Permit CITY TIGARD MECHANICAL PERMIT
�► itt DEVELOPMENT SERVICES PERMIT #: MEC2006 -00030
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/18/2006 PARCEL: 25111 CC -10000
SITE ADDRESS: 15780 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 127 JURISDICTION: TIG
Project Description: Replace gas furnace.
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
NONA GILCHRIST Description Date Amount
15780 SW GREENS WAY
TIGARD, OR 97223 [MECH] Permit Fee 1/18/200( $72.50
[TAX] 8% State Surcha 1/18/200€ $5.80
Total $78.30
Phone:
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
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: �.t/r �- Q c Permittee Signature: p ,
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.
,, Mechanical Permit Appli * t LCEIV "
FOROFFICE USE ONLY .
Da
City of Tigard �.. Re «i tes y ve d : J � % .,� 06 „ jr Psrni: N:' \es.( ✓t/6 0030
13I25 SW Ha]] Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.558.1960 JAN 8 ;, t ,_, \ Cther Per
_nspccnon Line: 503.639.4175 O _1 i ll Datd3 y'
e �"�. Date ReadyrBy: . iris a Sec Page '_ (Cr
_:Herne: ww•x.ci.tigard.or.us pppggqI CITY OF TIGARD Notified/Method: • 41(r r Supplemental Iatsr na::an • ;';It„rL�'F:Jry 14• +y •', ,) �tY^ K1[1cyi� • #.v It i, i �. p •1 S ` N@ 1 - `-( �_ r:, ' � ... ., i, �I . , , _ -
�ir'4, ' f i e ; � � f s' II " s;€, ;�T - •, .l% q " : ;' ,�;_ 'i14I'E12tr AT1tE ��?t'tS'GCi�.D i7L�E- :L 1 S'
1`r � �CJSEC�HECf
❑ New construction Addition /alteration!replacement ivtechanical permit fees' are based on the ,a :_c e: :n :.
perfo-med. Indicate tine value (rounded to the r.earest Dollar; i
• ❑ Demolition ❑ Other:
mechanical materials, ecu:pm.e ^,t, '.a::or• ove :^ead, Sr.: prct':
�•,�q';a � •q }?, �' � _•. •fir. ,x.r -.. Mll Y:;, \.a .i 1 '_ r..p .. ='. . .. F: - 'i . valu
• 1 �f(\i F,t1 r a ' r� = i. , o e o F ' A ; l j ' 4 , y- •. ; �
: 'rigs? ti p :.. e S
rnercial.� :ndustria: a 1'rQTi 'FQtiZPNLENT / SYS?r�ts FEES
l - and 2- family dwelling ❑ Corr
Accessory bui:ding -
❑ M_] ti- farail Master builder ❑ For spe:idl informnttGr, ase c5etsit,:
❑ Master Qt:rer:
. '" ,._.`yc� r r.a; a• a \r i � r d .,...�.. � Descrip:ton Wit; ". . _...
:Ga ',r L• �, \....�5!S % f� *1�.fr :r " : :,',i'";'''." ,i: 1'I H eating( cool inR - —
Air conditioning r neat :um -T-
g P
Job site address: /
✓ / jS 4-.) /zf (X14-7 (requires site plat showing lacenrcat) ' f _ _
CityiStatelZi: Furnace 100,000 FTU (dris%vcnts; / 14 _
S itubidg.;apt. no.: ?reject name: ' Furnace 100,000+ BTU (duct;/..etas; 1' V...
Gas hear pump i 1-; :G
. Cross street/directions to,ob si :e: Duct work I t, - 'r - -- •
Hvdronic hot water system t CC _
Residential boiler (radiator or T
l hydronic) 1- � � :.
Unit heaters. (f:el -type, not elecnlc;, T
in-wall, in -duct, suspended, etc. ' 1 C. • _
Subdivision: Lot no.: Flue;ven: for any of above , 10 CC
I Tax maptparcel no. Other: l n : u ;
Other fuel appliances
' M 2i W ]e t � A"ih' 4r�^ r.
