Permit C ITY OF T I O n R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -10035
DATE ISSUED: 3/20/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103D B -02300
SITE ADDRESS: 13455 SW GENESIS LP ZONING: R -4.5
SUBDIVISION: GENESIS LOT: 017 JURISDICTION: TIG
Project Description: Replace furnace and water heater.
CLASS OF WORK: OTR 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: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TED MAYHUGH Description Date Amount
13455 SW GENESIS LP
TIGARD, OR 97223 [MECH] Permit Fee 4/4/2006 $72.50
[TAX] 8% State Surcha 4/4/2006 $5.80
Total $78.30
Phone: 503- 968 -8819
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
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.
, . t
MeC}IAI t � al Permit A 5,`[3 . „IQI � Et ''+ ?; s 1 ' 1s Fi F O R C�k I4 E,TJSE;ON Y .
Cl < '
7 y O�' I� c1 �(�� - Date/By .3 04 Permit Noah .o�6C/G 610.i6 1312. SW Hall Blvd., Tigard, OR 97223 ,a Plan Review "
?hoot. 503.639.4171 Fax 503 598.1960 - !^ *l ., � Plan y: Other Perrnir, • •
lnspeeiiUtt Line: 503 639 41 75 r . „� �'�" Da te Ready /By' .Ions Srr Puke Z fur
ifteniei' W WW ci.ti ar d.o r.us MAR 1 ? �.S . : R + U: : ;__. m � /
h Noti Pied /Method, V /( Supplementai lnfarmn[imt
Y I i•yl 11Y
O r �� COMMERCIAL FEE" SCs` FIE.DULIW -USE CHECKLIST
I x, t e Meehanical permit fee are based on the value of the work
I El New construction D Ad tti0n/alteratiOn/replccment performed. Indicate the value (rounded to the nearest dollar) of alI
❑ Demolition 0 Other: _roeehvntcal materials, equipment, labor, overhea4. and _pt•Uft.
W CATEGORY OF CONSTRUCTION Value: S
1 - and 2 fatntiy dwelling ❑ Commercial/industrial ❑Accessory building M_ RESZAENTIAL EQUIPMENT / SYSTEMS FEES`
For special information use checklist.
❑ Multi•family ❑ Master builder ❑ Other: Description Qty. 1 Ea. Total
•
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address. 2y (� Air condittomng or heat pump
�') ' � � ► S �!/ (rrt ;uireN iite Ono shoWit �l£ICeI1,en ;) 14.00
City/Slate/ZIP: • • \ Furnace 100,000 BTU (ducts/vent%) f 14.00 POO
y � O ` �) C Furnace lUC1,040k BTU (ductatvettts)
1.90
ymteybldg /apt. no,: Plojet t nalnc �t� Yy U�� 1 Y� ). Gas heat pump 14,00
Cross street /directions to ;ob site. '�+A+ A` t�1 Duct work 14.00
- - - Hrdronic hot water system 14.00 ,
L— _ Residential boiler (radiator or
_hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, induct. sus. ended, etc. 10,00
�" Flue /vent for anzof above 10.00
Subdivision' Lot no.;
Other. J 10.00
Tax map /parcel no • .... Other fuel alliances _
I-- DESCRIPTION OF' WORK Water heotct 10.00 Q.1►�
a — Gas firc•lace NM 10.00
) Y 1�c, , 3, IC\Q'� Flue vent for water hearer or gas
1..1 z a a e` \
fireplace 10,00
Log lighter (gas) 10.00
Wood /.ellet stove Mill 10.00 UM
— Wood tire•lace /insert _MIMI
- • Chimney /liner /flue /vent NM 10,00
1g PROPERTY OWNER 0 TENANT Other: _ 10.00
Name: • r tr. . i Environmental exhaust and ventilation
Range hood/other kitchen
Address' 1.3 CD- ` \„)__Loy e ui•ment 10 no
Clothes dryer exhaust 10.00 - City /State /ZIP: ./ '5n(` 1 , `� 04 i'• (bathrooms, �`jj Single-duct exhaust bathrooms.
( ) F ms) 6 SO
Phony, ( ) � ( � In .. -,. toilet Compartments, utilit rooms) Attic /crawls )ace tans [0.00
APPLICANT Q CONTACT PERSON J ■
_ Other. 10.00
Busutess name ,.(N (\S D`` C , . Fuel piping •
Contact Hanle` $3.40 for first four 51.00 for each additiona
Furnace, ate, _
Address. - . , _ Gas heat um
City /State /ZIP: M Wall /suspended/unitheater „ ,—.
—
Water heatel
_ t �
_
L co trc•laca
E -mail 1n av\ QnC�n\\x\\().C• C�.. , RanGc
CONTRACTOR Barbecue _
_� ` \` Cis C `` Clothes dryer (pas)
l Business name 1 1 �,(� tCY �t� Other • _ ,_
[_.A2ddicss. )'1 C k). LlA,ci " a i.,_ .. MECHANICAL PERMIT FEES*
n \✓� v\� �Vi subtotal } t CirviStwe. ZIP � Minimum ) crmrt f�c (572 101 ��,�Q
Phone. (l 1! )231:1k,5(9\ Fax' ( ) S 1 �_ ,._ Plan review (25% of permrt fcc)
State surcharge (S`%t of permit fee) �
CIS r ` :2 IT fkl l0'1:�L. Pk:Ry[ I l F @E 3) J
I 1 . I /, ' Thy. per aril . p.ptt ' if a perotit i not ubtau,d •v,CU'n
I.
\ulhtll Vct1 , ..i lt:itttle _ - -- - ' - - 4 d.ty+.lIt. it I>aa UPCn rtcrplCri ux complete.
__ ----- ."a 6_- ` '' D it _ 11, i11 ;ct by I n.i umlly itu SIII tt. I0,1,n try \c rv," hotr
Td WdTZ:SO 900E ZT "- N EELSE8E 20S : •0N 8N0Hd but loop 'g EUT - H 1IlDNd : WOJd
CITY OF TIGARD
BUILDING DIVISION -• *7 PERMIT #:/f jJ.7O - /0035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 % iiii Nm irlpyl�" i i-
Inspection Requests (24 Hrs.): (503) 639 -4175 � `'J..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 3 `t' Z --- G---e-vt-e-c--/S LP CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
) PROJECT NAME:
DESCRIPTION:
OWNER: •<•"°' PHONE 511�D CR----117
CONTRACTOR: devv‘ e_ PHONE #.
Inspection Request Sched led For: Date: /../.
— /0 61 Pour Time:
� .
Code # I spection Description Confirm # Contact # Messagefr . . _
699 F rt C a . i(A-ce • ‘' CL11( Ci/ke_SL) t 2 ''
Corrections /Comments /Instructions:
I
'3 10 F kyG ___
A ,,__,.
. ,
11 .-'-.. _ _ ____,,
, , v..
r - All■ , girl
. '
, .
, ,
ASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI *NAL FEES ASSESSED
..-... 'a.
Inspector: Date: • ` 46 :i. � Phone #: (503) 718- 211k .