Permit CITY OF TIGARD
i t DEVELOPMENT SERVICES MECHANICAL PERMIT PERMIT #: MEC2005 -00080
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 3/1/2005
PARCEL: 1S125CD-07300
SITE ADDRESS: 09750 SW LANDAU PL
SUBDIVISION: LANDAU WOODS ZONING: R -4.5
BLOCK: LOT: 010 JURISDICTION: TIG
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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace.
Owner: FEES
GLOVER, DONALD + MARY F Description Date Amount
9750 SW LANDAU PLACE [MECH] Permit Fee 3/1/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchaq 3/1/2005 $5.80
Phone: 503 330 - 3638 Total $78.30
Contractor:
SERVICE NOW OF OREGON INC
404 SE BEAVERCREEK RD #228 REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 655 - 7558
Reg #: LIC 161582
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.
Issued By: Permittee Signature: j..€
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next 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 e i l d( i, ®
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ycity A Tigard a rd , _ F - R eceived Q L. /I
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�'T 005 pate /BY: J 0) - - � L Permit No.. \V ` -JK0Q �od 1J ll .
3 3125 SW 1 Blvd -, Tigard, OR 97223 y
Phone: 503.639.41'71 Fax: 503,598,1960 ®� 1 •
lo 1
Inspection Line: 503. 639,4175 '1 t P , f/•Iltta2 \. Other Permit:
G RD , l�att/13y:
te, 7,At ui. Date Ready /By: axis: td See Page 2 far
Internet: www.ei.tigard.or.us -�• ^0 ,S` Notified/A7eth »d. 1 ( r Supplemental information
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❑ New Construction 72g Addition /alteration /replacement Mechanic<91 permit fces� ate based on the value of the work
performed, lndieyte the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical at a labor, overhead, a profit,
m cri IS, equipment, 1-,b r, nd •
}} ' „ 1i V IR , ' h ;tt § k : C". `! .. 1i' = : ?C�dJ� --- gi l' :.. ".,4j u .I t � t r V . r4 Value: $ r S,
r_ , .. : 1.,}rn 1 • VR itilAt',�1W: 'PP ' ; .. M A'r „gW„ •i �' ,rq
® 1- and 2-family dwelling ❑ Commercial /industrial Q Accessory building e t : 1
For spacial information use checklist.
❑ Multi - family ❑ Master builder 0 Other:
4 a �ra:gy
�;Mr} , t .. iO .. C Description Qty. c Total
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° "1 � Z � .d0 �^ ��' rlY, kxt„ a��+- rA` 1',t�;t.fANI)�t),n :��E�?�!.. ,
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Job site address: \l .5v,) 50 Lfk.),1bp j t_kcE air conditioning or heat pump
_ _ (rettares site rlan 5howin_ ,la»
ce,eru) 14.00
City /State /4,11': 1600 Q R 9"- a a 3 . Furnace 100,000 I3TU ducts /vents) -' 14. Illni
Furnace 100 000-i r3TI.j ducts /vents C 17.90 M.
Suite/bldg. /apt- no G�
Project name: kirD 14.00
Cross street/directions to job site: v � Duct work 14.
I [ydratic hot water stem C 14. 00 Residential boiler (radiator or
hvdron ic) 14.00
IJnit heaters (fuel - type, not electric), C
in -wall, in - duct, sus,cndcd, etc. 10.00
Subdivision: Lot no.: Flue/vent for an of above MN 10.00 ma
Other; 10.00 MIN
Tax map /parcel no.:
Other fuel A IiAnt:cs
,;$ ? d),' X § :: ,t� },i;sD : :;; �,,,,r..,,,:t•ri. I6N : : : ia •`iti,.:. t;' ; . miter heater 10.00 IIIIIIII
Gas Fireplace • 10.00 ME
■ . ' R C\N G- &t-'fl. 4 5 f-v&N j c. , w LAKE,Fc*- ~LIKE Flue vent for water heater or gas
I:rc lace 10.00
Lo• Ii "hter(gas) 10.00
Wood/pellet stove - 10.00
_ _____ Wood fire Ircc./insert 11111. 10.00
�! �. t� a �, < - :.�, � . .,;, �, ,..... 10, r
rdwJ � .., +.. � � �;� : ' El : )�1,'1`4(,�. ... 0 00 M.
..:..........
Name: ,ON V E . Environmental ventilation
Address: • Range hex d /other kitchen
et ui'intent 10,00
City/State/ZIP: Clothes dr •er exhaust 10.00 NM
sin exhaust (bathrooms, Ill
Phone: (5 ) " 30 - -%,..5 It, Fox: (5o' ) '-ko\ -'391 P. toilet com 7artments, utility rooms) 6.80 ME
�. 1 y 4 , a� i Il 1 r � N ip k Ara , _ � 10.()0
�l��Kt 9 ,,.. d+���' , : �����< y( f �,} Nov �.'�'t � + "'Y :r t� I�' R ;., � a �1�': �" ,.. tt` • �,. . a ' � .�, , Attic /crawls lace fans
N r , e •r� - =f
Business name: S f�l' `E k5 C'tiQ� Other: to .00
Contact name: $5.40 for first four $1 -00 for earl' additional
Address: Furnace, etc. �MI
(ias hcza •thu
City /State /ZIP: (( Wtttifsus?ended /unit heater �
IMEMIIII
P hone: ( ) -. - -.' Fax: : ( ) MM.
E -mail: Eill NM
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Susincssname: Service Now of Oregon, Inc,. ClothESd1•YEr S _
Address: 404 S. 3eavercreek Rd # 228 _..5... t t jr;..: z-�!r
'; *. :. a „ .. 9 ..: r: �'t � :?rat? •,: £�'
.� ,,.. •Z )11r�rTIC tC..P ;1�� , u Yn �r- ;' k .t 7' }', ^r
Cit : Oregon City, OR 97045 Subtotal 3 y
Minimum
Phone: (503) 655 -7553 F ax: ( 655 - 7593 Plan review (25% permit fe �
) ��
CC13 Fie.: 16_1582 _ State surdtar -e (VA or ermit fee) -
TOTAL PERMIT FEE Waal
na
Authorized signature: �� 'nits penult ,tpplkatian eltires if ,0 permit is not obtained within 180
g da after it has been accepted ns compioie• i '' print name: + L t J " N J it Date: �l a OS Fee ti clhodolugy set t y'fi i- CUdniY 131 i1[ling Industry Service Board
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C . 16 111Ing \I'ennas \uJuC.PCrmltApp.tloc 12/01 440 -4617T (1 t /02 /COM/WEt1)
, . l- _
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00080
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2005
Phone: (503) 639 -4171 ' " °�iboi
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' � __..
INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7 :06AM PAGE: 79
SITE ADDRESS: 09750 SW LANDAU PL CLASS OF WORK:
SUBDIVISION: LANDAU WOODS LOT #: 010 TYPE OF USE:
PROJECT NAME: GLOVER
DESCRIPTION: Replace gas furnace.
OWNER: GLOVER, DONALD + MARY F, PHONE #: 503 - 3383638
CONTRACTOR: SERVICE NOW OF OREGON INC PHONE #: 503. 655.7558
Inspection Request Scheduled For: Date: 8/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012492 -01 503.655 -7558 V
Corrections /Comments /Instructions:
-✓ 6 C,/a_ /44- ?x/4/2/ 4146U S 33 ZSZ
PASS ❑ PARTIALAP_P_ROVAL ❑_CANCEL _ _NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: ? , S Phone #: (503) 718
- . - - _ .