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Permit � � r CI TY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00498 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/17/2006 PARCEL: 2S1 14 B B - 01500 SITE ADDRESS: 10285 SW SERENA WAY ZONING: R -4.5 SUBDIVISION: PICKS LANDING NO.1 LOT: 029 JURISDICTION: TIG Project Description: Replace gas furnace with like kind. 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES BRANDERHORST, JOHAN Description Date Amount 10285 SW SERENA WAY TIGARD, OR 97224 [MECH] Permit Fee 10/17/20( $72.50 [TAX] 8% State Surcha 10/17/20( $5.80 Total $78.30 Phone: Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact #: Reg #: 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 adoptedi • - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies o -se rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. • Iss ed By: '' ✓ � Permittee Signature: A. Call 503 - 639 -4175 by 7:00 a.m. for inspections that busin /day. This permit card shall be kept in a conspicuous place on the job site until • mpletion of the project. Approved plans are required on the job site at the time of each inspection. t. Mechanical Permit Application 0 _ ,ai ,; pi 01 1'lc t'Si: ()NIX City of Tigard Da�te/B if �'I_ Permit No.: , , /— 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 AIR, �. i Plan R i �a DateB Other Permit: Inspection Line: 503.639.4175 ,L -_'. ' Date Ready/By: See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: FEE ® Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE _ USE CHECKLIST ❑ New construction 0 Addition/alteration/replacement Mechanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ �l - and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES *. y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling I Air conditioning or heat pump Job site address: 6 2, e5 . ` er ,7� (requires site plan showing placement) 14.00 City/State /ZIP: , # /; al %lJ� f Furnace 100,000 BTU (ducts/vents) I 14.00 Suite/btdg. /apt. no.: , , Project name: 1 �. Furnace 100,000+ BTU (ducts/vents) 17.90 i - Gas heat pump 14.00 Cross street/directions to j . site: - f . a Duct work . 14.00 ��_�� 14.00 _ l�'I/� . .. � yil L � �T. .__ _ . Al �� Hydronic hot water system Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), OMEISIMW ii , I, in -wall, in duct, suspended, etc. 10.00 y- Flue/vent for any of above 10.00 ubdivision: , ` 4 aO a 2 Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 r • Gas fireplace 10.00 • • II 0 / a S W I ` _ l e A / 0 • Flue vent for water heater or gas fireplace 10.00 ( Log lighter (gas) 10.00 N )(1-11\ a— eW ©1/ a , Wood/pellet stove _ 10.00 Wood fireplace /insert 10.00 PROPERTY OWNER J ❑ TENANT Chimney/liner /flue /vent 10.00 Other. 10.00 Name: . f ., `, la / r. i IDS Environmental exhaust and ventilation Address: q �� Range hood/other kitchen • CDs, c `32 .� i equipment 10.00 City/State/ZIP: - l / Q. `-- O� J 9 Clothes dryer exhaust 10.00 � `' ` Single -duct exhaust (bathrooms, Phone: e 5 4 3 ) ! (� 6 6.7 / )' 1 7, Fax: ( L L , 6 ,..- toilet compartments, utility rooms) 6.80 ❑ APPLICANT 6 � V CONTACT PERSON Attic /crawlspace fans 10.00 Business name: Other: 10.00 u ,c Furnace, ` f Fuel piping „ _ . _ Contact name: 6(1(44 $5.40 for first four; $1.00 for each additional Address: D 1 1 l i� n � /� Furnace, etc. c l/ -(J'l _ Gas heat pump City/State/ZIP: • q, 0 912 WalUsuspended/unit heater Phone:.° .41' • , . ' •0 �' Fax: : ( 4 Water heater 40 k Fireplace E -mail L �rI!'1 � a. ' Range CONTRACTOR Barbecue Business name: O,t)l) E Clothes dryer (gas) Other. Address: MECHANI PERMIT FEES* City/ State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 79, . Plan review (25% of permit fee) CCB lic.: ' State surcharge (8% of permit fee) jf . C'v TOTAL PERMIT FEE '7 . - Z.0 Authorized signature: i / /O1.' This permit application expires if a permit is not obtained within 180 . i//` !tom t days alter it has been accepted as complete. ^ _ e Pen ..,a1...A..lnm, b.. 1.., T.:l'......�.. A..11,11.... 1..4.0... C......1,.. 11,......4 d - .aX 1 )!1dr^ CITY OF TIGARD 56rENP BUILDING DIVISION PERMIT #: MEC2006- 00498 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2006 Phone: (503) 639 -4171 :rt,�l Inspection Requests (24 Hrs.): (503) 639 -4175 _. ' �__— INSPECTION WORKSHEET FOR DATE: 1/11312006 TIME: 7:04AM PAGE: 51 SITE ADDRESS: 10286 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.1 LOT #: 029 TYPE OF USE: PROJECT NAME: BRANDERHORST DESCRIPTION: Replace gas furnace with like kind. OWNER: BRANDERHORST, JOHAN, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/13/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 039626 -01 503 - 968.6627 N Corrections /Comments /Instructions: 54 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 /AV Date: J /Il Phone #: (503) 718-