Permit CITY TIGARD MECHANICAL PERMIT
Al
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00277
DATE ISSUED: 6/19/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134AD-02000
SITE ADDRESS: 11367 SW LAKEWOOD CT ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 060 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:
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
KRISTI NELSON Description Date Amount
11367 SW LAKEWOOD CT
TIGARD, OR 97223 [MECH] Permit Fee 6/19/200E $72.50
[TAX] 8% State Surcha 6/19/200E $5.80
Total $78.30
Phone: 503 - 579 -0408
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 235 -0454 •
PRI 503- 235 -9083
Reg #: LIC 50244
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: • � _ 1 Permittee Signature:
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.
06/16/2006 13:08 5032350454 SKY HEATING PAGE 02
L.
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Yilechanigal Permit Application i• i i.)i i it l: i ,r ,,N,.,
City of Tigard ' . Reeelve4 a - / remit No
13125 SW Hall 1310., Tigard, OR Date/By; ■ D O .-_ /'1 1 co: 7
Pion 'Review
Phone: 503.639.4171 Fax: 503.598.1960 o G „ >� , „ i ,, i pl Other Fermat: ills Inspection .bane: 503,639.4175 ,U" • �) 2 `Mi •) f D Rcady1By: Ste Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Snpplesnene rnnAfinn
1 �i .WOTI '. °' J 4 � ` n x C )� 3ili w ' .. . USE Cll eKL '
❑ New construction } 1t Mechanical permit fees" are based on the value of the work
0 Demolition CI Other: pmfanned• Indicate the value (rounded to the nearest dollar) of. all
mechanical materials, equipment, labor, overhead, and profit.
•CATS i . 1 copigrittretioN' . ' Value: $
® I- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building
' 1 Eta 'i�''NTIt;3�OBIPlit'6.N'i'tAtIl 1 BEEF *
1Multi= Bamily 0 Master builder For special rrx{orma!>a» use checklist.
Other: Description r �Qty. ` Ea_ 1 Total
• ' _ _. 3011. SITE _ ttlkTlor44 AND L�OG'i�4, Beating/cooling
Job site address: 11367 SW .LAKEWOOD CT Air eenditioning or hest pump
(requires site plan showisitplacement) _ 14.00 \
City/State/ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ducts/vents) -. / 14.00 11{, Dee
Furnace 100,000 +BTUiduers /vents 17.90
Suite/bldg. /apt. no.: Project name:
Gas host pump 14.00
Cross street/directions to job site: Duct work 14.00
-
Hydronic hot water system _ _ 14.00
Residential boiler (radiator or
ydronic) 14,00
Unit heaters (fuel type, not electric).
in -wall, in -duct, sit. ended etc. 10.00
Subdivision: I Lot no. Flue /vent for any of above 10,00
Other: . 10,00
Tax map /parcel no.: Other fuel appliances
- DEsCRterrON, t ; WORx . . • Water heater 10.00
INSTALL FURNACE Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
'Wood/pcIlet stove 10.00
Wood fireplccc/inscrt 10.00
�` 11 OWNER .0 TEN Chimney/lfiner /ilue/vent 10,00
Other: 10,00
Name: KRISTi NELSON Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
CitylState/ZW: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)579-040$ Fax: ( ) toilet compa rtments, utility rooms) 6.80
'rx . Al iCAk'NI' ' . ti: CONTACT PERSON Attic/crawlspace fans 10.00 •
Business name: SEE BELOW Other: ._ 10.00
_ Fuel piping _
Contact name: $5.40 fair first four; $1.00 for each additional —__
Address: Furnace, etc.
Gas heat d ump
City /State/ZIP: Wall /suspcndedhmit heater
Phone: ( ) I Fax:: ( ) Water heater
E-mail: ^Fireplace
Range
Barbecue
Business nsmc_ SKY HEATING & AIR CONDITIONING NG Clothes dryer (gas)
Other.
- Address: 1,635 SE IVI;FIALEM A1E iV 1C1 t1<i 11 ' .
City/State/Z1P; PORTLAND OR 97202 Sabtutal if . 0
Phone: (503)235 -9083 Fax .4503) 235 -0454 Minimum permit fee ($72.50) 7
Plan review (25% of permit fee)
- CCB -lic:: -50244 —
Authorized signature:
/� State surcharge (8% of permit fee) S, W 6
� {l� qa TOTAL permit n FEE '? 8', 3
ature: 6 ( T his permit appiicetfnn exj�Cre,r ii ii p Emit is not obtained within IRO
days after .1t has heen accepted as complete.
Print me: JEAN
na LOP'R1 ,J l Date: 6/16/06 ' Fee methodology set by Tri-County Building industry Service Board
iMuildineerrolblMBCpormitApp .dot 12/01 440.451 Tr (11 /OLCOM/WM
CITY ��` ����
��n m o OF
BUILDING DIVISION PERMIT #: IviEC2006-00277
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1E12006
Phone: (503) 639-4171
Inspection Requests (24Hm�:(503)63Q~4175 ° J . w�' « ���
INSPECTION WORKSHEET FOR DATE: 1/2512007 TIME: 7:03AK4 PAGE: 51
SITE ADDRESS: 113§7 LAKEWOOD C7 CLASS OF WORK:
SUBDIVISION: ENGLEW}C>C> LOT #: 060 TYPE OF USE:
PROJECT NAME: NELSON
DESCRIPTION: Replace furnace.
OWNER: NELSQN, KRISTI PHONE #: 503-579-0408
CONTRACTOR: SKY HEATING & AIR CONDITIONING PHONE #: 503+235-9083
Inspection Request Scheduled For: Date: 1/25,2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final K 4 JN33 - 01 503-235-9083 N
Corrections/Comments/Instructions:
I PASS _-_ _
I I FAIL CALL FOR INSPECTION ri ADDITIONAL FEB ASSESSED
Inspector:
Date: ~/— ^7 Phone #: (503) 718-
. .
CITY elF TIGARD
BUILDING.DIVISION
ihk PERMIT #: MEC2006-00277
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 6/19/2006
Phone: (503) 639-4171 AtaitA
Inspection Requests (24 Hrs.): (503) 639-4175 . AWL 'LL
INSPECTION WORKSHEET FOR DATE: 2/26/2007 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 11367 SIN LAKEWOOD (.7r CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 060 TYPE OF USE:
PROJECT NAME: NELSON
DESCRIPTION: Replace furnace,
OWNER: NELSON, KRISTI PHONE #: 503.579,0408
CONTRACTOR: SKY HEATING & AIR CONDITIONING PHONE #: 503
Inspection Request Scheduled For: Date: 2/7612007 Pour Time: •
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 043879-01 503-235-9083 Y
Corrections/Comments/Instructions:
0 6--GC–c7 CIA/L 1.t4—q- Ast-n-- inA 66-r- . 7 . 5- 0-0
ASS 1 I PARTIAL APPROVAL ri CANCEL I I NO ACCESS
0 FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ,
A Date: 2 -- 26-- -- er7 Phone #: (503) 718-
. .
— _