Permit 1
C1TY TIGARD MECHANICAL PERMIT
f i ) DEVELOPMENT SERVICES PERMIT #: MEC2006 -10038
DATE ISSUED: 3/21/2006
---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S134AD -01200
SITE ADDRESS: 11383 SW LAKEWOOD CT ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 052 JURISDICTION: TIG
Project Description: Replace furnace, A/C & attic fan.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SCOTT & CA YOUNG Description Date Amount
11383 SW LAKEWOOD CT
TIGARD, OR 97223 [MECH] Permit Fee 4/5/2006 $72.50
[TAX] 8% State Surcha 4/5/2006 $5.80
Total $78.30
Phone: 503- 799 -8643
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
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: T7 Permittee Signature: _ fie \
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.
Mechanical Permit ' r. , iJ tin t
City of'Tigard s , % . „ , %. ”` -- U- -- 1 . D D >v a TS,Z 0 Permit No, 6 cow( / aa3
13125 SW Hall Blvd., Tigard, 0.12 1223 plan Review
Phone: ;:03-639 -4171 Fax: 503 598.19601AD / i 2006 A.,,,i ;l i p '; Ifi DatcBy: it:
Other Penn
Inspects nr Lino: 503.639.4175 c• l { Date ReadyI By: Juris: ® See Page 1 for
Internet www,ci,tigard.or -us I Notified/Method; j I Ip+ SupplcmcamlInformation
CITY OF TIGARD -
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❑ hlcw construction I ED Addition/alteration/replacement Mechanical permit fees* rim based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all 1
❑ Demolition • ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
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® 1- and 2- family dwelling , ❑ Cotrunercial/industrial ID Accessory building � fmii „e �w nas,rs uffi aaavttl ,
Q Multi-family ❑Master builder Et Other. For special information use checklist
Description 1 Qty- I E. Total
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' Job site address: 11383 SW Lakewood Ct Air conditioning or heat pump
( requires site plim showing placement/ 14 -00 ��,
City /State/ZIP: Tigard, OR 97223 Furnace 100,000 t3TU (duets/vents) t 14.00 I )
Furnace 100,000+ 8TU (ducts/vents) 17.90
Suite/bldgiapt. no.: I Project name: Scott & Carol Young Gas heat pump 14,00
Cross stteei/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: Lot no -. -T Flue /vent for any of above 10,00
Other; 10.00
Tax reap /parcel no.: Other fuel appliances
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Gas fireplace 10.00
rush/Pull Furnace, Air Conditioner & Attic Fan. Flue vent for water heater or gas
.__ fireplace , 10,00
- --- Log lighter (yeas) 10,00 _
' Wood/pellet stove 10.00
_Wood fireplace/insert 10.00
B nr i yf t n r f ly G �+ _ Chimney' /liner /flue/vent 10,00
a �� t'-6 �I ,a
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Name: Scott & Carol Young 1 Environmental exhaust and ventilation
Address: 11383 SW Lakewood Ct • Range hood/other kitchen
equipment 10 -00
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 10,00
Single -duct exhaust (bathrooms,
Phone: (503)799 -8643 Fax: ( ) toilet compartme utility rooms) 6.80 1
" tr i Fl .iii 9 0. F a r4', r kit :4(9:61 9 " � 'C k rh i ' `aY r t + 'ere . t, ,19 `, �. ` '� Atti
' c/crawlspace fans I 10,00 / 00
r' ,. c.,.. a i K lf• to „2e1. y ® i ` rai'm�
Business name: Anctil iheuting & Cooling Other: 10.00
Fuel piping
Contact name: Isabelle Yath ' • $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 4320 N Williams Ave . Gas heat pump
City /State/ZIP: Portland, OR 97217 Wall/suspended/unit heater ,
Phone: (503) 281 -0752 i Fax: : (S03) 282 -5722 Water heater
Fireplace -
E -mail: install u@anctilhvac.cotu ltangc
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Clothes dryer (gas)
Business mtune: Anetil Heating & Cooling }
Other: I
Address: 4320 N Williams Av e /wsvhx..r.- a ;r5rr.' v:r a.'w ' , ! ? = ,
a a C r u .. ^ . ref f4T( "i;1T ,
City/State/ZIP: Portland, OR 97217 Subtotal M, CO
Phone: (503) 281 -0752 Fax: (503) 282 -5722 -- - Minimum permit fee ($72.50) a, !SD
. _- Plan review (25% of permit tee)
CCI3 lie.: 8897 State turchitrSe (8% of permit fee) r 5 , o
— — — / -- — _ _..,. — — TOTAL PERMi'l' VEE e g ..
Authorized signature: • `' � I ' �7 ' A" p+Lr>Ait WINAcatWn WM/iTV& if n perovit 6 nut ot)ta (t w:tt.ia 'LSO I #�I•r�J1.r dayi triter it has been accepted us complete.
Print name: Isabelle 1'ath hale: 3 -20 -06 " Fee ytaetLu &IAytly .et by'lei-County Building Industry Service I.k> ;frd
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: 1Vle.C.2OG6" / DO33g'
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIM .. PAGE:
SITE ADDRESS: ) / 3 '83 Kew o o4 U CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:cO -) (._ 076 - 2
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -0 b Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
1'1 e33
=. PASS :TIAL APPROVAL ❑ CANCEL_ ❑ NO ACCESS
❑ FAIL V L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: 3 2 Z ^ 6Phone #: (503) 718- 2