Permit CITY TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC2006 -00484
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/10/2006
PARCEL: 2S 104AA -07000
SITE ADDRESS: 12770 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 2 LOT: 091 JURISDICTION: TIG
Project Description: Furnace replace.
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: 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
RASMUSSEN, PAUL Description Date Amount
RASMUSSEN, NEILS ESTATE OF
12770 SW KATHERINE ST [MECH] Permit Fee 10/10/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 10/10/20( $5.80
Total $78.30
Phone: 503- 887 -7011
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -0611
FAX 503- 234 -0439
Reg #: LIC 161085
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: //� 0 , _,,/ ___ 11... . 6 „ ..... 4, —
� _
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.
Oct 09 06 03: 05p
. -
Mechanical Permit Application toi4 ot.1,1( I. I sr ().1.‘
.._ Received ,,,,
City of Tigard (41 1_,OF # f) li Datc/By: V ,o ak ill Pennit No.: M
13125 SW Hall Blvd., Tigard, OR 9722317"h :r_ t'A. 4 '44 ' . 1
P Rie
lan ev
Phone: 503.639.4171 Fax: 503.598 Date/By: .1960 . Other Permit:
Inspection Line: 503.639.4175 ,y,,.„,, ti„, /it
Dc ,y: luri3 US Ste Page 2 for
Internet: www.ci.tigard.or.us OCT 0 9 - I I, Notified/Method: / Supplemental Information
y:1‘1...17477f0H,,,,7,,;47:41F..,,F,3,-„F.,75N7,717:97::77zTE-OZW,:M.,:':1:0M61.ffe,.. Fov,',,F4.-',--trliTY:TTire:u'ff.vANtvattiT,4'imm7r,--71:
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Ell New construction El "Additirid/al,feraiiin/ap-liaTtfentfl,7- ' Mechanical permit fees' are based on the value of the work
. ., . performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
''.1140.11MTPIC71511r%:MW,-.6,MW,5t,',1,VZ,Z;i:■.';','Nr,',R=--A‘V.,,,,,,,N,,,'i'75.,,:'1: Value: S
b: , , ,,-'' - • '-'4,:•17,:leALTZKRI:%4-.'(,.."^natAMTWZ-7 .;
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X1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
•::4..'.„,taa,,VA,AitOrirt,;.,';71, r',, - •MMMI .7 " ,7 1 - rt Trrff,MiT H ea t in g / coo l ing
Air conditioning or heat pump
Job site address: 1 '-e:" . - 1 i C.-, , k2; K..(),:j L. z ,:, 1 . i....,,, , i" . (requires site plan showing placement) 14.00 ,
..
City/State/ZIP: r '
'' i L.!: Furnace 100,000 BTU (ducts/vents) ( 14.00 kii-
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name: le, 'ICI. f), ,..,-.. • ..,
L.-, • t ., .t4....•,, .)t. 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
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other: ,. 10.00
Tax map/parcel no.: Other fuel appliances
.•. :.• Water heater 10.00
'- rrz7 AAP8rM' - , - =';',44uolv,P Gas fireplace , 10.00
1
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10,00
Wood fireplace/insert 10.00
' ''' ''''' '''"'"'''''''''''''-'2,'"'AW-larqrglingitts*P••-•,---i-••,-,1,,KtNoretv..litv...104 Chimney/liner/flue/vent 10.00
: 4 ' ;.W.W..300.0,F.14M4 1 .41,1 4 PArka:4:4_47iit?',UAliiiir''''XIAL 'V'T
, , . ..; ,,,,,,,.m„. ,k• i: ..,.. ,1 r4 other: 10.00
Name: 0it....t..i,... .,.. (<744,-') 1- 1.: Ici C... i- \..,, Environmental exhaust and ventilation
Range hood/other kitchen
Address: 1 ,./ 1 1 ',....‘ .--')1,A,' f., tik-- (. tJA I PLC.' ..-- . equipment 10.00
City/State/ZIP: - -. e._ ' Clothes dryer exhaust 10.00
. i t-( . f )
Single-duct exhaust (bathrooms,
Phone: ( - 1 ) 1,,, ) ,::, , 6- i -- T) U . - 1 , .,) Fax: ( ) toilet compartments, utility rooms) 6.80
':-:'?; rialigilarr Attic/crawlspace fans 10.00
- P.:;:,, s .-
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E-mail: • Range
- '""•;••• , ` , 4tm0 1 7-" , '74: - ‘ 1 04vakar.:"''' - ‘4 1 1 -7 • 7 ••':'':• , •' - tqi - '•? - s - -':', -. :.--...• , • 0 7 '": -- ,,, , - r'' , AW r ' i.,, '* . ' ' Q
4, At . 44:4A4.1 ,:: Barbecue
Business name: Sunset Heating and Cooling Clothes dryer (gas)
Other:
Address: 0607 SW Idaho Street v:':.lift:: , - - ' 7';,7,','"7"-'7. - 'NlFt;itki:zeg.'-':;
t,A
City/State/ZIP: Portland, OR 97239 Subtotal i (.4 —
Minimum permit fee ($72.50) 1:2 < \ ) Phone: (503) 2340611 Fax: (503) 234-0439
Plan review (25% of permit fee)
CCB lie.: 161085 State surcharge (8% of permit fee)
.._ ,
__ )-N \
TOTAL PERMIT FEE 1
Authorized signature: •
( ..
,.. ,i. ,- 0•••-' I'S1 -- %.,..,' This permit application expires if a permit is not obtained within 180
......., i\ '" ' . ,_, .
...t. days after it has been accepted as complete.
Print name: Shauna D'Anthilisla I Date: 113)( • Fee methodology set by Tr-County Building Industry Service Board
i: \ Bu I d ingU'crmd s \ MEC-Pcrmit App doc 12/03 440-i6 In (11/02/COM/WEB)
. _... ....
CITY OF TIG RD A
BUILDING DIVISION PERMIT #: MEC2008004e4
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/101006
Phone: (503) 639 -4171 , pill f
Ins Requests (24 Hrs.): (503) 639 -4175 ... J —
INSPECTION WORKSHEET FOR DATE: 10/13/2006 TIME: 7:00Am PAGE: 39
SITE ADDRESS: 12770 SW KATHERINE ST CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 2 LOT #: 091 TYPE OF USE: •
PROJECT NAME: RASMUSSEN
DESCRIPTION: Furnace replace.
OWNER: RASMUSSEN, PAUL, PHONE #: 503. 887 - 7011
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503.231 -0611
Inspection Request Scheduled For: Date: 10/13/2006 Pour Time: .
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 038146 -01 603 -231 -0611 Y
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL f CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: 1. Date: / a Phone #: (503) 718- --1-4"-*.---