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Permit
CIT OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00123 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/27/2007 PARCEL: 2S110BC -00501 SITE ADDRESS: 14670 SW HAZELTREE TERR ZONING: R -1 SUBDIVISION: AMES ORCHARD LOT: 002 JURISDICTION: TIG PROJECT: CLINTON Project Description: Replace (2) gas furnaces & ductwork. 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: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 2 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: > 10000 cfm: Owner: FEES JACK CLINTON Description Date Amount 14670 SW HAZELTREE TERR TIGARD, OR 97223 [MECH] Permit Fee 2/27/2007 $72.50 [TAX] 8% State Surcha 2/27/2007 $5.80 Total $78.30 Phone: 503- 639 -8345 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: mil, j Permittee Signature: _ e D 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. IS Mechanical Permit Application roil OIFR'I. USE ONLY ��� f ) R eceived 1 Permit No� JC!✓V� D ! �O City of Tigard X011 iF `' o atctay &/ 0 �� i 13125 SW Hall Blvd., Tigard, OR 972 S - " \-' Plan Review Other Permit: , Phone: 503.639.4171 Fax: 503.598.1960 ' " Date/13y: Inspection Line: 503.639.4175 Date Readv,By: Jwia_ il See Page 2 for I't1;�11:D Internet: www.tigard- or.gov FEB � ' '1°'n7 NotifiediMiethod: Supplemental Information i"' TYPE OF WORKIL,D)N(� 1..} 1,, `'.'" COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees` are based on the value of the work New construction ❑ Addition /altetationlreplaeement performed. indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment labor, overhead, and profit , Value: $ . CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYS I EMS FEES'` 0 1- and 2- family dwelling 0 Commerciallindustrial ❑ Accessory building For special information use checklist. ❑ Multi family 0 Master builder ❑ Other: ' Description Qty. Ea i Total JOB SITE INFORMATION AND LOCATION . Heating/cooling / Air conditioning or heat pump Job site address: / 7;9 � / ? e /70e /OW/ (requires site plan showing placement) 14-00 City/State/ZIP: Furnace 100,000 BTU (ducts/vents) e2-- 14.00 , Furnace 100,000+ BTU (ducts/vents) • 17.90 Suite/bldg. /apt. no.: i Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work / I4.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), . in -wall, in -duct, suspended, etc. ' 10.00 , Flue/vent for any of above 10.00 Subdivision: Lot no.: Other: i 10.00 1 Tax map /parcel no.: Other fuel appliances I DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 r Tr y � . ,1v �t� Flue vent for water heater or gas fireplace 10.00 /7..P�g a. e -- [,cam • . 7 -4.. . Log lighter (gas) , 10.00 f Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimney /liner /flue/vent 1 0.00 P ROPERTY OWNER © TENANT Other: 10.00 • f Name: __,Jd' /j ( /�/Lf74 Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 10.00 City/ State/ZIP: ; Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (.)3) 3 ? g 9 ,..... . Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT 0 CONTACT PERSON Attic /crawispace fans 10.00 Other 10.00 Business name: Fuel piping Contact name: m -p 1.b $5.40 for first four; $1.00 for each additional Furnace, eta _ Address: Gas heat pump City /State/ZIP: WalUsuspended / unit heater _ y Phone: 6 [ 9 . '� (� F ax ::6 l S g, 6 � Water heater Fireplace E -mail: . Range , CONTRACTOR Barbecue • Clothes dryer (gas) Business name: A • e 0 • , a • 6 _ I ! Other: Address: /) City/State/ZIP: I �- — 3 p A I MECHANICAL PERMIT FEES'` cT' Cit � 0,, , 6) 76-1 I f Subtotal • y r / Minimum permit fee ($72.50) Phone: (2)3) l -'�- - 20 Fax: � �' — 0 27Z Plan review (25% of permit fee) CCB tic.: State surcharge (8 °J° of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within I SO Authorized signature: g��4(-6;, days after it has been accepted as complete. / � /y I' / Print name: / [, 1 Date: �/7A ` Fee methodoaobry set by Tri- County 9uilding Industry St:nnce Baani 1 \MEC- Permit Ano.doc 04/06l06 / 440 (1 I'm/commas) Z'd OLZO ONILV H viewn100 e LO LZ clod CITY OF "T .:. D .. _^ BUILDING DIVISION PERMIT #: MEC2007 -00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2N27/2007 Phone: (503) 639 -4171 A A Im�ii� �� j Inspection Requests (24 Hrs.): (503) 639 -4175 ��' :_.. INSPECTION WORKSHEET FOR DATE: 4/10/2007 TIME: 7:00AM PAGE: 40 SITE ADDRESS: 14670 SW HAZELTREE TERR CLASS OF WORK: SUBDIVISION: AMES ORCHARD LOT #: 002 TYPE OF USE: PROJECT NAME: CLINTON DESCRIPTION: Replace (2) gas furnaces & ductwork. OWNER: CLINTON, JACK PHONE #: 503 - 639.834 CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 -624 -2704 Inspection Request Scheduled For: Date: 4/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 046249-01 503 - 6242704 N • Corrections/Comments/Instructions: r Lzr+ # g Z 4 • ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: Date: 4- _lv ° 7 Phone #: (503) 718-