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Permit . R .� CIT OF TIGARD MECHANICAL PERMIT A"14.*1 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00821 _44. � �I �! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/14/2005 PARCEL: 1S125DD-04000 SITE ADDRESS: 09845 SW VENTURA CT ZONING: R-4.5 SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 048 JURISDICTION: TIG Project Description: Gas 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: 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: 1 Owner: FEES JAMES B. WILLIAMS Description Date Amount 9845 SW VENTURA CT [TAX] 8% State Surchaq 12/14/20C $5.80 TIGARD, OR 97223 [MECT3] Permit Fee 12/14/20C $72.50 Phone: 503 293 - 9408 Total $78.30 Contractor: BEN'S HEATING & AC PO BOX 80607 REQUIRED ITEMS AND REPORTS PORTLAND, OR 97280 Contact #: PM 503- 233 -1779 FAX 503- 651 -3345 Reg #: LIC 64597 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: IM /AN 8t4 L-o CIG Permittee Signature: ,s e l4P L / CA7 / Al 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. DEC -13 -2005 08:16 AM BENS HEATING 503 651 3345 P.02 Mechanical Permit Application a , . Receiv WI::1 11 L;_I ItiI; t Isla' City of Ttfgard "� m I' _ -. 11.� L: il o 1?l)It = 131i}5. SW liall Blvd , Tigard, OR 97223 Dete/8y: Z •i3 -0 S f j Permit zoos -008 zr Phone: 503 639.4171 Fax: 503.596.1969_ .. Plan Review UC 2005 / 1 w <� \, Other Parrott; Inspection Line: 503.639 4175 `� -1 . - �' I DBtaBy. ' ^ *emet: www ` - : '''L, Date Ratdy GI See Pap 2 for Notifled/Nrethad: M N � ��� F Sugpletnentallnformation .,. yi n,�,r s f, 0. ,,c.i ,,,,It s l ilt.. . ? t i ,I r. pp,' I' ela�,i ,,.. 'R,nin t:.',:, n; d , .� ° ., I (111 l' , a , 9 . 9:n i 1 , � I r ' . r1 4� y l l t i t . I II I g , , ` . t .1-0 F� I � I l f y � � p t 1 1 i 1� rim li lfiM ,,-, i l 11 I'f� "t � A 1 IIl1 4i n. li , 19; Til l� i. l�.... �hl1u��1. u1_ t1N7 .�d.,.fll�fla,,.l1L _ �Id t , I. I9 ��hdL I .... ,�.. t, , : : r a lll l , , ii l'NI� lI A�� ' Iol ∎dl I r., . `�� yl�i A P � 11 , � � 41ll l lo vA � fl�l "� "` 111 �:rlu J B ` " I •u ,4 "l �lh11:�4,lElfNllp �1 NI° ❑ New construction jiT Addition /alteration/replacement Mechanical permit fees" are based on the value of the work ❑ Demolition ❑ Other performed. Indicate the value (rounded to the nearest dollar) of all y ,� r � mechanical materials, e•ui.ment, labor overhead, , d •r of ` I {�I, i I JII tt t l 9 I i i+ ip '� ilil'i ti ((i I r' r li� 1 j I I 17 t ∎ iii , .(,, it J +I Iilfll' 11 iI I' l' r 1 ' } to :,t; �.' tAi!.I - rAllfLI :1 ,, :11 41 t.0 . 11 .. . . �c' .41Uiti n'I. i� r:∎"upou..