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Permit
` ii/sl St , il 'CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00557 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/13/2008 PARCEL: 2S 114AB -05500 SITE ADDRESS: 09365 SW MILLEN DR ZONING: R -4.5 SUBDIVISION: KNEELAND ESTATES LOT: 042 JURISDICTION: TIG PROJECT: WALKER Project Description: Install gas furnace. 11/18/08, ADDING A/C. 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES PAULA WALKER Description Date Amount 9365 SW MILLEN DR TIGARD, OR 97223 [MECH] Permit Fee 11/13/200 $72.50 [TAX] 12% State Surch 11/13/200 $8.70 Total $81.20 Phone: 503- 718 -2508 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: C-�(.alt 4( Permittee Signat e: .41. ��1 Call 503.639.4175 by 7:00 a.m. for inspections that business da . 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. J , `1c , Mechanical Permit , pplication w `�� FOEi :oI I I {'E,I `L )N1 V'' . '. City of Tigard ./� . Rec ... Permit 1 0- 13125 SW Hall Blvd_ Tigard, OR 97223 1 Q m Phone: 503.639.4171 Fax. 503.598.1960 NQ� 1 p �y eK Other Permit: T I GARll Inspection Line: 503.639.4175 \ .e GNR� �, tc Ready /By. t�� h ES See Page 2 far Internet: www.tigard- cr.gov l o 1� Wetified/Methvd: Suppicmentat informaan V TYPE OF WORlelu1. ,v � . CONLMERCIAL FEE* SCHEDULE - USE CIIItCKLIST ❑ New construction �dditioniaheration /replacement Mechanical permit fees* are based on the value of the wort performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. _ CATEGORY OF CONSTRUCTION S RESIDENTIAL EQUIPMENT / SYSTEMS FEES* - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory' building For special information use checklist, ❑ Multi - family' 0 Master builder ❑ Other: Description Qty Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 9 2 6,...5- 4 e /� t + Air conditioning or heat pump v 1 J / r U (requires site plan showing placement) 14,00 City /State/ZIP: (r }-om, Furnace 100,000 BTU (deets/vents) 1 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 • Suite/bldg. /apt. no.: Project name: . Gas heat pump 14.00 Cross street/directions to job site: 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 • Subdivision: [cat no : Flue/vent for any of above 10 -00 Other: 10,00 Tax map /parcel no.: Other fuel appliances �. DESCRIPTION OF WORIC Water heater _ 10.00 Gas fireplace 10.00 ---)s/1- 6-1 , / rJr —A, Flue vent for wain heater or gas fireplace 10.00 /./ - Lo iii titer (gas) 10.00 Woodlpellet stove 10.00 Wood fireplace/insert 10.00 © PROPERTY OWNER I El TENANT Chimney/liner /flue/vent 1000 Other: ' 10 00 Name: 1 a �� n `-1 / �� f/ � -� Environmental exhaust and ventilation Address: rte- Range hood/other kitchen 10.00 equipment City / State/ZIP: Clothes dryer exhaust 10.00 7 ( n r . S Single -duct exhaust (bathrooms, Phone: ( 3) �f- /! •5 71 � q - 0 7 F ax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans , 10.00 Other: 10.00 Business name: Fuel piping Contact name. 4 J 'Dc q / L y 55.40 fur first four: $1.00 for each additional Address: Furnace, etc. Gas heatpump City/ State/ZIP: Wall/suspended:unit heater Phone: 3 )6 2. q -- —) D Fax:: )� l 8- (. 5 ]. 7 6) Water heater . Fireplace E -mail: Range CONTRACTOR Barbecue • Business name: ( ) (,e m bI c,, p,,.+�.A.,,f- E / c, - Clothes dryer (gas) Address: e, / o x . .Z 3 Other. 0 3 1 N(ECH.1N(CAL PERMIT FEES* City /State/ZIP: ! , , , , d ,- 9 2., -/ Subtotal J Minimum permit fee ($72.50) Phone: (S?[) C. r - I — 7- 70 $ Fax: ( 33 ) �/f ? - ' i r3--]6 Plan review (25% of permit fee) CCB lie.: 7 fp 3 S q ' State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized si ture: This permit application expires if a permit is not obtained within 180 d ays after it has been accepted as enmpiere. Print name: yt /' /, �� ; / Date: /7/ / ? zi ry 1 a Fee methodology set'by Tri- County Building Industry Service Bocrd (% 440 -4617T(I ro2�CO E'd OLZ0 869 ONIld2H d18Wl100 B017 :L0 90 9l AoN gir HEATING & COOLING, INC. P.Q. BOX 230397 ' TIGARD, OR 97281 { 503 }624-2704 SITE PLAN afS' j ADDRESS: 3 6 5 Si-) 4 17'd OLIO 869 - £09 ONI1d2H VI8 Jfl 1OO eO17:L0 90 91. AoN , . til TIGARD BUILDING DIVISION PERMIT #: MEC2008-00557 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2008 Phone: (503) 639-4171 A . Va Inspection Requests (24 Hrs.): (503) 639-4175 a" --" INSPECTION WORKSHEET FOR DATE: 12/3/2008 TIME: 7:00AM PAGE: 19 SITE ADDRESS: 09365 SW MILLEN DR CLASS OF WORK: SUBDIVISION: KNEELAND ESTATES LOT #: 042 TYPE OF USE: PROJECT NAME: WALKER DESCRIPTION: Install gas furnace. 11118/08, ADDING NC, OWNER: WALKER, PAULA PHONE #: 503,.718.2508 CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 50 • Inspection Request Scheduled For: Date: 12/3/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 078728-01 503.799-8079 0 - rit3k Corrections/Comments/Instructions: 1 co - 1 : - 30 eA-248 , ....— 1 A i Al Illfil' . I I A rMail INIM i i mm t . A4 imp F. 0,- ■ .■ - , . I A i ' • C / -.....,, f fl PARTIAL APPROVAL 0 CANCEL Fl NO ACCESS n FAIL I CALL FOR INSPECTION FI ADDITI , A EES ASSESSED O■ 4 vir ' Inspector: . IIVP Date: r2 , idg , Phone #: (503) 718- z4