Permit t"
CITY TIGA MECHANICAL PERMIT
14 DEVELOPMENT SERVICES PERMIT #: MEC2005-00775
° -- i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/22/2005
PARCEL: 2S111 DD -15300
SITE ADDRESS: 08743 SW HAMLET ST ZONING: R -7
SUBDIVISION: MILLMONT PARK LOT: 030 JURISDICTION: TIG
Project Description: Install A /C, 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: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DALE BLUE Description Date Amount
8743 SW HAMLET ST
TIGARD, OR 97224 [MECH] Permit Fee 11/22/20C $72.50
[TAX] 8% State Surcha 11/22/20C $5.80
Total $78.30
Phone: 503 -598 -8934
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Phone: 503 - 624 -2704
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: �l A�_ser Permittee Signature: __L-C., (?'
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.
.. v•
• .• • ..
, -
Mechanical Permit Application,,n FOR OFFICE USE ONLY
City of Tigard 5\0J1-)
.3 P.eceived
i Date/B 1/ _ 80 Permit ,:c.s _ 775
125 SW Hali Blvd., Tigard, OR 972 Is** y.
-7
Phone: 503.639A 171 Fax: 503.5V.1140' Plan Revie 1 — 1°)
Cther Per:nit:
Inspection Line: 503.639.4.75 1 ..: tilt....1,1 A 4\ Date/By:
Internet: www.ci.tigard.or.us
0 'I
u i J • Date Ready/By:
Notified/Method: r El See Page 2 for
--; .mat.on
' Supplemental Inor
1 • J.: ;..:;'';'..:':it=t 41'.;J:... 5.N.Y.,,,.. • ..;:-.....,..,--,:. - ... :::........• :, - • •- .c..ommEp.c -FE r .scHEDTSLE - USE CHEC KL is-
0 New construction S-ActOonlalteratiorvreplacement
Mechanical permit fees" are based on the value of the work
, I
performed. Indicate the value (rounded to the nearest :foliar') Cl .
0 Demolition 0 Other:
mechanical materials, ecuipment, iabor, overhead, and profit
II'I•X•=414:I.:4I'IIIIIIII:II:I-Ii"-:\:I.1-'ektEd•ditie--45t';..e6ritl&I6isT -:' ' . • '''',.• • ' '-', •:. Value: S
.i . .0SE1"? . TTAL EQUIPMENT / SYSTEMS. FEES'
Cal - and 2-family dwelling 0 Commercial/industrial 0 Accessory building
Far speciel info rrnarion use checklist.
0 Multi 0 Master builder El Other:
Descnption I Qty. Ea. Total
:FI.,.1I}.;::`''.''..i1:t,:•-i0.13',Isi*:47*.ciiii■4:#00--..1.0410:)..-4#o;,..,Y:..:2''-.•-•:•::::--,••:.;....,:,.:.% r':1.1 Heating/coolin
Job site address: f 7"V3 52d Air conditioning or heat pump
, (recuires site plan showing placement) . /
City/State/ZIP:
Furnace 100,000 BTU (ducts/ye:us) ' / , 14 DC
Furnace l00,000-+ BTU (ducts/vents) 17 DO
Suite/bldg./apt. no.: Project name:
Gas heat pump l 400
Cross street/directions to job site:
Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 1400
Unit hea:ers (fuel-type, rot electric), I
in-wall, in-duct, suspended, etc. 10.30
. Flue/vent for any of above ! 10.00
Subdivision: Lot no.:
.
Other: I 10.00
Tax map/parcel no.:
. Other fuel appliances
: I
kl 10.00
Water -,
Gas fireplacz.• 10.00
. - 1-'--- , 7 -Z e 74a./0 ) Flue vent fo i water heater or gas
; fireplace 10.00
/,{_,...4...15--"fz:2_.e._,e_ -/f-C---•
_ Log lighter (gas) ' 10 00 I
Wood/pellet stove I 10.00
Wooc fireplace/insert 10 00
,...• .,-,... .„ •. .. i • ... • , .-. - • ,• Chim 00
0, ney/liner/flue/vent 10.
:' ; :';I i I V ; in'A l 47i 13 9-MV1f. I ;IM-Fg..e '1 2- 7 V •I':••!:'-;*I.1;:._ri .. .-- . -. - -..• :-: - -.- ,,,
:
10 00
Name: t,o / Environmental exhaust and ventilation
Range hoodiother kitchen
Address:
equipmen: 10 00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone26 ) ,...„5' e r73 .Z' Fax: ( ) toilet compartments, utility rooms) 6.30
,, Attic/crawlspace. fans . 10.00
Other: .0.00
Business name:
Fuel piping
Contact name:
Aq. ■0,9 Ab y $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
aty/State/ZIF':
Wall/suspended/unit heater
Wat
Phone (" lb v D2 ,,.. 0 „7( Fax: : (3 e r '03) . 5 , e,;(;,71-) Water heater
— Fireplace 1
E-mail:
Range
." 'fi l ;. : : : :; :: : -4 ■1 ;" -1:_1, - ;t7, 1' ,I ' ,1:: : . • c ' .-: •:'., Barbecue
Clothes dryer (gas)
Business name: / ik.f 4 ...," 1/ - "ma c -I- _,,,
— - Other.
Address: / 0. aox olt3e>,17 _ ;.l.. :.,
Ci:y/State/ZEP:
Subtotal :
7 / G- ..9-..42-eJ 0.03— ? 7 e?
Minimum permit fee (372.5C)
Phone: ‘ ) 4 07 e . 7.9 , 7z Fax:(3- ) 5 . 1 9• � , Plan review (25% of permit fee)
CCB lie.: 7 4 3 5 9' State surcharge (8% of permit feel
TOTAL PERMIT FEE
Authorized signature: (22---e..e......P---0::2 4 This permit application expires if a permit is not obtained within ISO
, days after it has been accepted as complete.
Print name: , 4424,. .4 ,,,,,,- Date: / 1 * Fee me:hodology set by Tri-County Building industry Sersice Eioar
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281 •
(503)624 -2704
SITE PLAN
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ADDRESS: c.5
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CITY OF TIGARD ilk :t
BUILDING DIVISION PERMIT #: MEC2005.00776
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/22/2005
Phone: (503) 639-4171 ApuR k
Inspection Requests (24 Hrs.): (503) 639 -4175 .414:f
INSPECTION WORKSHEET FOR DATE: 1211/2005 TIME: 7:08AM PAGE: 52
SITE ADDRESS: 08743 SW HAMLET ST CLASS OF WORK:
SUBDIVISION: MILLMONT PARK LOT #: 03 0 TYPE OF USE:
PROJECT NAME: BLUE
DESCRIPTION: Install NC, replace gas furnace.
OWNER: BLUE, DALE PHONE #: 503 -598 -8934
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 - 624 - 2704
Inspection Request Scheduled For: Date: 12/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022706 -01 503 -624 -2704 N
Corrections /Comments /Instructions:
/R-
•
PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
1,