Permit i 1
Aith CITY OF-TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00019
lid DEVELOPMENT SERVICES DATE ISSUED: 1/12/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171
PARCEL: 2S104CD -10200
SITE ADDRESS: 13611 SW TRACY PL ZONING: R -7
SUBDIVISION: HILLSHIRE ESTATES NO. 2 LOT: 101 JURISDICTION: TIG
Project Description: Replace: gas furnace, A/C w/heat pump & water heater w /tankless.
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: 1 DOMES. INCIN:
NAT 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: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ROBERT CERBONE Description Date Amount
13611 SW TRACY PL
TIGARD, OR 97223 [MECH] Permit Fee 1/12/200E $72.50
[TAX] 8% State Surcha 11121200E $5.80
Total $78.30
Phone: 503 - 590 -9300
Contractor:
CARSON OIL COMPANY INC
3125 NW 35TH
PO BOX 10948 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97296 -0948
Contact #: FAX 503- 227 -8521
PRI 503- 224 -8516
Reg #: LIC 8388
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.
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Issued By rp Permittee Signature: SP
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.
Jan 12 2006 10:08AM carson oil 503 227 8521 p.1
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�1Vl echanical Permit Application 1 c i « }_ } ,} O\ I
13125 SW 11811 Blvd., Tigard, OR 97223 REC ' Received
_
City a'I Tigard �� / Pia � Permit Na�.�s+ lira [ -006'49 Phone: 503.639.4171 Pax: 503398.1960 Date/By. l� OthaPermit l 1,
h3spt:etion Lope: 503.639.4175 • 1 2 '
JAN 41' . 'Li.. Date Y B See Page 2 for
Internet www.ci.tigard.or.us Noufieallble r k r - I sapplentemtat Infirmation
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Mechanical permit bees" are based the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded d to the nearest dollar) of all
❑Demolition ❑Otter
mechanical materials, equipment, labor, overhead, and profit
. 3 y ' { c �g'2 91 75 ftif Wt. ,'' . '7 < �.r .sl��,.r`.: :- It ✓11r' 1X Value: S
r1 ...:a6Ish _ . - wo. ...44.g � r'ry .ztal.'-w ;"4 t.., ' `�gC}t , ifai - :.t. YT at:i3.f �s^ ` :L 1 , vd:t 1 ^>rr aae?i='7,4: I n ,�„ : ,{gcv:'ru . -Acs-
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building } ; 4--!";;•
om~ �. ',,, ` ..._<i' �^rs' { "� =" E :,4s :
❑ Multi- family ❑ Master builder ❑ Other:
For iced for+eadaw sae checklist.
Description I Qty. � 1 , y I Ea. 1
,S13.� 3 ` F ' F r � ' � , `i � P; �': ; `� e ,. . , ,ofr,N4 -.r •cps rk. Total
• iz _a ex ..- _ z ? i�7e3�,R,` i a.° .ii-4; :Ole ` . w Healing/cooling
Job she address: 13611 SW TRACY PL coadititning heat !> tmm
(tom site plan showing pled) 1 14.00 1 4,00
City /StateJZIP: TIGARD, OR 97223 Furnace 100,000 BTU (daasivc1a) 14.00
Suite/bldg./apt. no.: I Project name: CERBONE Furnace 100,000+ BTU (d.rcts/vemts) I 17.90 I '1•qo
Gas heat pump 14.00
Cross street/direetions to job site: SW MISTLETOE DR Duct work 14.00
Hydronic hot water system . 14.00
Residential boiler (radiator or
hydrunic) 14.00
Unit heaters (fun -type, not electric),
in-wall, in -duct, suspended, etc. 10.00
Subdivision I: Lot no.: Flue/vent for any of above t 10.00 14 aO
Other: 10:00
Tax map/parcel no.: Other foci appliances
`'G' FFTI 4u -ti , 7.h.? "i y , , t } q �' F t i - i fw � L. .'r ge n r; v _ t ro .N h1r+. <.�,aY ( . « 1 7 * , 3 1 5 °�,'s '
yy'�� nt 1 1 S 2 r ` Z +? � H.. r r :�, 4.A. i,E al � ," Water healer 10:00 �10
uL-;a��:r.� ;"S�'h�+2 .hF o.'�" +! nv - r. . �ri • �� .,�:....z .,.,_..� �:s}.. �� ,�;.!�?"
