Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00790
4111‘vilt 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/29/2005
PARCEL: 2S1 14 B B -01800
SITE ADDRESS: 16335 SW SYLVAN CT ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 032 JURISDICTION: TIG
Project Description: Furnace replacement.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
STEPHANIE HIGGINS Description Date Amount
16335 SW SYLVAN CT [MECH] Permit Fee 11/29/20C $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 11/29/20C $5.80
Phone: 503 639 - 9387 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Phone: 503 624 - 2704
Reg #: LIC 76359
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: '
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business 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.
1 ■;', .
"
Mechanical Permit .4.7* ,/ i--; ! FOR OFFICE USE ONLY
.... L...r :_.
City of Tigard Received i„
OR 97223 1e1 e .„,,
'
DatelEy: 2-ti 05 615 Permit No.
I\ C.../-4 V 79a
13125SW Hall Blvd., Tigard, f! , -
Plan R
Phone: 503.639.4(71 Fax: 503.598.1960 1 - ' .4 . Ctber P ermit :
Inspection [inc. 503.639.4175
...0411111y, D a:eV y:
vIew
Date Realy/Eiy:
Internet: www.ci.tigard.or.us GiTY OF -ilu:ARL: NotifiediMethod: pr 11N Tup See Page 2
ta1 IT:for me do n
litnt DiNG Di visioN, .. a
t. F'..4. cll*** WORK .. .. . ., - . :?. : ,...,. , . .. ,, , . . .434 : .s.1..Y.:17::,.... k otsp.iriteitet-Atitt*. , stErEbt: LE - USE criECKL rs•
0 New construction XAddition/alterationircplacement p r , , 1 1 Mechanical permit fees• are based on the value of the work _
1'6.. 4 :., 2005 I performed. Indicate the value (rounded to the nearest dollar, o:
El Demolition E Other: mechanical mater:als, equipment, labor, overhead, an: prof::
,7: f itiqeMptiliii'60661.410tEr61 • .:: ' .... \iv.. 6 . Hi:i6 . 'jW/ ` ' Value: S
14 1 - and 2-family dwelling 0 Commercial/industrial 0 AfibigoilArtiklainISION .:....;..., ItX-S.....0 tQcr,PlifEistT / SYSTEMS FEES*
For special information use checklin
0 Multi-family 0 Master builder 0 Other:
Description I Q...y. Ea i - Iota
L. ' ... :-.f -' . ..:k: C e.. 1 : - ;• : ;; . T t- 1 .. i 111. 0 P 0 - .: 4 .: , ' ::::::,..-..: .-:-. - :.. Heating/cooling
Air conditioning 07 heat pump
Job site address: / _3 3 5" _Sic, __Si rtkii..2 _././--- (requites site plan showing :lacemeot) ! 14 00
City/State/ZIP: Furnace 100,000 BTLI (dices/vents) _ i ' 14 00
Furnace 100,0004 BTU (ducts/vents) : 17.90
1 Suite/bldg./apt. no.: Project name:
Gas heat pump 1 l 4 00
Cross street/directions to job site: Duct work 14 00
14ydronic hot water system 14 00
Residential boiler (radiator or 1
hydronic) : 14.00
i
Unit heaters (fuel-type, not electric),
Lot no.: in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above
Subdivision:
Other: 10.00
Tax map/parcel no.:
Other fuel appliances
,,.: &VII' D:004: .. :,;; , %: ;. I . . , •V.... 4 1 , .. ,:... Water heater 10.00
Gas fireptace 10.00 .
7101-4,4a-e"...., Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
:
' Chimnev/lineueivent 10.00
'14-41t..1.044-.064...44.t)1510:4Zik.,.:;;;ViitakW0t113.i.:441:iN;11:1 Other: - dfl .
: 10.04.1
Name: e.......--/ C.-0. //71/./9/4.(.6 Environmental exhaust and ventilation
Range hood/other kitchen
Address:
equipment 10 03
C i tyiS taterZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
' Phone:4113)V 1 9:_ g 7 . Fax: ( ) toilet compartments, utility rooms) : 6.80
r4izztIrs supate,rt4,.;,',1A1,-Si7sfa:; a :11V,,,-,,•.:._ Anickrawlspace fans 13.00
1 :..1": 1 .1.11i1.1 1 :.1 ) 110-- - ;;. ...',...11.-.87.`.1.- AtitilelSt......:.,...,..,,. ... . . : ...: t.l.,i 'c
Other: I 300
Business name:
Fuel piping
Contac: name: / a 9 - /6 I S5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: .
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Wat hea
Phonei_ -) )1 q ,2 02 ey el Fax: : ( j . 0 91) .5 a -it , er ter -
Fireplace '
E-mail: .
Range :
;-..k Barbecue
ilift -.1 ..;.. : 1 . :: . i.:.4 '....i.i:; - : :: " .. .T::' , 1 ,
Clothes dryer (gas)
Business name: C-C, 44 ry 6 /4.- 7/1-e--4-77"14. ' (-AP es I, 4..c.
Other:
Address: 00 c=3 3 T c CAL i?ra&iri FEES-
City/State/ZIP: Subtotal
7 - 7 - 4. .9-..2-,r7 0/a-. 9 -747/,,A ...9
miiimun- permit fee ($72.50) - 1/001
1 Phone: 0 ) 4 a ,,, , Fax 3 ) 5-1 ir �o, 76 Plan review ;25% of permit fee)
GCB lie.: '7_ .3 5 9 State surcharge (8% of permit fee) •V
TOTAL PERMIT FEE 7». 30
Authorized signature: This permit application expires if o permit is not obtained within :
days after h has been accepted as complete.
Print name: /2 < ,4 6,,, ,..... y 7 , I Dat 7 yo.s ..... i • Fee methodology set by Tri-Court BLEIdilg :edustry Se 7V:Ce P. uarc
..,11tli:■1 in cAP er mir &Mr t -Pr ITnir A r.r. fir, I ,Irti
Z' d OLZ0869C09 6uneeH qqwnloo 8 09:90 90 6Z AoN
.t.
° tit(' OF.TIGARD
BUILDING DIVISION .
• PERMIT #: ME:C2005-00790
• .13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.):.(503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/29/2005 TIME: 7:00AM PAGE: 45
SITE ADDRESS: 16335 SW SYLVAN CT • CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.1 LOT #: 03 TYPE OF USE:
PROJECT NAME: HIGGINS
DESCRIPTION: Furnace replacement.
•
OWNER: HIGGINS, STEPHANIE PHONE #: 503-639-9'387
• CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503
Inspection Request Scheduled For: Date: 1212912005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
69 Mechanical final 024133-01 503-624-2704
• Corrections/Comments/Instructions:
et•Id 7
•
k l PASS PARTIAL APPROVAL LI CANCEL , 1111 NO ACCESS
I FAI El CALL FOR INSPECTION • ADDITIONAL FEES ASSESSED
• Inspector: Date: I Phone #: (503) 718- _2 74/,