Permit CI TY OF TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00729
�'I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/2/2005
PARCEL: 1 S134AD -02500
SITE ADDRESS: 11353 SW IRONWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 065 JURISDICTION: TIG
Project Description: Install furnance & A/C units.
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:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS: •
> 10000 cfm:
Owner: FEES
ARTHUR ASHBY Description Date Amount
11353 SW IRONWOOD LP
TIGARD, OR 97223 [MECH] Permit Fee I1/2/200E $72.50
[TAX] 8% State Surcha 11/2/200E $5.80
Total $78.30
Phone: 503 -579 -8515
Contractor:
HEAT RELIEF CO
1311 NE 116TH AVE.
PORTLAND, OR 97211 REQUIRED ITEMS AND REPORTS
Phone: 503- 260 -0077
Reg #: LIC 122424
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: , f' Permittee Signature:
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.
Oct 31 2005 4:59PM HP LFISERJET 3330 p.1'
.
2
4echanical Permit A lication so 1:<)it t), ,• 1('i': , .;i _ <,.1.
:ity of Tigard Received `
5125 SW Hal! Blvd., Tigard, OR 972 iew
� DateBy, 1--.2 -/ -- , - N °� . . 0 1 ` " S_ 9
Plan Rev
lone: 503.639.4171 Fax: 503.598.1.60 ^0 �[ trt J �'�
ci ( Date/By. Och Permit:
spection Line: 503.639.4175 o J ■ _ _'_ I Date Ready/By: lurk; - RI See Page 2 for
,tercet: www.ci.tigard.or.us , '..r0 Notified/Method: --tom I;t , Supplemental Information
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] New construction i. - d • h onta Mechanical permit fees* a based on the value of the work
performed. Indicate the va! a (rounded to the nearest dollar) o
] Demolition ■ Other: mechanical materials, ul ment labor, overhead, and profit,
� �" ' rr 75
;r ~i I ) i I I 1 " x Ir ' . k ' ,'1 , ,;' , 1, -1 1'..1 ) ; 9 V lue S la
s e oro d
A I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ' ''''' ° ' `' s . _ - r I �, ■• '�: •
For special i arm:al use checklist.
Multi family ❑ Master builder ❑ Other
� _ Description Qty. I Ea. Tot
''»�tk ; lt-t s j ° ;W.ila 1. f.rd....',,: . . , : J _. Y, S J II ' ! r19,•;•,, ' ` t V H ea t lu
ob site address: g/cooling
C►rition� heatpu • � a 71��� �' � 1[mq cond uve ssitepla wpla rne 1 14.00
;ity/StatefZlP: - 1 - '1. 012••■• 1 Thu•3 Furnace 100,000 BTU (• vents) i 14.00
Furnace 100,000+ BTU (d , ta/vents) 17.90
iuite/b1dg. /apt. no.: J 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 (filet -type, not electric),
in -wall, in -duct, suspended etc. 10.00 _
>ubdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
fax reap /parcel no.: Other fuel appliances
`.if spat TOI.:- .41... i.i I :r;' ° :3 :: ' I '' '!..•:::,+IIJ�t ( i t ' k, { Water heater 10.00
--rte � )' - p.r [/ra /J , 0 2 S r " , Jw r ?9 Gas f nt f 10.00
(�/F Flue veent for water heater .r gas.
tit S L A `,. • y1 fireplace I 10.00
Log lighter (Ras) 10.00
, Wood/pellet stove 10.00
Wood fireplace/insert 10.00
t �C, , / : Chirrmey /liner /flue/vent ' 10.00
..... ... _.. _ , .:.. Other: 10.00
dame: • a Environmental exhaust a d ventilation
Address: j 1353 S w� 1�Bi <P Range hood /other kitchen
equipment 10.00
City/State/ZIP: \ -k 61 ryerexhaust 10.00
Clothes d
Phone ( I 3 67 ^ ¶I S. Fax ( ) exhaust (bathr exha r • .ms,
k ����y}�s toilet compartments, utili rooms) 6.80
4ar'^C r'17;F ?' f •.r,: .! rt ^ ' ctt ,1 . r I , r I ; ..,j. Atticterawlspace fans 10.00
Business name: 14~ t2A�� AF I R e Other: 10.00
Fuel piping
Contact name: t Ya k ._ c.Sc_ 0 $5.40 for first fb r; $1.00 for each additional
Address: 13 1 1 N e I I e A - Furnace, etc.
Gas heat pump
City/State/ZIP: f (J f 71 ( .1 t) Wall/suspended/unit C -1 spended /unit heate •
Phone: (953, ) -( )-( )77 I Fax: : (5/Z ).c1_Actsly Water heater
E -mail: Fireplace
� h 44
%.3 �+ ibT } i t -.4:Aia ' z r r r' :a ; ` L r -r �i; Range
-
.,., y ca i •, ,. s,,:,:, , . .., . a. t r , tl,. rr ;i �:� Barbecue
Business name: L4CA# tZe_h e. A - Clothes dryer (gas)
Address: _ ` 4 WC 1 j (: Other
r 4 t a + vP,
City /State/ZiP : a d O. ' 7 -►1-Q n .
r Subtotal
Phone: ()) .14 - 007-7 I Fax: (.:38. ) .24.1�8ity Mini m permit fee (572.30)
CCB tic.: ' aat{ay J Plan revi (2S%ofperntit fee)
I
____-..„... State lurch r$e (8%ofpermit fee) ,1
• TAL PERMIT FEE , U
Authorized signature: This permit appllcauon cap rea Ira permit Is not obtained within 1
/ days after It be been accepted as complete.
Print name: p1arr.... n cA Ld Date: I • Fee methodology set by Tri County Building Industry Service Board
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CONTRACTOR NC HEAT PUMP UNIT SITE PLAN o
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()( et /-u EASE REFAX APPLICATIO;v WITH SITE PLAN. N
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CITY OF TIGARD - • - .
BUILDING DIVISION PERMIT #: MEC2005-00729
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/212005
Phone: (503) 639-4171 A:VIV
J
Inspection Requests (24 Hrs.): (503) 639-4175 ,191 'IL.
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 7:13AM PAGE: 56
SITE ADDRESS: 11353 SW IRONWOOD LP CLASS OF WORK:
• SUBDIVISION: ENGLEWOOD LOT #: 065 TYPE OF USE:
PROJECT NAME: ASHBY
DESCRIPTION: ni.t-TfforTlinlLAIC units. )
OWNER: ASHBY, ARTHUR C )/
PHONE #: 503-579-8515
CONTRACTOR: HEAT RELIEF CO (.0 5'5' PHONE #: 503-260-0077
Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699\1 Mechanical final 022015-02 503-319-5991 N
Corrections/Comments/Instructions:
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PASS fl PARTIAL APPROVAL II] CANCEL pi NO ACCESS
FAIL pi CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 1/ Date: / / ' 6---/ Phone #: (503) 718-
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