Permit CIT OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00195
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/25/2005
PARCEL: 2 S 114 B B -01900
SITE ADDRESS: 16355 SW SYLVAN CT ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 033 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:
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
HATHAWAY, LORI Description Date Amount
16355 SW SYLVAN CT
TIGARD, OR 97224 [MECH] Permit Fee 4125/200f $72.50
[TAX] 8% State Surcha 4/25/200 $5.80
Total $78.30
Phone: 503- 684 -8993
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Phone: 503- 640 -3607
Reg #: LIC 66578
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.
01/12/20,01 14:31 FAX 121002i 003
rte
Mechanical Permit A i •o FOR OFFICE USE ONLY
City of Tigard o ° 7 /:/ ‘ ,5"- . 76i ,, Permit No.; , • 1 5-
13125 SW Hall Blvd., Tigard, OR 223
Plan Review
Phone: 503.639.4171 Fax: 503.598.19§91n 2 , r�m , , :7,,: trt ; Date
/ OrherPermit:
9
Inspection Line: 503.639.4175
ANC n 200 � 1 1 { y
Internet: www.ci.ti erd.or.us ' _ -.. Note Ready/By: o; see Pam for
g CITY OF T�C RD Notified/Method: supplemental IotormaeSOn
`rj RAF I .t • N 4 • _, {l' - p�� y'""; Fl ,.,c; ,,:7•:a r nc . ... ., � } „ .7p • . „ y • - ,, ∎ caLl. l ° +'R{1� ••i � r . +' r . s�
- ' 11,,- ,ah.ITi 11....y�k ;vr41',,1;-140nil ,,, ? I. „:i -i,us -`, • ae? r d9 ! 'l'. ? - , r :, =17 ..,Olt. !a ' , 1k111 . � Y ' � � ,R SC 1".' U'SEI� 'KLIST.•'
_ Mechanical permit fees• are based on the value of the work
121 New construction Cam' Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical mate equipment. labor, overhead, and profit.
:4 a if`P '(: ;,:1 g° "gi l4r iti Ji' 'Oi i l41.l ; ?;, -W � ` y , Value:
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building , +'I•rd'? S D ji t L SXBTEM4 'FEES'
El Multi - family ❑ Neater buildCr ❑ ether: For special information use checklist.
'Description I Qty.1 Ea. I Total
9 ' Sl v ` H a lp in n ana' W3 O1 LOCA1I[O ' . iw• i l I 'l l' d . :o-1 + Hcatin coolln
Job site address: � ` Air conditioning or heat pump
( v � J � I�(( VP'(..)0-1., ( requires site plan ahawingplacement) 14.00
City /State/Z1P: v '` b / } L.Z,l f Furnace 100,000 BTU (duetslvents) C 14.00
Furnace 100,000+ STU (ducts /vents) 17,90
Suite/bidg, /apt. no.: 1 Project names Gas heat pump _ 14.00
Cross street/directions to job site: Duct work _ 14.00
1-iydronic hot water system 14.00
. Residential boiler (radiator or -
hydronic) 14.00
- - Unit heaters (fuel•type, not electric),
in -well, in-duct, suspended, etc. 10,00
Flue/vent for any of above 10.00
Subdivision: I Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
~ �.. : l i?Ilbt , 14 . 0k 1 :
r: -p��,� 1 1��7�/ T +' r ' e;l {•d„ [•!f, �i N +
��, �i tT �w�:' Gi*' �Y. ��o:; jWc f., �! 1► 11D �S7CQ "-`{ i�b'Y't� � 3i-��Ef �i '�Y� Water heater 10.00
, : .'�1 , .a: u s,fiFy':,
Gas fireplace 10,00
Flue vent for water heater or gas
0 A �} fireplace 10.00
C.Jt Log lighter (gas) 10.00
WOOd/pellet Stove 10.00
