Permit .a +
C IT 1 OF TIGARD MECHANICAL PERMIT
^' I DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00294
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2005
PARCEL: 2S 112CA -02300
SITE ADDRESS: 15210 SW GENTLE WOODS CT ZONING: R -4.5
SUBDIVISION: GENTLE WOODS LOT: 015 JURISDICTION: TIG
Project Description: Replace furnace and a /c.
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: 1 DOMES. INCIN:
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:
Owner: FEES
VOLLSTEDT, BRUCE T + DEBORAH J Description Date Amount
15210 SW GENTLE WOODS CT [MECH] Permit Fee 6/2/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchaq 6/2/2005 $5.80
Phone: 503- 291 -6642 (wk)
Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Phone:
Reg #:
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 OA' • - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -80' 32 -2344.
•
Issue By: A �1 f Permittee Sigrketure: A ��A_- �,- -
-
Call 503 - 639 -4175 by 7:00 a.m. for inspections that b ess d.y.
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.
JUN -01 -2005 WED 10:15 AM FAX NO. P. 02
03/01/2006 08:06 FAX 5036981980 CITY OF TIGARD el °VG Dt e (i)it 11 ; ! I ki'I J (NI > \1 = \'
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Cl' of Tigard . ^0�s ` ®� a Pofmtl Na_ ._� r r� ' ■
13175 SW Nall Blvd., Tigard, OR ,7 11 to : sw °e'erN ode
Fboac: 503.639 -4171 Fax, i F '150 betc/B :
inepeeelor Llr s: 509.631 ! , ' 09 , 11.1. fl 1 vas Ready/Br Ir
women www.ci.t3snrd.00us 0 `- \ ti NaiSed/Melltod: ∎4' ( a
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fi ; y1 Y " a : s . ue ,,:•,t t . . 1 .. � ! 1� I.I .. n�, „s c ev.� ,.1n ■ u�uai�wr i a Nfeebaniaal turaut fester are based Ott Ilia value of the work
Q New onnstNCdon 0 Adc3iiV - • • 0itsplacenint performed. Indicate the value (sounded to the neatest dollar) of ell
[a Denlnlidon 0 Othe 1 :1._ hanical Inman value $ labor overhead and refit
1 , f : ' Je• ' • ('1 1 .,' 1'+_ - lu%r' OR ' " � 1 �f�V � V Mypir � :Mili.} 2;f '
.1'0. • ' 1. :, .1 '1 � ..J...: , 1,' .. I . J ....t :I L • ..Dl. 1 % "! t fl Mr J: tagirg IM'�.r. ] .
a1. and 2- ecn illy dwelling Q Cana: terciaUimdusl ial [] Accessory building ' l r
❑ M,alti amily 0 Mash builder Q Other T Desori •tip ear Fla. Tow
�i 1. � .. � I .•;' J .: r . r - 1 t o .. "} I� , i 4 " _ M .
r c F - Air conditioning Or heat runlet t4.U0
Job site address: _ t 3 , W • tees sit . • , . Vlin. • l ac e • • +
ei 4's ar e 1 .,. `� 14 Mal
>S' Ste '' : ( ' . a c +�� Furt>tica 100 .00+ BTU ducolveats MN 17.90
Suite/bldgJapt W.: Project OM Deo • • • • 1400
GOOSE reet/directions to job site: • -� r� - . f o . Auot work 14.00
Ii . 6 • iC RoSbtl" rem IIM 14.00 •
r, - 14.00
' • nit ionises (fuel gips, not elaotrie),
in.wall in,dac sue ended. ete. 10.00
y r 10,00
Subdivision: . , , ! r 10.00
Tuft:op/parcel no.: Otis fuel • tlanoeu
•.1 1 ; i Y ,, $ Water heater 10 IIIMI
jj
1 n ,3 10.00
. , ' . L . ..' i.. ti . f t. I r w . �. _. 1 i ! . , .. :.... , Oae . ..lent
• uc vent for water heater or gas
LIv+lace 10.00
10.00 MINN
W... f • ellet ,awve 10.00
Wood di - lace/insert _ 10.00
_ Oblmne /liner/flueNaut _ 10.00 NMI
P 4 t • n 1 . e -t'= '.'_. II 1 ' " , .
� ;Try 1 ` P ... , .. ?a ilS +;1.' i Other. _ 10.00 OMMI
Addrm: / ---- /Q J ..J Co - e,"-F1n - ,>,• -f- . ,. 10.
City/Stata/LIE': ,---f , a e C • cloth . et exhaust Mil
3ingto•da,et exhaust (batbrovme.
pax: ` e 2 S toiletc eitkwets al rooms • -SO
a9 �6yZ _ )aC r
1111°116t ) r f 1 1. 1 ✓ i'i� 4' X 51 ^r _ 10.00
..; Ia L 1 0.00
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• �l'J y �: y ' . � � . . . � �i .. 1 � r w � � � .!'• I DOther lllielnt"9E Dame:
Contact Dame- 5.40 for Drat four 1.00 for sash additional
Address; .
Ciea Asst .,
City /State : WuU/sud • - dad/unit heater ME
Phone: ( ) per: ; ( ) Water heater IMO
13.-mail: '' : •1 ‘ 1 • • 1 t 4 ' Babette _
Clothes . , MINI
Busmcias MUM Oirriii Other -
Address: ,I %' .. :A, „,.,%..s. g.• ...:��.i ...,..r ! ., :mil,'
Subtotal
City/State/ZIP; - it fee 72.50)
Those: ( ) Pax: ( ) Plan review PS% of • - 't foe
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JUN -02 -2005 THU 11 36 AM FAX NO. P. 01
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200& -00294
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2005
Phone: (503) 639-4171 mnirituv. l
Inspection Requests (24 Hrs.): (503) 639 - 4175+-
INSPECTION WORKSHEET FOR DATE: 6/10/ ' , 115 TIME: 7:05AM PAGE: 79
SITE ADDRESS: 15210 SW GENTLE WOODS CT CLASS OF WORK:
SUBDIVISION: GENTLE WOODS LOT #: 015 TYPE OF USE:
PROJECT NAME: VOLLSTEDT •
DESCRIPTION: Replace furnace and a/c,
OWNER: VOLLSTEDT, BRUCE T + DEBORAH J, PHONE #: 503 - 291 -6642 (wl•
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 008967 -01 503.639 -0702 N
Corrections /Comments / Instructions:
•
•
iA PASS ❑ PARTIAL APPROVAL ❑ CANCEL IPI NO ACCESS
❑ FAIL V/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ‘.1 0.3 Phone #: (503) 718-