Amount
SUSAN C [MECH] Permit Fee 12/27/20C $72.50
16240 SW COPPER CREEK DR [TAX] 8% State Surchar€ 12/27/20( $5.80
TIGARD, OR 97224
Phone: 503 684 - 3762 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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: . //, i� Ar Permittee Signature: ri7 &p (l-(.
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.
a 9
g 4 ..-
Mechanical Permit tiarti FOR OFFICE USE ONLY
City of Tigard Received I 1
13125 S Hail H1vd., Tigard, ' , 301 t DateBv'� �� � Perrin N ��0
SW 04
Phone 503 63S 4171 F I r Plan Review Date/By: �4 r. r •. , A 44 1 � Date/By:
Ot le r F e rrru t.
Inspection Line. '03.63 C? 1 . _ ., • DamRead Ready/
By: Y y l�rc-
0 See Page 2 for
Internet www.ci..tgard or.LS NottfiedNethod Supplemental Information
-. : :��:„, . 'TYP : :QF V ; , .,c.7 COWI:ER -SCHEDULE — USE•CHECKLIST
❑ New construction A ditioa/alteration/replacemeni Mechanical permit fees* are based on the value of the work
performed Indicate the value (rounded to the nearest collar) el a
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
. : , ` . :.... 'v'i;_ ' ` C TEGOR:1' OF= CONSTRUGTfON value' 5
_ ^ ' ' (RES,TDEPI'ITAL EQUIPNIENT / SYSTEMS FEES*
,- ard2 'family dwelling 171 Commercial/industrial ID Accessory building —
❑ Multi-family ❑ Master builder For rpecier information use creckttst
❑ Other'
Description I Qry I Er_ Tam
1 , „ . r".•:', JOB SIT- 11YF.OI2114MTEOI� ;i 1D ' .00 TIONl , Heating/cooling
,:_,1•__ :•.;; ,1.. ... .. .. HeatinR/coolin
/ ,/� e� l Air Tre sh pla or heat pump
Job site address:
/ G. L � . / � ./3� 4iC1 (requires sire plan showing placement) 14 OG
City /State/ZIP: Furnace 100,000 BTU (ducts / vents) / 14 OC
Furnace 100,000+ BTU (ducts: vents) 17 9C
Suite/bldg./apt no : Protect name:
Gas heat pump 14 00 I
Cross street/directions to job site: Duct work 14 CC
Hydronrc het water system 14 00
Residential boiler (radiator or
hydronic) 14 00
Unit heaters (fuel -type, not electric),
• in -wall, in -duct, suspended, etc 10 30
Flue /vent for any of above 10.30
Subdivision: Lot no.
Other 10 OC
Tax map /parcel no. Other fuel appliances
,;.]:,'.4'..,1. "'„ :,:x - ur.. Y x ,c„ E CI IETION' .F :',411K t' ` t :.. - rr'•,. ,,w,L' Water heate- I 10 00
�..• , ° Gas fireplace 10 30
�-< 7l .L�� 7e,t-p
£._4__t_7-7 1ti4 1 Flue vent for water heater or gas
fireplace , 10 OG
Log lighter (gas) 10 00
Wood /pellet stove 10 00
Wood fireplace /insert 10 00 ,
L ', t _tt p psy+ �f� / + r�p •;.� . y ,, •r� ry i Chimney /liner /flue /vent j 1000
,.',i't ' � y :0010.:.' 0:i fii .t kl .' : "ti4:1, :4 JA1 =:1_�.'L t.
,.... .�. - ,. '. 7iI''• ” � � ; :. .:�' := : :.: , �,,- t. !�N�I' '? .. -,' - - Other, 10 00
Name: ( -- 5. '"7 / t/t/e--• �€2■1-1-4y) E)--79 Environmental exhaust and ventilation
Address' Range hood /other kitchen
equipment 10 00 •
Ciry/Slate /ZIP: Clothes dryer exhaust 10 OC '
Single -duct exhaust (bathrooms, ,
Phone: ( Fax �l731 .61-e(394 � ( ) to:let compartments, uhit:y rooms, 6 80
-e, i 4.;'y,._g xs A..'T'' 4... :c t.l`'s °u: •'' :l l Attic /cr acefans I C.00
Business name:
Other: l C 00
Fuel piping
Contact name: /2 At/14 0 l.0 1/ 55.40 for first four; 51.00 for each additional
Address: Ft_mace, etc.
