Permit il CITY OF TIGARD MECHANICAL PERMIT
� ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00157
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/31/2008
PARCEL: 1 S134CB -06900
SITE ADDRESS: 12455 SW NORTH DAKOTA ST ZONING: R -7
SUBDIVISION: ANTON PARK LOT: 031 JURISDICTION: TIG
PROJECT: BREAUX
Project Description: Replacing electric furnace and installing heat pump.
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: 1 DOMES. INCIN:
ELE 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
ROGER & GRACE BREAUX Description Date Amount
12455 SW NORTH DAKOTA ST
TIGARD, OR 97223 [MECH] Permit Fee 3/31/200E $72.50
[TAX] 12% State Surch 3/31/200E $8.70
Total $81.20
Phone: 503 - 590 -3651
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. f ' /� � �
Call 50 /� Permittee Signature: ice- 0j�,'` /��
..39 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 Application �V r•o1( orrlcy 1. SE ON1.I
City of Tigard
0j,,i..k �� Iteeeived 3 �� t 7
13125 SW Hall Blvd, Tigard, OR 97
6 Phone: 503.639.4171 Fax: 503.598.1960 s orb Datrz,- A a �r Othcr Pcrmit
inspection Line: 503,639.4175 G
' O , > Ia Sec Page 2 for
T 1 G A K D n ` ` 63 Sec Supplemental 2 f orormatioa
Internet www.tigard- or.gov C. 0 AA``G
. • : ` � • T of wORMaj3V :. . • ' 6/419 FEE' SD
t .ULE - usednECKLLST 1
�+ Mechanical permit fns' are baud on the value of the work
❑ New construction / . Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
' El Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit
• Value: $
.. CATEGORY OF CONSTRUCTION -
RESIDENf1AL EQUIPMENT/ SYSTEMS FEES'
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty, I Ea. t Total
JOB SITE INFORMATION. AND LOCATION . • Heatiag/cooliag
�,� r Air conditioning or heat pump
Job site address: /1 C../ G✓ ,�A ,� (requires mite plan showing placement) t 14.00 ( % GO
City/Stale/ZIP: Furnace 100.000 BTU (ducts/vents) 14.00 / r'/. ii/
Furnace 100,000+ BTU (duets/vans) 17.90
Suite/bldg.i apt. no.: 1 Project name: Gas heat pup 14.00 .
Cross street/directions to job site: Dud work _ 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 10.00
Flue vent for any of above - _ 10.00
Subdivision: Lot no.: Other 10.00
Tax map/parcel no.: Other fad appliances
DESCRIPTION OF WORK .. .. Water heater 10.00 •
_ Gas fireplace 10.00
JA C G e-,/ z- , --.0 , 0.a--/ !i i l/P1,4 - 4 --L_J Flue vent for water heater or gas
fireplace 10,00
/.0 /i/-^ ja'y, Log lighter (gas} __ . 10.00
Wood/pellet stove 10.00 .
Wood fireplace/insert 10.00
Chimney/linerltlue/vent 10.00 .
PROPERTY OWNER I - ' .. ❑.. TENANT ... Other 10.00
Name: ,/., Are_ 8 r ei/e x Environmental exhaust and ventilation
Range hood/other kitchen
Address: .
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 43) , J ffl .:451/ Fax: ( ) toilet compartments, utility rooms) 6.80
Attickrawlspace fans 10.00 _ l
O
❑ APPLICANT. . O CONTACT PERSON 10.00 +I Other: i
Business name: Fuel piping
Contact name ( j A j 6 y $5.40 for first four, $1.00 for each additional
Furnace, etc.
Address: Gas heat pump _
I CityiState/ZIP: Wall/suspended/unitheater
'' ff G� Water heats
Phone: 03 ) (� .^/ t 7 D W Fax: ( ) 5 I r�'� 7 7 (J Fireplace
E -mail: Range -
• CONTRACTOR .. Barbecue
•
l u m h/ a, /-f..�. i (? o-Db JL ■ Clothes dam* (ems)
Business name: `t�
Address: qq 2 3 ox . 0 3 91 U MECHANICAL PERMIT FEES'
City/State/ZIP: �� y�// Subtotal ' In ' U()
/ G R,10 2 Minimum permit fee ($72.50) 7g , SZ
Phone: (S1t) (r, 2 7) I Fax: l ) S `-- D Plan review (25% of permit fix)
CCB lie.: 7/1 3 S 9 ' Stare surcharge (12% of permit fee) g`, " /(Z
TOTAL PERMIT FEE U • a'O
Authorized signasignature: F
� _ _ � Thb permit app6ea600 expires if a permit is not obtained wilbin 180
days after it has been accepted as complete-
[ Prim name: ,� tOtt i kV 1 Date: .,7 i 9 / v • Fee methodology set by in- County Building entry `'ice Board
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CITY OF T.I(;ARD
BUILDING DIVISION PERMIT #: MEC2008 00157
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3 U200f1
Phone: (503) 639 -4171 ` ;' r�
11
Inspection Requests (24 Hrs.): (503) 639 -4175 _.._' ` -_-.
INSPECTION WORKSHEET FOR DATE: 402000 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 12455 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: ANTON PARK LOT #: 031 TYPE OF USE:
PROJECT NAME: BREAUX
DESCRIPTION: Replacing electric furnace and installing heat pump.
OWNER: BREAUX, ROGER & GRACE PHONE #: 503 - 590.3651
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 5036242704
Inspection Request Scheduled For: Date: 4/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 06771401 503-624 -2704 Y
Corrections/Comments/Instructions:
Oa — - ...L £341_. 144l4 n ib hA%, (- 5 - - L57 f3 -0 / . ., `r dAge<
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
IA ,
Inspector: Date: 4--2-' al Ph one #: (503) 718- Z4-46-