Permit CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00285
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/17/2007
PARCEL: 2 S 102 C B -0 3700
SITE ADDRESS: 09995 SW GARRETT ST ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 011 JURISDICTION: TIG
PROJECT: JENSEN
Project Description: Installation of a heat pump and a 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: 1 WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
STEVE & LORI JENSEN Description Date Amount
9995 SW GARRETT ST
TIGARD, OR 97223 [MECH] Permit Fee 5/17/2007 $72 50
[TAX] 8% State Surcha 5/17/2007 $5.80
Total $78.30
Phone: 503- 620 -5573
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -1950
FAX 503 -538 -0165
Reg #: LIC 97152
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.
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Issued By: � Permittee Signature: y� �� �, . , _ . L g Ste_ ArpfirA.47,07
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.
May{•1% 07 03:42p Malcolm Lamb 5035380165 p.2
Mechanical Permit Application FOR OFFICE OSE ONLY '
Received � � ��
City of Tigard Date /By: 5j I R lot Penntl No H 05 9 o 2
Lz�� T cViI�
EC -- - 5
13125 SW Hall Blvd., Tigard, OR 97223 `� L� „RV 140 Plan Review 1 t
Phone: 503.639 4171 Fax: 503.598 1960 ”' ui D a t e / By: Other I'crout
F
Inspection Line: 503.639.4175 ,s • I i - Date Ready/By: Mos. ® See Page 2 for
Internet www.ci_tigard.or.us MAY 1 6 /1RR, Notified /Method. �c Supplemental Information
TXf E ' W
t COMMERCIAL FEE* SCHEDULE - USECHECKLI
°� 11 " Mechanical permit tees* are based on the value of the v.-oil, ❑ New construction [r Addition /alteration /replacement
performed Indicate the value (rounded to the nearest dollar)
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value. S
�- and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi - famil 0 Master builder 0 Other Description l Qty. I Ea Te
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: `9� c::, St."--) r' , 0.�- _' '41111 Air conditioning a�i pump n
(requires site plan showing placement) II 14.00 I'1•Q0
City /State /ZIP: i Q �� ��_ Furnace 100,000 BTU (ducts vents) 14 0(1 1,1 v�-'
Furnace 100,000+ BTU (ducts /vents) 17 90
Sulte /bldg. /apt. no.: Project name: ` l c )� Gas heat pump la 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 eltxtric),
in -wall, in -duct, suspended. etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 101)0 I
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
&)\--- p� Gas fireplace 10.00
X V\ '7k\ \ l 3 t x y \ v�.v Flue vent for water heater or gas
����� tint place 1000
d � Log lighter (gas) 10 00
Wood/pellet stove I0.00
�
Wood fireplace /insert 10.00
g PROPERTY OWNER El TENANT
Chimney/liner/flue/vent 10.00
Other, l0 00
Name: � .� L�,,l,e...„ QM ...a �g,�� Environmental exhaust and ventilation
Range hood/other kitchen
Address: �S,=\, S ' �t2 _ ai" equipment ui mere 10.00
City /State /Z_IP: am Ia. - lb Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (Th3 to - r._.\ °I 60 toilet compartments, utility moms) 6 80
E- APPLICANT 0 CONTACT PERSON Attic /crawlspacc fans 10.01)
Other: 1(1.00
Business name: p ip
F.T. . t A 12— -P./'a lam - i Fuel piping
Contact name: - \,.�_�,, yti $5.40 for first four; $1.00 for each a dditional
Furnace, etc.
Address: 1 .1E) c::1 S — C .s `S c S-V12. ,„....j Gas heat pump
City /State/ZIP: �\o - 1:5 - (2 Wall /suspended/unit heater
Phone: (5.D :' Fax: :5'b3 z01 [4::,° Water heater
Fireplace E
E -mail: i
Range
CONTRACTOR Barbecue I
:..t. Clothes dryer (gas)
Business name: Ft, kA ,e A ms
s ` I p e }V ^ - Other:
Address: l-Q S - A IA Q Q MECHANICAL PERMIT FEES*
City /Slate /ZIP: 1.,... Q r■D le_ p 9 l - r Subtotal .00
_ l °4°�JJI Minimum permit fee (572.50) -42.%0
Phone: () -3) > _ l�.0 _. Fax: �. CS'3% _b I GS Plan review (25% of permit fee)
CC13lic_ 91 So., State surcharge (8%of permit fee) 5 •go
TOTAL PERMIT FEE TR,30
This permit application expires if permit is not obtained nithin I
Authorized signature: ko`v ‘---- l i s - 12 - 1 . days after it has been accepted as complete
Print name: '-----J _ v ...� i�/\ � _ _ �rj Date: �, ' Fee methodology set by Tn- County Building Industry Service Boar
13uJdm5 I'cnuns MIrC- t'cnnaApp dog 12 03 440-46171 (11 CUM welt)
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Ma , 16 07 03:42p Malcolm Lamb 5035380165 P. 3
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/ Property lines
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CITY OF TIGARD , ,, • . ,_., ,
BUILDING DIVISION
Aitk --ERMIT #: MEC2007-002135
13125 SW Hall Blvd., Tigard, OR 97223 D E ISSUED: 5/17/2007
Phone: (503) 639-4171
, . 6 0 111 1 1 1 1. d dop /-
Inspection Requests (24 Hrs.): (503) 639-4175 --)
' INSPECTION WORKSHEET FOR DATE: 9/24/2007 TIME: 7:0 it . PAGE: 37
SITE ADDRESS: 09995 SW GARRETT ST CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 011 TYPE OF USE:
PROJECT NAME: JENSEN
DESCRIPTION: Installation of a heat pump and a gas furnace.
OWNER: JENSEN, STEVE & LORI PHONE #: 503-620-5573
CONTRACTOR: FOUR SEASONS HEATING & A/C INC. PHONE #: 503-5381950
Inspection Request Scheduled For: Date: 9/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 056172-01 503-620-5573 N
Corrections/Comme.nts/Instructions:
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JI<A PARTIAL APPROVAL n CANCEL 0 NO ACCESS
FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
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Date: 1/4 9/ 1 , -1 ./
Inspector: Phone #: (503) 718- 2 2_,
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