Permit CITY TIGARD MECHANICAL PERMIT
�i� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00622
'�' �=-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
DATE ISSUED: 10/4/2005
PARCEL: 25111 BA -02104
SITE ADDRESS: 09895 SW INEZ ST ZONING: R -3.5
SUBDIVISION: INGEBRAND HEIGHTS LOT: 011 JURISDICTION: TIG
Project Description: Replace furnace.
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:
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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ROBERT SCOTT Description Date Amount
9895 SW INEZ ST [MECH] Permit Fee 10/3/200E $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 10/3/200E $5.80
Phone: 503 - 570 - 8749 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97224
Phone: 503 453 - 4822
Reg #: LIC 62196
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: --Z Permittee Signature: 4N /7/ �J
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.
Sep 29 2005 9:46AM CLIMATE CONTROL INC 5039687224 p.1
1V'echa�nical Permit Application FOR OFFICE IISF ONLY
City f Tigard r f, �'' Received fa
`7 b i a '�' -.: Y '' Date.By: //.a2f' % Permit No � s 4 „;.? a
13125 SW Hall Blvd., Tigard, OR 97223 t plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ! Other Permit:
Inspection Line: 503.639.4175 ; : IF, 9 2 �� �L� Date Ready/By: , -sU�► Date Ready/By: tuns: E1 See Page 2 for
• Internet: www.ci.tigard.or.us Notified/Method: -7-76-, _
S upplemental Information .
ca. ift.� . ARD • : , - x: ..COMMERCIA FEE *,: SCHEDULE: -, USE CIiECItL,IS9
❑ New constriction ddition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of a
❑ .Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
_; :::;;:-= :: -.... ; . '
CATEGORY OF CONSTRLTCTIOAI : : :.. Value:
7 -and 2- family dwelling 0 : RESIDENTIAL EQUIPMENT/ SYSTEMS FEES'. , . .
/ ❑ Accessory building
❑ M�lti - family ❑ Master builder For special iisforrnai,on use checklist.
❑ Other:
Description Qty. I Ea. Total
ripti
;> • LOCATION. ''.. : JOE SITE , AND . Heating /cooling
11
Job site address: �+ �' 7 ' , ` �+ ^ g or heat pump
a
�a a 1 I� A ir conditionin (recuires site plan showing placement) 14.00
City/State /ZIP: ' od 9 7 Furnace 100,000 BTU (ducts /vents) i 14.00 +,
Furnace 100,000+ BTU ;ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: S i 051/2=1.37 Gas heat pump 14.00
Cross street/directions to job site: Du °t 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: f Lot no.: Flue/vent for any of above 10.00
Other: _ 10,00 _
Tax map /parcel no.: Other fuel appliances
DES IPTION OF WORK Water heater 10.00
1 ate, A ' - � ;t �.p Gas fireplace 10.00
1 LL�.aC� '�(�j i J(Jt4A Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) _ 10.00
Wood/pellet stove 10.00
Wood firepl ace/insert 10.00
. •'PROPERT OWN R . El Chimney/liner/flue/vent 10.00
.. C- � Other: 10.00
�
Name: t � J \
A Environmental exhaust and ventilation
Address: - M 9 5 c S uS 4�n c ' Range hood /other kitchen
J ` equipment 10.00
City/State /ZIP�,�
r (� i (312... 7 4 �' Clothes dryer exhaust 10.00
Z J 7b q �J_ � ( ) compartments, Sine exhaust (bathrooms, •
Phone• 0 V,, � 5 I y rr.� Fax: toilet compamennts, utility rooms) 6.80
. y. APPLICANT NCI .CONTACT PERSON . Attic /erawlspace fans 10.00
1 Business name: _
■ rn ..tom C 6 Other. 10.00
Fuel piping
Contact name: $5.40 for first four: 51.00 for each additional
Address: 1 W LL) 70tH Furnace. etc.
l Gas heat pump
City /StateJZIP; 9 Wall/suspended/unit ended /unit beater
ti
•
P
Phone' (/\ ,) 4_53 _ . � ? F ax: : r . Water heater
-^-t1 t�•�� �] 1 to re _ 7 7 Fireplace
E -mail:
Range
CONTRACT R Barbecue
Business namee] S ad C ..tt 1 i ! b / Clothes dryer (as)
a Other:
_� 1
Address: n 1 / MECHANICAL PER.�•IIT FEES"
City /State /ZIP: F C ' gt7a 07.44 Subtotal
Phone.) C -� C_ Fax: 1.,Jrt 1 / _ a - '-']'� lvlinimum permit fee nnit ($72.501_7a
�?4 :..� - { LP Q ( Plan review (25% ofpem>it fee) s, �D
CCB lie.: + ( (2�,t t 0 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signet e: i A ' r ! ',. ; This permit application expires if a permit-1s not obtained within I80
_ days a fter it has been accepted as complete.
Print name: �_. rlrjl 1► ..� PN� S by Tr: Count Y Building * Fee methodology set h Board
` 8 ]ndu;t rY Service
i: 1 Building \ Permits \MEC - Permit App; doe 12/03 440 -4617T (I I /02 /C0M/v,'EB1 7 O y/ 1 36
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0 ii-u- - 6 ( 5■- si-.2_-0 1- Al
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WOF TIGARD <it.'+;,- W INEz_
.• , ..
BUILDING DIVISION A ,„ 4-0D$5 PERMIT #: MEC200500622
15125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005
Phone: (503) 639-4171 avitivi611111\
Inspection Requests (24 Hrs.): (503) 639-4175 . '1.1.
__
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 59
/
SITE ADDRESS: 09895 SW INEZ ST CLASS OF WORK:
SUBDIVISION: INGEBRAND HEIGHTS LOT #: 011 TYPE OF USE:
PROJECT NAME: SCOTT
DESCRIPTION: Replace furnace.
[
OWNER: SCOTT, ROBERT PHONE #: 603-570-8749
CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503-453-4822
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020219-01 503-463-4822 N
Corrections/Comments/Instructions:
A : 14
Ca..le /J i./4/ c / -1- cr44eMA-0 14,--
•
,
,‘ 0 PARTIAL APPROVAL .*-;*'- ANGEL 0 NO ACCESS
F AIL FAIL ri CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 7 ItA ( kddni
91 Date: 1 5 * Phone #: (503) 718-
CITY OF TIGARD 5 ' 'r-= -�
BUILDING DIVISION PERMIT #: h+lEC2005-f10
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005
Phone: (503) 639 -4171 nia 11
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 66
SITE ADDRESS: 09895 SW INE.Z ST CLASS OF WORK:
SUBDIVISION: INGEBRAND HEIGHTS LOT #: 011 TYPE OF USE:
PROJECT NAME: SCOTT
DESCRIPTION: Replace furnace.
OWNER: SCOTT, ROBERT PHONE #: 503 - 570 -8749 ■
CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 - 453 -4822
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time: (J"
Code # Inspection Description Confirm # Contact # Mes .e'- ti 4
699 Mechanical final 020344 -01 503- 453 -4822 N - �1
Corrections /Comments /Instructions:
%4/ 01 etA m d-' -ct
r
l -en-) ,e,*"‘ ‘6,5 4 its.: - 74 `n9,4o /''ct 412l644
l d . O-A / -. v i �i C - i -e i/ - /' c i.� &'1 ' '�'LLc . c
4 --/- ge44/ 4 41 cc v1 a Y P pe a �--
11'2,, 1 ii, z A , f,f i l� . fr� i
cX( PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: d' V Date: i G / Phone #: (503) 718-