Gas heat hump
Ctry/State /ZIP: Wallisuspended./uart •seater 1
Phone ( v 5 ) i,7,2 y ?-7 : 0 , 0 3 ) 0 v ( 3) ,57( 4 7d Water heater
E -mail: I Fireplace
m „- y . ft,µ,, :C � r.. n Range
'. f: : : :i :r-.... •--," '.,— •-._i'� �`* ONT 2A.CX,OR �7,:,i { , :;—_j.--1..?-g: _ r' Barbecue
/� ''', y C'othes dryer (gas) '
Business name: w t / h !eL {_AA -77w. "3— C._,,
t , t,e' Other: I
Address: b d : ,_
D ,� Q X 3 3 7 r , , I11C HANIC.�I PERMIT FEES* •
City /State. /ZIP: / / G _4_ �/2. 5' 7L3 Subtotal
Phone: 1) 4 R ye ,,..27 4' el Fax. y , .5 0 eyoZ '7' Minimum per m.1 fee (S t ee
sJ P l an review (25% of permit fee)
CCB lie.: 76 .3,j 9 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: ,::::0...2 This permit application expires if a permit is not o6latned within 13
days after it has been accepted as complete.
I Print name: 4 c /el, - �,7.67. f Date: /2_72;7/ • Fee methodology set ay Tri•Coant•: Build :rig Industry Ser•.icc Boar._
• R1.iIrllnn ,i, ,tsAFf_o.m,,, e.,.. .1., -- 11,11 z
Z'd OLZ0869£09 6ull.eaH elqu,lnloO d9. :10 90 LZ 080
CITY �= � u ^-`
��w u m ��n TIGARD /
BUILDING DIVISION '
~�~~"~~~�""~~° ~~"""~~"~~"~ PERMIT #: &6Ec2(0500S40
13125 SW Hall Blvd., Tigard, ORA7223 DATEISSUED: 1312712005
Phone: (503) 639'4171 4,41"Iod
Inspection Requests (24 Hrs.): (503) 639'4175 s 44-
INSPECTION WORKSHEET FOR DATE: 1/6/2006 TIME: :00Ak0 PAGE: 50
SITE ADDRESS: 18240 COPPER CREEK [}R CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 L #: 106 TYPE OF USE:
PROJECT NAME: CANNON
DESCRIPTION: Replace gas furnace,
• OWNER: CANNON, STEPHAN F AND, y PHONE #: 503
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-6242701
Inspection Request Scheduled For: • Date: 1/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 hAmchanftm|fina| 024453-01 603'624-2704 N
Corrections/Comments/Instructions:
��
�� �� 72-2-
�*� � -�
'' -_~'~ ~_ / .
Lk; PASS I I PARTIAL APPROVAL 0 DANCEL n NO ACCESS
[7 FAIL I | CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
/ L
.
|nopecto�� / Date: 6P /o�6 Phonm #� /5O3) 718- � ' ` '
\ �r
CITY OF TIGARD ■ " .1 ', • Ir
BUILDING DIVISION .
. PERMIT #: MEC2005-00840
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1212712005
Phone: (503) 639-4171 147 410 I 4 \
Inspection Requests (24 Hrs.): (503) 639-4175 ....„ ---.
INSPECTION WORKSHEET FOR DATE: 12/3012005 TIME: 6:59AM PAGE: 74
SITE ADDRESS: 16240 SW COPPER CREEK DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 106 TYPE OF USE:
PROJECT NAME: CANNON
DESCRIPTION: Replace gof furnace
OWNER: CANNON, STEPHAN F AND, PHONE #: 503-684-3762
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503
Inspection Request Scheduled For: Date: 12/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
V.19 Mechanical final 024181-01 503-6242704 N
Corrections /Comments/ Instructions:
\V \:, CSe l' .0 I) kf , 6 CAM NV CC ti i_ * Ji : 1 r
„ sowo p Lor( i - T Hrc is\i\e4t 1 ' PwkrTs
,ftt■\il, L. \ (V1-
•
PASS 0 PARTIAL APPROVAL CANCEL 0 NO ACCESS
FAIL . CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: - - -7 4 ...„ /,.. . , Date: , , _ Phone #: (503) 718- ...2-• yr‘