I i ia r�' �t 1 O t1tiCCYtt 4 .t���e,. L lf. t ;4':!,, � =•� ' -! :' :: r
` :.. .. ,.r -.,,> • — > s ; Water heat ! ^ .r
art v�i'W t !S :s'.�i' €'.;~�> a: f
Gas fireplace I l u _
/lip", /D +a ,l.O
fe.t., j_.„ i Elie vent Wat r heave: or gcs
I Erep:ace
t _Log ::ghter (gas) I 10
Wood /pellet stove 10 i)
i Wood fireplace/insert i 10.0;. :
' '7 ±� t, va .,� 1, vr4;•s,. Ci-imrey,'liner.'(lueh :enl 1_
Oher: I
Name: Ar/./q �' /C/ 1 Environmental exhaust and ventilation
Address. Range hood!o[ her kitchen
equipment I :i G .• '
City /State;Z1P dryer exhaust _
: Clothes dr
y I I �.vt•
Sing.e -duct exhaust (bathrooms,
Phone: ( ) • n • Fax: ( ) toilet ccmpartrnen :s, uti::ty roerns'
( ` .' g1 .• a ��� r ...r.., a ". : Active rawl ace tans I J.C.0
535 fiGi'r7 ,s;3ts' uQ+t :'.. r P
i Business Other: I 1 ness name:
G._.t_
! Fuel piping
I Comae: name: Aq,,,
D/? j� S5.40 for first four; $1,D0 for each addisicnal _
I Address: , Furnace, etc.
Gas heat pump
•City /StateJZP: i
'alllsu;pended!tait heater
Phone' ( 7C, ? b.; y s.7 () V Pax: : 0 '6) 3 ) J ?( 49,??/70 Water heave-
E -mail: Firep:ace
•ray •'7 _ Range
�•',• �� l u ' 7 4:'}�i4� � i't'rt a ' �. nkz'C TY vM� �f y: • `jf' tl` .'' ' t > : :,y+ ----
..sek r a ! $ '`?'lI' ' a . :o.. r ' ": r' "" .- Barbecue
Business name: C p / M b /� 7/... ...4 Clog ^es dryer (ga;)
Address: o 6,9)( 3 Cti err i
, ,r; •.:. .g.k '1•;0IC4PEP.IYII',T';l
cityistate!Zl?.
7 4. #9 0� 9 7� i nZ. 3 SLbtota. --
?:none. ,i) G t7 r{ " c, "T I Fax.- .5 Er DoZ 7e, tv1ini Hu Plan review 25 rt per et (5'0 Si t
, /o of p.r. - .n feel :
CCS tic.: - --- -
3,5 9. I State surcharge (8a /o c: per:-. : :t fee:
I � TOTA ;l_1"
L• ? ERC FEE •
Authorized signature: a.".)- fi e.. I / tbi, permit applt :alion rep.rer if a pe•'ni. is not ;Jt ain.a ., i ;n;n I:
days cfter it has been accepted as complete
Print name: QQ��
�/f/f G a/�7� )/ y Date: l L 0 I , Fee methccoleg; sal ''byTr.Cou :uy Building . cits:ri, Se-..ire 3.w.:
•
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CITY OF.TIGARD
BUILDING DIVISION PERMIT #: M C [1[If; 00030
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: iPi
Phone: (503) 639 -4171 ak gyp (i
Inspection Requests (24 Hrs.): (503) 639 -4175 ?:_..
INSPECTION WORKSHEET FOR DATE: 2/6/2006 TIME: 7:02AMMM PAGE: 613
SITE ADDRESS: 15710 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERF-IELD 140.2 LOT #: 127 TYPE OF USE:
PROJECT NAME: GILCHRIST
DESCRIPTION: Replace gas furnace_
OWNER: GILCHRIST, NONA PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 &2427Q
Inspection Request Scheduled For: Date: 2/60006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 076208 -01 603G24. 27N I
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: �� Date: 2__-6- Phone #: (503) 718-