Permit q CITY OF TIGARD MECHANICAL PERMIT
:. COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00588
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/8/2007
PARCEL: 2S 111 AB -07800
SITE ADDRESS: 09385 SW INEZ ST ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT: 023 JURISDICTION: TIG
PROJECT: GREEN
Project Description: replace gas furnace and install a/c unit.
CLASS OF WORK: ALT 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
GREEN, DONALD N JR AND Description Date Amount
MARJORIE M
9385 SW INEZ [MECH] Permit Fee 10/8/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 10/8/2001 $5.80
Phone:
Total $78.30
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.
Issue = � ���� Permittee Signature:
Call 503.639.4175 7 a.m. for inspections that usiness d
by 7:00 a p ons t at us ay.
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.
1
M -chariical Permit Applicatio FOR OFFICE I S cz�t.�
City of Tigard v , D� /d r«,rritrlo.: /L�EG2QDS
1 3125 SW Hall B vd., Tigard, OR 97223 7 /r/ 5 � -
II Phone: 503.639,4171 Fax: 503.598 DatcJBy: .1960 0 T 2oo Flail � Other Permit: '1 1 Ci A R I} Inspection Line: 503.639.4175 COTY . D ®F Tl Date ReadyiBy _ Juris. E Sec Page 2 for
Internet: www.tigard- or.gov BUI11i6 ®I � ® � It ��� ® � a Notified/Method: 77 �/ 1
Supplemental information _I
U91itd V iv
. • • f - TYPE :OF.'WORK•: ' :97M41,1ERCIAL SCHEDCTLE — USE CHECKLIST
0 New construction ' ❑ Addition/alteration/replacement Mechanical permit secs• are based on the value ot'the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit. • CATEGORY OF CONSTRUCTION • . Value: $ •
.RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling; ❑ Commercial/industrial ❑ Accessory building 1
1 For special Information use checklist.
❑ Multi - family • ❑ Master builder ❑ Other:
I Description I Qty. I Ea. Total
JOB SIB INFORMATION AND LOCATION • I Heating/cooling
Job site address: l �- j Air conditioning or hero pump
/f t: l�J n ! y 1 (requires site plan showing placement) 14.00 ray 00
City /State/LiP: !Furnace 100,000 BTU (ducts/vents) / 14.00 1 / 4. '0Q
Suite/bldgJapt. no.: Project name: I Furnace 100,000+ BTU (ducts/vents) 17.90 '
1 Gas heat pump 14.00
Cross street/directions to job site: 1 Duct work 14.00
1 Hydronic hot water system 14.00 ' I
Residential boiler (radiator or
hydronic) 14.00 1
j I:nit heaters (fuel -type, not electric), i
in -wall, in -duel, suspended, etc. 10.00
Subdivision: Lot no.: 11 Flue/vent for any of above 10.00
I Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK • ' .. , t,.-: Water heater 10.00
4,4 ! Gas fireplace 10.00
Zi2 /or 6 9- 4 11 ttZ.,,...."---/ Flue vent for water heater or gas
7,94,— / 7 fireplace I0.00
�� < ` I Log lighter (gas) 10.00
. I Wood/pellet stove 10.00
Wood fireplace/insert 10.00 1 • '6PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: nvir _ 10.00
Nye z.,9'9.4,7 C. c Environmental exhaust and ventilation
Address: Range hood/other kitchen
• equipment 10.00
City /State/21P: 'Clothes dryer exhaust 10.00
' Single -duct exhaust (bathrooms,
Phone 3) .�f 7� Fax: ( ) toilet compartments, utility rooms) 6.80
0 APPLICANT v � 9 • ❑. CONTACT PERSON Attickrawispaec fans 10.00
• Business name: Other _ 10.00
Fuel piping
Contact name 171 VII 4, 55.40 for first four; $1.00 for each additional
Address: I Furnace, etc. 1
. Gas heat pump
City/State/ZIP: . WalUsuspended/unit heater -i
Phone: (73 t ) .L / 3 :7 D f. Fax; :0)3) S 6 �7 6 I Water heater
E -mail: Fireplace
Range
• 1 I
CONTRACTOR .. Barbecue
/ Clothes dryer (gas)
tu b Business name: c) I 14447Di ( i If _p�l 'I n t6.. J
) I l
Other:
Address: i) X —3 c 347 IT MECHANICAL PERM FEES*
City /State/ZIP: / / 1 X12. "`' �� c9 7L/ I Subtotal 24 , no
Minimum permit fee (572.50) "4-2, Sp
Phone: 67) J 3) !0 I -',2)-74, 9 Fax: v, J 9 - 0 27Z) Plaa.review (25% of permit fee)
CCB lie.: 635 , i State surcharge (8% of permit fee) , 8'0
TOTAL PERMIT FEE . 30
This permit application expires if a permit is not obtained within I80
Authorized signature: days after it has been accepted as complete.
Print name: Date: 9 // ,
G" /9 /4 ,Q . 7 C Fee methodology set by Tri- County Building industry Scrvicc Bowel
I: Ruitding\Permis C- PermiiApp.doc 04/D6/06 440.46 . (IUO2/COM!WEBI •
C 0LZ0 869 - 009 ONLLV3H VI8Wf 1OO 0 60:60 LO 90 PO
•
HEATING &COOLING, INC.
P.O. BOX 230397.11GARD, OR 97281
(503)624 -2704 t
• SITE PLAN
•
•
J `
ADDRESS: ,
Z'd OLZO - 009 DNI1V H VIBWfI1OO e60:60 LO 90 PO
CITY OF TIGARD ,,--- -
BUILDING DIVISION • PERMIT #: MEC2007-00588
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/8/2007
Phone: (503) 639-4171 A*40(40,
Inspection Requests (24 Hrs.): (503) 639-4175 - ffgfar• All., •
INSPECTION WORKSHEET FOR DATE: 10/12/2007 TIME: 7:01AM PAGE: 79
Mc. 150/.14a7 '5
SITE ADDRESS: 09386 SW INEZ Sr CLASS OF WORK:
SUBDIVISION: PENROSE-.: TERRACE LOT #: 023 TYPE OF USE:
PROJECT NAME: t3REEN
DESCRIPTION: replace gas furnace and install aic unit,
OWNER: GREEN, DONALD N JR AND, PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 50:3-G242704
Inspection Request Scheduled For: Date: 1011212007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes
599 Mechanical final 057389-01 503-624-2704
Corrections/Comments/Instructions:
4L___e_. 174 /VeL--- L‘____Arit6,
t(,,C--- S 192-4/Z)
t)piri A4i6( 2 s- 4-1.-1 i
PA t I% 'ARTIAL APPROVAL El CANCEL fl NO ACCESS
n FAIL
g/CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
20
Inspector: A-4401■■: Date: 1 /Z 6 7 • Phone #: (503) 718-
•
■
. .