Permit 4.
a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00386
TIGARD DATE ISSUED: 7/24/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111 CD - 07100
SITE ADDRESS: 15780 SW SERENA CT ZONING: R
SUBDIVISION: KERWOOD ESTATES LOT: 016 JURISDICTION: TIG
PROJECT: PIERCE
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: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HAL PIERCE Description Date Amount
15780 SW SERENA CT
TIGARD, OR 97224 [MECH] Permit Fee 7/24/200E $72.50
[TAX] 12% State Surchai 7/24/200E $8.70
Total $81.20
Phone: 503- 624 -5713
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -579 -2250
FAX 503 -579 -9104
Reg #: LIC 108535
This permit is issued subject to the regulations contained in the Tigard Munidpal 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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Iss ed By: 4# Permittee Si: nature:
Call 503.639.4175 by 7:00 a.m. for inspections th • .urine day.
This permit card shall be kept in a conspicuous place on the job rte 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 t TS u t ,, ,i `r t n d a
h . W .� , �. ( l I I( �, 1 .� a, cd " '."' 't � Lk "r, °r " '1 a �na,a
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. City of Tigard Received , , t
ed s v�� "
ti +.� 1's
w 13125 SW Hall Blvd., Tigard, OR 9 ,,. :; Daie By: ? a ea /.9 I Pcnait Nn. /Lf t7 g —'� 5
...Al lan Review
Phone: 503.639,4171 Fax: 5 .r . . F ;
ii t li t > Inspection Line: 503.639. � ' R Date/By other Permit
'r '+ Interne www.tigard - or. g 3200 Date Ready/By; turfs: lid Sao Page 2 for
\ � ��® qA
Notified/Method. Supplemental Information
. TYPE OF WOJ � �` .AWN. I COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction f (:ldition,r i. , ,1. ent Mechanical permit fees'" are based on the value of the work
❑ Demolition ❑ Other. ta ` `` performed. Indicate the value (rounded to the nearest dollar) of all
�J mechanical materials, equipment. labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
l- and 2-family dwelling ❑Commercial /industrial RESI�ENTIA]L R
❑ Accessory building SYSTEMS FEES
Multi-family ❑Master builder ❑Other: For special information use checklist.
JOB SITE INFORMATION AND LOCATION Description I Qty. 1 Ea. I Total
HeaHilpJeoolinR
lob site address: / 97 8 ( S VJ s c. r e } Air conditioning or heat pump
�� (requires site plan showing placement) 14.00
City/State /ZIP: '' f"-z- f - -/ / § / zi 7 2.2._ , / Furnace 100,000 BTU (ducts/vents) I 14.00
Suite/bldg./apt. no.: J 1 Project name: Furnace 100,0004- BTU (duc,sJveats) r 17.90
i Y e- e- Gas heat
Cross street/directions to job site:
p 14.00
Duct work 10.00
Hydronic hot water system 14
Residential boiler (radiator or i
hydrania) - 14.00
Unit heaters (feel -type; not electric),
in - waft, in - duct• suspended, etc. 14.00
Subdivision: I Lot no FJuelvent for arty of above 6.80
Tax map /parcel no.: Other 10.00
•
Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/, ct d---17 & , — Gs fireplace 10.00
; Flue vent for water heater or gas
.— CA-) C
Log 10.00
/ �; o lighter as
rr R (gas) 1 D.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
P OPERTY. OWNER 1 Q TENANT Chimney/liner/flue/vent 1 0.00
Name; 0_ [ R
! �^ L' Other: 10.00
Environmental exhaust and ventilation
Address: S /L- .7 Range hood/other kitchen
equiptent 10.00
CitylState /ZIP; Clothes dryer exhaust 10.00
�[�� Single =duct exhaust
(bathrooms,
Phone: '`
J ,5 ,7 Fax: ( .—j-- bn c
❑ APPLICANT toilet comparents, utility rooms) 6.80 •
0 CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other' 10.00
Contact name: Fueipipiol
$5.40 for first four; $L00 for each additional
Address: Furnace, etc.
City/State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( ) ` Fax: : ( ) Water heater
E -mail: Fireplace
' Range
CONTRACTOR Barbecue
Business name: A !e 146-41 n ` & 1 f? Clothes dr y er (gas)
Address: l' ,"\A V 1/14 me_ raj �, p�� 'Other:
•
I MECHANICAL PERMIT FEES*
City /State/Zrlr 01. my /i 2 Z2 , y, u,
}-� _ Sub total, .
Phone: ( �j' jj Fax: ( jG r 7t IO M permit fee.($72.50) 1 S C
'
CCB tic.: 0 /// 3 Plan review (25 %ofpemu fee) - — ,
State surcharge (12% of perinit fee) 5' 0
TOTAL PERMIT FEE ,/
Authorized signature �%�,/ 1 f 'V' s This permit applicadoe expires if permit is not obtained thin 180
r CT! t/V 14 - days after it has heed accepted as complete.
Print name: 2 U L VA/ . \,7 � ,e 4 3)-1: - "i4/el----
ate: ,� i • Foe methodology' set by Tn -County Building Industry Service Board
!:\ Su ;m
itdinglPc itstbff-C- PermitApp,doo 01/19/07 f tZ �/ /
44-46: Tr rilifiviai) ,
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00386
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2000
Phone: (503) 639 -4171 I � I
Inspection Requests (24 Hrs.): (503) 639 -4175 °-
INSPECTION WORKSHEET FOR DATE: 9/16/2008 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 15780 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 016 TYPE OF USE:
PROJECT NAME: PIERCE
DESCRIPTION: Replace furnace.
OWNER: PIERCE, HAL • PHONE #: 503 - 624 -5713
CONTRACTOR: ABLE HEATING & COOLING INC PHONE #: 503-579-2250
Inspection Request Scheduled For: Date: 9//612008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 075498-01 503-579-2250 N
Corrections /Comments / Instructions:
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�re�vi�n�
//1L c/. ti/ e � LJS1 ! T 1 t%T !/w "T"d /J 47er/(/ ' %i 47 V'e-; is
•
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/PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: - P O 6 Phone #: (503) 718 - Zs/ 4es---"