Permit ' CITY OF TIGARD
!� '*.• MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00229
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/26/2007
PARCEL: 2S110DD -12700
SITE ADDRESS: 10880 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.13 LOT: 697 JURISDICTION: TIG
PROJECT: JOHNSON
Project Description: Replace gas furnace
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
GRACE JOHNSON Description Date Amount
10880 SW HIGHLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 4/26/2007 $72.50
[TAX] 8% State Surcha 4/26/2007 $5.80
Phone: 503- 639 -9793
Total $78.30
Contractor:
EASTSIDE HEATING & AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 774 -3281
FAX 503- 774 -3057
Reg #: LIC 3258
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: JL
Call 503.639.4175 by 7:00 a.m. for inspections that business 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.
Apr 25 07 09:40a Fax Server 503-774-3057 p.2
,
•
Mechici11 _Permit Application - Foit oFFEct: l SL
City of Tigard - ' 1
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13125 SW Hall Blvd., Tigard, OR 97223 .
Ran Review
Phone: 503.639_4 171 Fax. 503.598.1960
AP -- •'' . .. , - , 1 , ‘ 1 0 7 D-113Y: Other Permit:
Inspection Line: 503.639.4175 .7-1.144 ''.. 1-. Date Rcady/By. Jurn: fill See Page 2 for
Internet www_citigard_or.us
CITY OF A D N°6fiedilvicth°d: Supplemental Information
RIJILDIPIr_A pylFicr.
4:4 , i
ED New construction . EtAdditionlatterationfreplacement Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition 0 Other: mechanical materials. equipment labor, overhead., and profit
'7:.'.,: OF •O'rOF*.ircrIcir.i. ..'-i::: -4,V4.7:Lt.A.1.1"3.0 Value: $
: .:':?
KL1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building - *-0 *#41.40
For special information use checklist
D Multi D Master builder 0 Other:
Description Qty. I Ea_ 1 Total
44';;;;;;0* Resting/cooling
: . Air conditioning or heat pump
Job site addressLIOD Stk) pc " L ( 01 . 1 - 2J - ..
(requires site plan showing placement) 14.00
, 9 - 1
City/State./ZIP: I ) .90_ Vet, 0 Ire (7/•,) b
) i r..,,,C.-1 Furnace 100.000 311J (ducts/vents) I 14.00 14.Clic
Furnace 100,000+ BTU (dam/vents) 17.90
Suite/bldg./apt. no.: Project namk
1 i Gas heat pump 14.00 _
Cross street/directions Co job s ite: Duct work 14.00
- 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 , 10.00
Tax map/parcel no.: Other fuel appliances
tiisciiiiir 1*.OF .WORK '.1&::.
0•-f--1.CL('-f
---)
q/ IS rl'N N _ • Water heater
Gas fireplace
Flue vent for water heater or gas I lo.00
, 10.00
fireplace 10.00
Log l ightcr (izas) 10.00
_ Wood/pellet stove 10.00
Wood fireplace/insert . 10.00
60,Niii .,:V...4:r. : 1 .7:_;_, 4 .- 2 . tis v Chimney/liner/flue/vent 10.00
Other: 10.00
Name: ra A P o h r - ) , , ,... )
1....- ..- c, Environmental exhaust and ventilation
Range hood/other kitchen
Address:
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: (. ) 67 -39 -0 Fax: ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
'.''." IDIAPPladttNitki:?',. ,'•;: - kie r , r , : Artickrawispace fans 10.00
Other: 10.00
Business name: - - f - s - i ap 1.4 e ( x4.; r Q 4- P17 v CC; r') A - . _ Fuel piping
Contact name: 4 .4, t ., 2 d $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspendedlunit heater
Water heater
Fireplace
E-Illail: e/-,A ra_.s OD, e-61-A-sli clg il-IPA.--+I oq •cesrei Range
'' -ifIl ' - '' ;--.54k' -Vft57ccOt"001x.:-*6-.?Q.AY.:4-•-...,4:4.-V.,:-':'..! Barbecue
Business •
name S A iv 1 (L.-Pi r--)q -a- kir- ("e.' r--) A - Clothes dryer (gas)
Other:
Address: --7.‘71-0(-) y Pl r? ittrbviiii.0
City/State/ZIP: pc r 4,1 az3 r A 0 ?, q -7.4_01 Subtotal f t CZ_
Minimum permit fee (S72.50) - 7.2 . )
Phone: Cy _ L .. 1 ...., z , rv.i ,.. i Fax: ( 5-) 2) 7 7 L - C...) 7 Plan review (25% of permit fee)
CCB lie.: S, State surcharge (8% of permit fee) .9, 37,,_.) -
TOTAL PERMIT FEE -7 . ;,D
Authorized signatureA.; c. This permit application expires its permit is not obtained within 181)
f days aficr it has been accepted as complete.
Print name: 1,4;;v1 _ v r-Cr-A,k- I Date: Li 1 5 10---7 . Fee methodology set by Tri-County Buil Industry Service Board
I ABUi !din EoPcrrrai tsINF-C-Ptrm nApp . dcc 12/03 440.461 7T ( I IATVCOWWEB)
CITY OF N
l , RD ..
BUILDING DIVISION
PERMIT #: ME02007-00229
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 4/26/2007
Phone: (503) 639-4171 142 041,1i #
Inspection Requests (24 Hrs.): (503) 639-4175 ,-1.4. - 1.11
INSPECTION WORKSHEET FOR DATE: 5/4/2007 TIME: 7:00AM PAGE: 52
SITE ADDRESS: 10880 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.13 LOT #: 697 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: Replace gas furnace
OWNER: GRACE JOHNSON, PHONE #: 503-639-9793
CONTRACTOR: EASTSIDE HEATING & AIR CONDITIONING PHONE #: 503-7743281
Inspection Request Scheduled For: Date: 5/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047639-01 503-774-3281 Y
Corrections/Comments/Instructions:
n PARTIAL APPROVAL fl CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
Inspector: , Date: 6 4 Phone #: (503) 718-