Permit C ITY OF TIGARD MECHANICAL PERMIT
�
1� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00517
°� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/23/2005
PARCEL: 25111 CA - 03200
SITE ADDRESS: 09445 SW SUMMERFIELD DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 379 JURISDICTION: TIG
Project Description: Replace furnace.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
EUGENE & M CLAIR Description Date Amount
9445 SW SUMMERFIELD DR
TIGARD, OR 97224 [MECH] Permit Fee 8/23/200: $72.50
[TAX] 8% State Surcha 81231200E $5.80
Total $78.30
Phone: 503 - 639 -3606
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 • REQUIRED ITEMS AND REPORTS
Phone: 503- 281 -0752
Reg #: LIC 8897
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: Permittee Signature: cf ,Q, q
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business daa\r.
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.
6 ach nical Permit Appia faith' I \r E " sl "FOR OFFI USE ONLY;' -
-I ty Or x X .(I � Date/Brd� Permit No.. t
312.5 SW H 1 d'.Taigar ,PR 7E 3 Y s Q Y�1' u V 0� � �
]] � 1 PPlan Review
hone: 503.6 9. I-ax: $0 G p 2 d` 1 uole� Other Permit:
tspeelion Line: $113.bi9.41 _ ! o'. 1 • Date RcadylBy: gifill 0 See Page 2 tut
ttemCC www.Ci.iiF st J., 9� , " X005 UI
L+l I Y Li i' t ll •" Notified/Method; Supplemental Information
�` t 1 �iVte.`ON
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, , . , • .- T,YI'E OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
{ r =v "' Mechanical permit fees* are based on the value of the work
] New canst coon � XAddidon/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition • p Othet': mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
' . RESIDENTIAL E.QU.IPMENT / SYSTEMS FEES'
.I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
Fro special infarmalion 4SC ekOCllisl-
] Multi- fancily 0 Master builder • ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heatiug/cooling
Air conditioning or heat pump
!ob site address. RH qS SW 4 VCt .aQ- '1r\EN aR. ..tet- - (requires site plan sho+vine placement) 14.00
:ity/Stare/ZIP: ,, t.c.z, CP.- T1-2_2..xik Furnace 100,000 BTU (duct /vent,) L 14.00 1"- .cO
Furnace 100.000+ BTU (ducts/vents) 17.90
;aim/bldg. /apt. no.: Project name: Gas heat pump 14.00
=toss 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 -duet, suspended, etc. 10.00
� � -- - Flue/vent for any of above 10.00
"Subdivision: Lot no.:
- _ Other 10.00 _
Fax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
_ • Gas fireplace 10.00
ev \e5 G-2- lt.rV\A C.'. Flue vent for water heater or gas
fireplace 10.00
Log lighter (gss) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert ,
�' PROPERTY OWNER I ❑ TENANT Chimney /liner /Otte/vent _ 10.00
Other. _ 10.00
Name: t vc�rssQ.- / MA� C"-Ni�`t- Environmental exhaust and ventilation
4ddr Range hood/other kitchen •
`i4t.t5 .z ss -. equipment 10.00
City /State /ZIP: ` Z2 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( So3 - kq_ 4,,ob . Fax: ( ) toilet compartments, utility rooms) 6,80 ,
❑ APPLICANT ❑ CONTACT PERSON Attic/erawlspace fans b 10.00 ,
Other: 10.00
Business name: -
. -- , Fuel piping _
Contact name: 55.40 for first four- S1.00 for each additional
`"
Addr��5: Furnace, etc.
..,,.,.r Gas heat pump
City /State /-LIP: - Wall/suspended/unit heater -
Phone: ( ) Far: s ( ) Water heater
------ Fireplace
• E -mail: Range
CONTRACTOR Barbecue -,_
Busine� name: Clothes dryer (gus) I
ibmNC.t \\ It� - \\ C,po \r (n . Other:
Address: MECHANICAL PERMIT FEES*
Ci /State /ZIP: • 9.0 1_ ..&1 ��. -- Subtotal 1M. C0
Minimum permit fee (:512.50)
Phone: (% ) 2,531_ ( - 7$ - 2-. Fax: ( ) -` Plan review (25% of permit fee)
C•C'fi lit.: befar State surcharge (8% of permit fcc) I ,,`✓j �1
0
TOTAL. PERMIT FEE I1-
_
_ authorized signature ; : / 6r dat
_
This per rpp after i t expire been uccePt u permit is out ubtatnc0 within ISO
. attar it ha bt d is rnmplcee.
- FCC methodology ac•t by Tn -C ounq• Building Industry Si '. BOMA
O iill■ IIaII;i. bale:
Td Wd6L:L0 SOOE LE 'End EELSEBE LOS : 'ON BNOHd Gut IOOO '8 6utlle 1IIONU : WOdd
CITY OF TIGARD ...
BUILDING DIVISION PERMIT #: MEC2005 -00517 '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/200
Phone: (503) 639 -4171 -'�I +
Inspection Requests (24 Hrs.): (503) 639 -4175 :.
INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7 :05AM PAGE: 64
bull -(/ -0mot , ftjbe - &eoeK
SITE ADDRESS: 09445 SW SUMMERFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 379 TYPE OF USE:
PROJECT NAME: CLAIR
DESCRIPTION: Replace furnace.
OWNER: CLAIR, EUGENE & MARY PHONE #: 503 - 639.3606
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503 -281 -0752
Inspection Request Scheduled For: Date: 9/13 /2005 Pour Time:
Code # Inspection Description Confirm # e- . — - Message
699 Mechanical final 015465 -01 503 -639 -3606 Y
Corrections /Comments /Instructions: �'''� /PC
)'`''I ! nI O K__ L • d S '8 3 /L1 .
'''',. ris:
ta SS e PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL //, • LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: .1. ` Phone #: (503) 718-
` .