REPLACE GAS FURNACE WITH NEW GAS FURNACE Flue veal t far IO.OD
ar water heater or gas
REPLACE A/C WITH NEW HEAT PUMP fireplace 10.00
Log lighter (gas) 10:00
REPLACE WATER HEATER WITH NEW TANKLESS WATER HEATER Wood/pellet stove 10.00
Wood flreplaodinaert 10.00
r . `" 117ii;+ : �� aar6T . rw,
sr � y S , �,,,`nr• -�.�� r z fir• Chimneyfioa/@odvmt 10:00
� . , if: :.,::1.� tko.. i .A.s ui , : file h :s ,: : 'z :rte # 'a - .:�1i -� , other 10.00
Name: ROBERT CERBONE Environmental exhaust and ventilation
Address: 13611 SW TRACY PL Range bOOtVother kitchen
egniprneat 10.00
City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)590-9300 Fax: ( ) toilet complements, utility rooms) 6.80
T, fi 'rfk } �i, '' 1� rr •4l :l', Y „; 4 ��j<,il' ? ma x
h t14��rt� c_FL s�.:iay".� �i" .�`c., u�ce�`ry'r4<Z r � �L, A1t1C/0raw19paeef8119 10.00
i
Business name: CARSON OIL COMPANY INC F 10.00
Fuel plelas
Contact name: JIM HARCOURT f TERI Z BUISKY S5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 3125 NW 35 AVE
Gas heat pump
City/State/ZIP: PORTLAND, OR 97210 WaW heater
Phone: (503)224 -8500 I Fax:: (503) 227 -8521 Water heater
Fireplace
Email ZIBUISKY@ CARSONOIL COM
Range
-<: +. hYf1? 2 };t iNji: :'.A�.S'•, VP` clir. '. y � Y f*-1.r ` wi. c�.}..t�n' r. bs ik Nl.W�ra w
Z volt vY rY' 7r , r y � 2 r 7 3 t t ti +� r y E� y
11 3� . . i2a FYZ ,,ci :.E: ' rAAT ,1. �rv{ i4iPf3 Cfi•'_x b 9f ° r t, 2yw rarifsG: l ti { '� Barbecue
Business name: CARSON OIL COMPANY INC A e'er ( )
Other.
Address: 3125 NW 35 AVE R .<a41' '' : , :;' ;' •F
P"t x' f- ;; � u ^� Tii'..:�n''>'�, ' + .:•
4.:.4:5,»tr..ci_t..r:..., .-fit �.�.1-'a1-t ` ..1_f : _'raktratii .42+
City/State/ZIP: PORTLAND, OR 97210 Subtotal 51 • 90'
Phone: (503) 224 -8500 I Fax: (303) 227 -8521 Minimum permit fee (572.50) 12.50
Plan review (25% of permit fee)
CCB tic.: 8388 State surcharge (8% of permit fee)
TOTAL 5", SL)
Authorized signature: �A �( This penult application expires Ha-permit obtained w thta 180
✓`� - - days after lt has hem accepted as complete.
I Print name: TERI ZIBIJLSKY ate: 1/12/06 I • Fee methodology set by Tri- County Building Industry Service Board
L•ubm'1su${Per> GPerm t;t03 4404617r(tMO/COM/WES)
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13611 SW Tracy Place
Tigard, OR 97223
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CITY OF TIGARD
BUILDING DIVISION _ PERMIT #: MEC200&000 9
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13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: '1112/2A10(3
Phone: (503) 639 -4171 '(0�'
Inspection Requests (24 Hrs.): (503) 639 -4175 s' "'I I..
INSPECTION WORKSHEET FOR DATE: 4/21/2006 TIME: 7:02AM PAGE: 62
SITE ADDRESS: 13611 SW TRACY PL CLASS OF WORK:
SUBDIVISION: I ESTATES NO. 2 LOT #: 101 TYPE OF USE:
PROJECT NAME: CERk3ONE
DESCRIPTION: Replace: gas furnace, A/C w /heat pump & water heater w /tankle:ss.
OWNER: CFRBONE, ROBERT PHONE #: 503 - 9300
CONTRACTOR: CARSON OIL COMPANY INC PHONE #: 503 - 2241 - 8516
Inspection Request Scheduled For: Date: 4/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021462 -02 50'.4-411.43M N
Corrections /Comments /Instructions:
Ii PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C- hP Date: L iZt 6 Phone #: (503) 718- Z6 -/ y