Wood fireplace/insert 10.00
;.9• ,�,• :: �, •'' 1L12. ' w i w.• h v. ,.r ... ;) 1'" Ail Tr .• . ' 19 �:� Chimney/liner /flue /vent 10.00
.:,.. ��,1 "I +i -•, 'e OP _� , I ' ' I I iS y r F � / p M t il,41 [� u h t '�'' i ' 5
r I. �' v j s'.St.�'e�:50.rS '.I 1�.��r,rl
other: 10.00_
Name: le•lf>•`, j aJ e44_� Environmental exhaust and ventilation
Address: / Range hood/other kitchen
__ equipment 10.00
City/State/ZW: Clothes dryer exhaust 10.00
p �� Single -duct exhaust (bathrooms,
Phone:
( ) bey -tr.,' j Fax: ( ) toilet compartments, utility rooms) 6,80
r.u r, i 1 � ° fV` �r '4d �I • tP " " ' ,°."° r r' o' ry i c, ttic /crawl ace fans
. C k id , y fh .' i,,-t ' , /. ', l i A ep 10,00
•;;; , � ,�,�6'�e',;;'��.� - , • "�, . -, 'nt'{,1ii�u " 4f;��. v:� ,Rt "M'� .1,
n. I T'P'� 'f� ;II!' i
Other: 10.00
Business naive: c - 1 7 C 1 i
- e L `, w , e. - Fuel piping
Contact name: d � S 1� �a
6 `--e kr S5.40 for ftrst four; St.00 for each additiona
Address: A- p-C, « 0 1 - L' -b1 Gas h ea t p u
City/State/ZIP: Gasheatpump
Ci - .
ty 1-11
f I (S' _ 6 c . . r -a ant , q 9--/ L 3 Wali /ouspended /unit heater
Phone: (� ) � ( t7 ' C }' Fax :: (SL �) � / , Water heater
Fireplace
E-mail: Range
" iY yy 1 ���� �' ��� ,,♦ N I , �,5'1^R � ;fe FIr1r n, i' f "•�-��"x. ,,,',r . I
� �I:i4dlea]lis:lf':rl�.'��.1� ��� ;d .-Il ?`��;',!�. i jic 'd- ;t�S�y�,7w(,.Yij1�!�'��r� I��:. I�� {� r . Barbecue
Business natne:
Clothes dryer (gas)
Other:
Address: ge-l.:IIler.O,i- ,, "#4 0 `_ „ , F 413 aw , 4, . •
City/StateJZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 6 C„ •$ }' g- S tate surcharge (8% of permit fee)
) TOTAL TOTAL PERMIT FEE 7i 3 0
( iIAi_.4 Au thorized sigature: .%-:-He......, .%-:-He......, Cpl 1,11.-0...i..,....% This permit application ekplree if u permit Is not obtained within tad
day, after It ha; been accepted on complete.
Print name: / rut.. (, I S C Date: OZ S d (` • Fee ntetaodelogy as by Tri County Building industry Service Board
,:■euileliet ■PerranalvSC- PatmhApp.doo 12103 440.461Tr(i1/O2JCOM/WEa)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005"00195
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4125f2005
Phone: (503) 639 -4171 Allotii Inspection Requests (24 Hrs.): (503) 639 -4175 J ' L
INSPECTION WORKSHEET FOR DATE: 5/17/2005 TIME: 7:11AM PAGE: 69
SITE ADDRESS: 16355 SW SYLVAN CT CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.1 LOT #: 033 TYPE OF USE:
PROJECT NAME: HATHAWAY
DESCRIPTION: Replace furnace.
OWNER: HATHAWAY, LORI, PHONE #: 503- 684 -8993
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503 -640 -3607
Inspection Request Scheduled For: Date: 6/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message l .
699 Mechanical final 006990-01 503- 640-3607 Y p
Corrections /Comments /Instructions:
z . c Z— L't .., ..c /_ 4/ L, • - 5 3 4 33 6, -g , au -
•
I ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL r CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: !S - /7 °L-C- Phone #: (503) 718-