Permit i
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i _ . CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00020
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2009
PARCEL: 1S133DC-17700
SITE ADDRESS: 13247 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 032 JURISDICTION: TIG
PROJECT: HEMAYN
Project Description: Replace furnace.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: W ODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TRAVIS HEMAYN Description Date Amount
13247 SW LAURMONT DR
TIGARD, OR 97223 [MECH] Permit Fee 1/12/200 $72.50
[TAX] 12% State Surch 1/12/200. $8.70
Total $81.20
Phone: 503 -441 -3097
Contractor:
ANDERSEN HEATING INC
6463 DAWN AVE
LAKE OSWEGO, OR 97035 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 841 -0742
FAX 503 -536 -6615
Reg #: LIC 168214
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.
I i ./, ..... Issued B 1� t // Permittee Si nature:
Call 503.639.4175 by 7:00 a.m. for inspections th f'siness 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.
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.. Mechanical Permit Application , FOR OFFICE USE ONLY
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City of Tigard Date /B ed �� Perm No.: /'Tt
71
- u 13125 SW Hall Blvd., Tigard, OR 97223 y . rr' 111
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /By: 7u 0 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: ( C C� Supplemental Information
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TYPE OF WORK ;m • a • - ' .COMMERCIAL; E *
FE .SC — . USE CH E CKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
,.,C'A TGORY" OFt;CO_ N ' - , Value:
. RESIDENTIAL" EQUIPMENT I SYSTEMSFEES* -
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea, I Total
` , , SITE' INFORMATION' AND .LOCATION- ' , Heating/cooling
Job site address: 13247 SW LAURMONT Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts /vents) 1 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: TRAVIS HEMAYN
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
a'' s .4 'DESCRIPTION, - OF ` WOR _ IC- 5 , ' 4 - Water heater 10.00
REPLACE FURNACE Gas fireplace 10.00
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
-_ -. - Chimney /liner /flue /vent 10.00
f' P ;QWNER ' , ,, . "_,, ':::2,,,- ' ■ .;;TENANT . -.. ; ,, ., / ,
Other: 10.00
Name: TRAVIS HEMAYN Environmental exhaust and ventilation
Address: 13247 SW LAURMONT Range hood /other kitchen
equipment 1 0.00
City/State /ZIP: TIGARD, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (541)441 -3097 Fax: ( ) toilet compartments, utility rooms) 6.80
'.0,r"-APPLICANT'' `"'' `, " ``0', CONTACT*PERSON - Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
. - CONTRACTORx _ .. ' , Barbecue
Business name: ANDERSEN HEATING, INC Clothes dryer (gas)
Other:
Address: 6463 DAWN AVE ' MECHANICAL PERMIT FEES*',: .
City /State /ZIP: LAKE OSWEGO OR, 97035 Subtotal eb
Minimum permit fee ($72.50) J
Phone: (503) 841 -0742 Fax: (503) 536 -6615
�
Plan - review - (25- %.of- permit - fee) -- --
CCB lie.: 168214 State surcharge (12% of permit fee) S
TOTAL PERMIT FEE g i , 9,0
This permit application expires if a permit is not obtained within 180
Authori:-ds'_ a re:
days after it has been accepted as complete.
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e I • ,
CITY OF TIGARD ..,
BUILDING DIVISION T PERMIT #: MEC2009-00020
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: iti2/2009
Phone: (503) 639-4171 INIet I
,
Inspection Requests (24 Hrs.): (503) 639-4175 ::: 41,
INSPECTION WORKSHEET FOR DATE: 1/13/ '• 8 TIME: 7:00AM PAGE: 3
4.11.--( Pit_ c AR. .
SITE ADDRESS: 13247 SW LAURIVIONT DR CLASS OF WORK: I
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT T #: 032 TYPE OF USE:
PROJECT NAME: HEMAYN
DESCRIPTION: Repl furnace.
OWNER: HEMAYN, TRAVIS PHONE #: 503-441-3(n7
I
CONTRACTOR: ANDERSEN HEATING INC PHONE #: 503441-0742
Inspection Request Scheduled For: Date: 1/130009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 079645-01 603-841-0742
Corrections/Comments/Instructions:
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M PASS :a ) ri PARTIAL APPROVAL CANCEL NO ACCESS
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• FAIL ra CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
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Inspector: A ■••■•■-._. Date: 1:' 2 1 Phone #: (503) 718-
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