Permit \.
C1TY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00043
DEVELOPMENT BMENg r S o ERV SERVICES 503-639-4171
DATE ISSUED: 1/24/2006
— 13125 SW
PARCEL: 1S133DD-04500
SITE ADDRESS: 11561 SW SHOREVIEW PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 084 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: 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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MELVIN LOUIE Description Date Amount
11561 SW SHOREVIEW PL [MECH] Permit Fee 1/24/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11241200E $5.80
Phone: Total $78.30
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: FAX 503- 691 -1879
PRI 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_9.52 -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 /
Iss ed By: � �i Permittee Signature: __ ' _
Call 503 -639 -4175 by 7:00 a.m. for inspections that b mes
is permit card shall be kept in a conspicuous place on the job site u til mpletion of the project. .
Approved plans are required on the job site at the time of each inspection.
Mechjnical Perniit- Application FOR OFFICE USE ONLY
City of Tigard Received Y 111/1111111
13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 PE eview
[Aw;a • 1)ate Other Permit:
� •
Inspection line: 503.639.4175 j J. ' i 1 Date Ready/By: RI See Page 2 feu
Internet: www.ci.tigard.or.us "' _ 8
Notified/Method: FM Supplemental lnformatfen
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❑ New consttllcllon Addition/alteration/replacement Mechanical permit fees• are based on the value of the work , -V
El Demolition ❑Other performed Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
am z Y Ft � ' ' a "`Yk tr te. '' Value $
i / i,i r., Or t": r;, Je)Cp2 Y rr: t �t ,� f
! 1 and 2- family dwelling ❑ Commercial/mdustrial ❑ Accessory building • , ,. ,=-- r w --,..2 _; . . ,..t. ,ti_ .. �,
❑ Multi-family ❑ Master builder ❑ Other. For special information use checklist
Description I Qt I Ea. I Total
2,55$ . , ';• 50rNfilita17J fNI `. eating1
Job site address: // 5C../ .5 a vie,.r Air conditioning or heat pump
S t 1 l �° (requires site plan showing placement) 14.00
City/State/ZIP: -y .&4/4.0 ,�.•,p //� 97 Z 2 3 Furnace 100,000 BTU (duas/venrs) ( 14.00
Suits /bldgJapt. no.: � I Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
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
Subdivision: Lot no : Flue/vent for any of above 10.00
/ Other: 10.00
Tax map/parcel parcel no.:
Other fuel appliances
x,� �,"
�'. ' -_- c ^ -.-,1.. 1"�. D ; • ..< O'.. ;` • ° ` 4;, Water heater 10.00
/ Gas fireplace 10.00
P1 C / /''f e) - Re ;' ,>✓1e/C /fJ1 (} < Flue vent for water heater or gas
Ft //Z zit AGE ( � �cv / 9 0/ Log l gh ter (gas) 10.00
10.00
_ Log ligh A 5 /"i/�LC L� Wood/pellet stove 10.00
Wood fireplace/insert 10.00
z � .r' o ="° °,• ;v? ' ^. Chimney/liner /flue/vent 10.00
s ?„c,. a�s�ai.a.`..r z Other. 10.00
Nam : /-/../1 /.
�U � " Envir onmental exhaust and ventilation
Address: t , / S LJ < oe ,�v PL Range hood/other kitchen
J equipment 10.00
City/State/ZIP: �tpv .4AD 4 .7 , `' 7., 2-�3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( )
toilet compartments, utility rooms) 6.80
y..
} t al o 1 s e i s .„ .1>,, g1� r e - ° _ , Ariidcrawtspace fans 10.00
Business nam -. /1� l ���i7- -, i
Other: 10.00
Fuel piping
Contact name: 7( y ,� 5 -7? �,� tA) e e /2 � $5.40 for first four; $1.00 for each additional
Address: .° ] Furnace, etc.
U A li�'!;,1! Z Gas heat pump
City/State/ZIP: Fu 4L 7 I'//...t-Pa. ' . WaWsuspended/unit heater
Phone: `- / C 7, Water heater •
( ) ( � _/5 5 ° Fax: : ( ) l� / 6 '� � /�
E-mail: Fireplace
Range
?. ; r.:& Str Y� * vt�-"'ki 5 ,g ,f fif 'T•V.,.j ,,,�, •,�- r d-X x : „-;r.« Barbecue
Business name: T d - . , •_ , Clothes dryer (Ras)
d-.„ 7� mil. t/ 6 c Other
Address: rTM� ,..gam
r� - ¢
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) /• ; Minimum permit fee ($72.50) f v 1 •
Plan review (25% of permit fee)
CCB tic.:
9 3 d State surcharge (8% of permit fee) 80
4
7 TOTAL PERMIT FEE g . 30
Authorized signature: V �,i3 t� 7 ` This permit appUcdko expires If a permit b Dot obtalaeb within iso
days after it has been accepted as complete.
I f I • c.. n.,.tin.4,L..... M. T.:_r......, nn:t 1:ne. T.,,r..a.., c....:n. A,....4
• CITY OF TIGA.RD
BUILDING DIVISION PERMIT #: MEC200-00'.13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 112l/2110C;
Phone: (503) 639 -4171 Atte
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 216/2006 TIME: 7 :07AM PAGE: 70
SITE ADDRESS: 11t361 SW iHOREVIEW PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: Q134 TYPE OF USE:
PROJECT NAME: LOUIE
DESCRIPTION: Replace gas furnace with like kind.
OWNER: LOUIE, MELVIN PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 503- 6:32 -1£;0r.,
Inspection Request Scheduled For: Date: 2J6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 026/24-01 W3- 793.5027 Y
Corrections /Comments /Instructions: //
0.4,2@L t
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 -
\.
C1TY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00043
DEVELOPMENT BMENg r S o ERV SERVICES 503-639-4171
DATE ISSUED: 1/24/2006
— 13125 SW
PARCEL: 1S133DD-04500
SITE ADDRESS: 11561 SW SHOREVIEW PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 084 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: 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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MELVIN LOUIE Description Date Amount
11561 SW SHOREVIEW PL [MECH] Permit Fee 1/24/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11241200E $5.80
Phone: Total $78.30
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: FAX 503- 691 -1879
PRI 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_9.52 -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 /
Iss ed By: � �i Permittee Signature: __ ' _
Call 503 -639 -4175 by 7:00 a.m. for inspections that b mes
is permit card shall be kept in a conspicuous place on the job site u til mpletion of the project. .
Approved plans are required on the job site at the time of each inspection.