Permit CITY TIGARD MECHANICAL PERMIT
�� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00616
c'! I I 131 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/28/2005
PARCEL: 2 S 103 D B -03500
SITE ADDRESS: 11270 SW QUELLE PL ZONING: R -4.5
SUBDIVISION: GENESIS NO. 2 LOT: 033 JURISDICTION: TIG
Project Description: Replace gas 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:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
HAGLUND, LINN G AND DEBRA M Description Date Amount
11270 QUELLS CT [MECH] Permit Fee 9/28/200f. $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/28/200E $5.80
Phone: 503 639 - 0799 Total $78.30
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone: 503 692 - 1565
Reg #: LIC 5193
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 0 .4C b calling 503 - 246 -6699
or 1- 800 - 332 -2344. A V I
A LO
Issued By: 45(12:41 Permittee Signature / -'
Call 503 -639 -4175 by 7:00 a.m. for inspections that busi r 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 PermitEclatED • FOR OFFICE USE ONLY
Ci6 of gard Received • Affps- - IA
13125 SW Hall Blvd., Tigard, OR 9'7.SEP 2 8 2005 • Permit No.
4,‘ Date/By: „,,, ra __401 La -...154,1k. • e:V . -
Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 4". IttlriC'1.!' Date/By: Other Perrot
Inspection Line: 503.639.4175 CITY OF TIGARD AAA- -'1L. Date Ready/By: 0 See Page 2 fbr
Internet: www.ci.tigard.or.us BUILDING DNISION Notified/Method: / . Supplemental Information
a _
Mechanical permit fees* are based on the value of the work
ID New construction Addition/alteration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
El Demolition /2 Other mechanical materials, equipment, labor, overhead, and profit
Value $
-f,,,,K-.,t5+ g ).4.(0 .. : .° -::- " M I ZZail.:1 4 :: *l eece , - - ,,as. • .-- -. ,-.._,.- - - .. ._.' ..-- - -,, - -. ., - wrimt :,, .,=
= k 4 'AalkstaN1411: 1. --r -L li.e.
IA 1 and 2 dwelling El Com ercial/industrial 0 Accessory building :
For special information use checklist.
El Multi 0 Master builder 0 Other: . Description I Qty. I Ea. I Total
V,C ** riiO4,40:0A1Wit:04Y,'i-7:'N'-:*. Heating/cooling
Air conditioning or heat pump
Job site address: ii 2,?- 0 5to 0 t jEz.z.e /21
(requires site plan showing placement) 14.00
City/State/ZIP: 1764 ,‘,. n o 972:43 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bIdgJapt. no.: I Project name:
Gas heat pump 14.00
Cross street/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
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
61StiiiPhiiit'OPWORI&;.' -- :ir: ' - ,--.: In ;::: Water heater 10.00
Gas fireplace
10.00
p osc-i pu LC_ '' Reilii OVE EXIST/N &AS RAZ/a ArZ e Flue vent for water heater or gas
fireplace
10.00
± gio PL.AC.' tAy 0/4 -z » t.rAS Fvp-AlAce
Log lighter (gas) 10.00
3 0 /( 671/ . Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. . A , Chimney/liner/flue/vent 10.00
Plidii4litielzit*iiik .., *"1 4 .0A/5 , t; A
10.00
Name: ( /
1.--1 AIN 14 Afs AI f) Environmental exhaust and ventilation -
Range hood/other kitchen
Address: /1 z S U) 4), „ P
equipment 10.00
City/State/ZIP: ri t A g, tO OR 97 2.2. 3 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( 5 -03 ) I _ 07- ic? Fax: ( ) toilet compartments, utility rooms) 6.80
, ' 1 ,4Pf*I . -.) ' ' k E- 7 " . ,:,4-: '; '.'i'a ' ?.•.'- - '' " .. ::" .: ..' -400*4 7 ,0 ) .*** - :‘ , : . :::i . ;', " 1 : Atticoth 10.00
krawisPace fans
na l 0
er: 10.00
Business e: Agaok plUcHAN/C_,4/
Fuel piping
Contact name: 3eizAt PC-LAA, $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: / 0 S 30 s TEIA LArjg R17
Gas heat pump
City/State/ZIP: - r i m L O 970 6,1_ . Wail/suspended/unit heater
/
Phone: ( 5 ) eZ 5 I Fax: : (5 ) 4 - /Tev 5 - Water heater
Fireplace
E-mail: Range
`-'1 - ....aw.4 , p , A - , - ,.. = , - , - . Barbecue
. ;i•:i:1:.:..7.;: ' - --r-'''''-' h -'-■
Business name: 4
Clothes dryer (gas)
/2 R bi.....) /1 er,,4 Apc,Ai,_
Other:
Address: / 0 330 5J
/ U4 ‘,411 4v •,,,,,... : ... -‘,.
City/State/ZIP: 7 cA. og. 970 6 a Subtotal
/
' , ; Minimum permit fee ($72.50)
Phone: 0 ) 4o ? a - /Tea. S" I Fax: ( 5 ) 3 ) f, q/.. T i
Plan review (25% of permit fee)
CCB tic.: t t if 3 State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1 •
Auth -e-ip
4 . Thb permit application expires If a permit is not obtained Within 180
orized signature : if i
days after It has been accepted as complete.
011 IV I ,...
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CITY OF TIGARD VII e oc = 00 0
BUILDING DIVISION T PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 , u+ehp� b I +l
Inspection Requests (24 Hrs.): (503) 639 -4175 :�� `__..
INSPECTION WORKSHEET FOR DATE: I ®/V5 /0t TIME: 4 Od et" PAGE:
SITE ADDRESS: ( -70 Alk e l l.C. Q'L CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: LN ' k--\--zt,Lkik_v‘A PHONE # 9- a 7qq
CONTRACTOR: Air-c On e (1, )12_ ! PHONE #: '70/3 — 0
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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rections /Comments /Instructions:
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I►_) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4/
Date: l 0/13/e5---- Phone #: (503) 718-
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00616
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: (503) 639 -4171 VIM'
Inspection Requests (24 Hrs.): (503) 639 -4175 .�.. /// i)�
INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 121
SITE ADDRESS: 11270 SW OUELLE PL CLASS OF WORK:
SUBDIVISION: GENESIS NO. 2 LOT #: 033 TYPE OF USE:
PROJECT NAME: HAGLUND
DESCRIPTION: 8
Replace gas furnace.
P
OWNER: HAGLUND, LINN G AND DEBRA M, PHONE #: 503- 639 -0799
CONTRACTOR: ARROW MECHANICAL PHONE #: 503-692 -1565
Inspection Request Scheduled For: Date: 10/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message 0 601;29
699 Mechanical final 017924 -01 503-793-5027 Y 1,
Corrections /Comments /Instructions:
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1
.,.s.. 1 \/e-(."-; ! Z' fvG .
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
7(FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
G/(4/ I i Inspector: �` Date: \ ��' /� Phone #: (503) 718 -