Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00844
^---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/29/2005
PARCEL: 1 S133DC -15700
SITE ADDRESS: 12930 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 012 JURISDICTION: TIG
Project Description: Replace gas 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:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
STEVE CAHOON Description Date Amount
12930 SW LAURMONT DR
TIGARD, OR 97223 [MECH] Permit Fee 12/29/20( $72.50
[TAX] 8% State Surcha 12/29/20( $5.80
Total $78.30
Phone: 503 - 524 -3127
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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:
-e Permittee Signature: �QQ
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da
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 Application FOR OFFICE USE ONLY
City of Tigard Received - "!..'1
Daters d'( 4. Pcrmit N ''V\E,Cd.;1745 - /O C k W
13125 SW Hall B:vd., Tigard, ° RECEIVED A
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit
keetitit 1 1111 7 11 HAt. , Datef3y:
Inspechon Line: 503.639.4175 DEC 2 9 2005 ....ii. '11' r Date Ready:By Jvt i:. El See Page 2 for
,
, Internet: www.ci.tigard.or.us
r
NotifiediMetho -17(1 Supplemental Information
1 ! ,.."- '-':- -t:?;' :1..:,-*: 7 . ii ::.' - 7,` :. :::: ,'"":;!":_ , , :'+':;'::: • ''' ..-." ' C6S1ME tE:* - USE CHECKL ES
Di C,
Mec'ranical permi: fees are based 0 the value of the ‘,..
0 New constiuction Adclition/afterationfreplacement
performed. :ndicate the value (rounded to Cie nearest dollar) o:
n Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
i iiiiii& '-••• ::1'.. --- :, -:'' :;-),',,, ': :. '-' .f! ,.. Value: S
' ,-- • : •li1RES1DE15014AL-BQUTPNT / SYSTEMS FEES*
1 and 2 dwelling 1:1 Commercial/industrial 0 Accessory building .. ..„, ...,
For special informazion U S 2 check/iv.
El
Multi-family E Master builder 0 Other:
Descriptior I Qty Ea. - orr.
4 ; :. , .:-: :..- :.....:. ---- .' ffeatingicooling
Job site address: /02 (5 ',,,J /.K. iN Air conditioning or at pump
(requires site plan showing placement) t
, 14.C/0 I
City'State/ZIP: Eirnace 100,000 BTU (ducts/vents) J 14.00 I
Furnace 100,000+ BTU (ducts/vents> : I 7 .9C
• Suite/b I d a dant. 710.: Project name: i
Gas heat pump I 14.00 .
Cross street/directions to job site: ; Duct work 14.00
Hydron:c hot water system I 4.00 1
Residential boiler (radiator or
hydronic) 14.0']
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc I 10.00
.
Flue/vent for any of above 10.00
Subdi vision: Lot no.:
. Other; . - 10.00
Tax map/parcel no.:
' Other fuel appliances
a z.t.t.,47:1:ti.r . - A*s*1/40490:: t,.w Water heater I : 10.00
Gas fireplace I I 10.00
)7.- C,/1 CC- 7A --Le.,re----- , Flue yen: for water heater or gas
fireplace 10.00
Logi:ghter (gas) 10.00
._ Wood/pellet stove 10.00 1
Wood fireplace/insert 10.00
r :i;;
i-,,,;!,;;;st,. * A . i .,, i , , .;.E.,- Chimneylliner!flue/vent 10.00
-,...r.....- ..,-.,•..4.,,,,,44,-'ir,....-,-...,„-,.,..i r y.::.. '' , ':" . :''':' 1 .• , . Other: 10.00
Name: V 4
<4..- e- 4o9 ft/
' Environmental exhaust arid ventilation
Range toodiother kitchen
Address:
equipment 1C-.0C.1
Citv!State,'ZIP: Clothes dryer exhaust 0.00 !
Single-duct exhaust (bathrooms, ; 1
Phone ) ) .........., /4/0 < J/z. 7 Fax: ( ) toilet compartments, utillty rooms) I 6.80
ikaf.41 ;t , . ,.. )cleil401r4itvg . i.. , i ', A ,,,." AtticierawIsp ace Cans 1C.00
Other: 10.00
Business name:
Fuel piping
Contact name: 6 /94 4 -1 •0/) . $5.40 for first four; 51.00 for each additional
I Furnace, etc. I
Address:
Gas heat pump ,
City/State/ZIP:
Wall/suspended/unit heater I
__.
Water heater
Ph"e l ;) ) 19/2 4 / 7 '7 b 4 / Fax: : ( 1)3 ) Seif 42.;'7'1) Fireplace .
E-mail:
Range
4 -- .1 .4." .)-.,,'' ...t.4:41„ ,,,L, Fter .. --. . .,.• ---,;.-:,-, -.. ;::.r. ,
;,i...,r$ ,
,..:141 . 741, ' „f : • ; . !.i'.. s, k 7 . - l: - . - ; r 1. :4 .. 1 ': : .! - ' ,11 ' 1 4'.....1+' , Jr 1 -41:1PE':.....: 1 ;.:...?..«,;',! 1 =r;',;!_i,.'Vl;',1.• ... ,.,;;:..; Barbecue
Clothes dryer (gas)
Business name: C ....c ,
4 14 417 /4,, /-G44 77 pa ( ..- C. 1
es ; i 0114 Other: 1
Address: o 60 )$. *%R 3 ,,Y , T :: r • -.,;,•:' .; -''" NIZCHANICAL. FEES'
. - ...".••• • • • ,..., .
Ciry/StateiZIP: Subtotal
7/ G. .69-.4-e1 0/2-- 5 7c ...
Minimum. permit fee (S72.50)
Phone: ' ) 4 47t Fax: (-- ) " f� 9 A e ,_ _
_ Plan review (25% perrnit - - - - -- -
CCB lie.: 7 4. 3 ,5 IP • State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7/3 44
Authorized signature: r;74244.2-7-7--e-e-re----le24T--4-115-4/ This permit application expires if a permit is not cbtainEd "I Ls i!
days after it has been 3 ccepred as complete.
Print name: " r,f
4 CLII 1 4 4% 76.1 Date: / p.2 ... c • Fee methodciagy set by Tt Bui:d:tig usoy Sier4.1i: 2 Board
t \BuildineYerrnits‘MEC-PemlitAno da= i2Ini
z'd OLZ0969C09 buneeH eqwripo el7C:60 90 6Z oeCI
- C7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200';:v00M4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/290006
Phone: (503) 639-4171 Alxvilii?'
Inspection Requests (24 Hrs.): (503) 639-4175 .......-_,W - —
INSPECTION WORKSHEET FOR DATE: 2J24/2006 TIME: 7:03Alvi PAGE: 'ICA
SITE ADDRESS: i293() SW LAURMONT DR
/OT #: 0.12 CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK TYPE OF USE:
PROJECT NAME: CAHOON
DESCRIPTION: p *ace ga.: furnace
'\.
OWNER: CAHOON, STEVE PHONE #: 503-6A-3127
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 60
Inspection Request Scheduled For: Date: 2124/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mocitatnical final 02746I3-01 W3-62:4•2704 N
Corrections/Comments/Instructions:
.:.-- ■
6a/i_e_ kr,;clei
y PASS Fl PARTIAL APPROVAL I I CANCEL . 0 NO ACCESS
0 FAIL n CALL FOR INSPECTION . n ADDITIONAL FEES ASSESSED
Inspector: 4 141 Date: 2- 71/0 Phone #: (503) 718