- &14A JI: �tllh IIl ih �dt} : l i VI h � � � � � I � A � fi 1,� �� l�r�l'�� I u } i t y �'4G V { I ��ail4q 1 iv pj�� I +a +, °i INC � lid 1 - and 2-family dwelling t� 'I1 t 17�• 6i t C' 1 �11'y i o f t t �I} MI' 'i } ' , I , : Ic�I1stg* Y g ❑Commercial /industrial ❑ Accessory it c�t�use, s all .1 ,aiarN •.ILi �- tQtaa:��w ,,� . 51R' ■ i Multi- family ❑ Master builder [] Other. For special information use checklist, l ��`ti'G i t f iInI�1'1lt1lY +µlsuriJ. tmul FIr11 ".rifinldl * -lr: S;hu, yrlFCl•" „ p ➢.r {iii +,t � � y J1 � ` hi I�It , { N7 Description Qty Ea Total isf iaTe �''faMAlililll h�l!'I. u �I���h41110111: 1 • N 11ALt• 5 � i ��;I�1i�11 1 f Irl 4 1 1 .1i;4 :11111 'Va l : lill� Ot OP,'`dL!Ni i f lll 1 1119!I �' I . t . �SI`�l' ,1 Heatin ; cooks; Job site address: AP Al ' IAA 1i G ! Air conditioning or hear pump -• uires site .tan ehowin. • laccinent 14.00 City/ State/ZIP: °i 74 © t q.1 k , 3 Furnace 100,000 BTU ducts/vents) r;' 14.00 ./a t n0.: -` l Furnace 100,000+ BTiJ ducts/vents 17.90 S ui e/bld g p I Project name: Gas heat 'urn. 14.00 Cross strcet/directiona to job site: Duct work 14,00 H •ronic hot waters .tem 14.00 Num Residential boiler (radiator or h dronic 14.00 Unit heaters (fuel -type, not electric), In -wall in-duc sus•ended etc. 10.00 MI Subdivision Lot no.: Flue/vent for an of above INN 10.00 Other: MI 10 00 IIIIIIIII Tax trap /parcel no.: Other fuel a , . llattcee yy'li I rl,l F i'. :dr U fl _ . 1 J , , o , ll II }� W � , . 4 n r r l d t n I h ' i' I t ;i.' [i���rt i'. .li hJi ii 1(,1,1.- i'dirt {I p� I , ..;&:4; Iii ��.lt�7f c,i 1 � 1. 1l 4 l 1 i I ).!I n 7 > )' '''' 1 4, , t . ,t I ,% lu � �I 1 Water heater I= 1 .00 W ' � G 5 l >V 1, � t 1 ' v die� rm to ��r_ �.: �I?. 1: ��b � n� 4 1 �1�1� .Ili'I.�� + I� h ` �.1::.. ` :.: Y. +�CIh W IMMO /� �.// 10.00 t � a� 1+1/7�a.i� Gas ti •lace Flue vent for water heater or gas fir 'lace 1 0.00 Lo:li: ter :as _ 10.00 Wood/' cllct stove 10.00 } Wood fir •lace/insert 10.00 r'��iif� lij�� fiJIJ i i � Iqq 1 ` a II I'.i ` t >, '`i. JT, I�a(t ti 1 M , k 1 rl t1 77J ry �j , I 1 1+i tt. p Il t� I t'� i k ti t }l + r! 11 I ,� � Qi� I {�I Chin= /liner/flue/vent 10.00 ' ;vuJ! r11 li, ;;.' d�J}IN:¢Ni1N I.... "r,'ll.til,Jr¢N!_ti�Gf ili,l,,.l.._. tl ;. I,01. -vl t- 'AihoultiliiPall�eli : >.fl'i¢} Lei !,' r Ocher; 10.00 Name: -' W 1 I 1 t i Environmental exhaust and ventilation Q ] e J .}� /� Range hood/other )dtchen Address: 9fmt <.. sit 1 n I�v4 G. • - -II.. 1 111 10.00 City / State/ZIP: -rti ® r 91 A a 3 Clothes d er exhaust 10.00 Single•duet exhaust (bathrooms, Phone: •- • L' ax �3) 0�, 3 �7 F( ) toilet co • artmcnt9, udli rooms 6 80 t<� :. I 'I Fi t �v u I �11f n J si ; i i'l "S'li iu, X I'Ijdd $$ h t i E �5«ri 'xi M w 1>+-1 eM c i1,4'sl! xi 'fit l !'� t i 1 I, I t ekl, rl A �pt i 1 1 t i F I�} I V IP �i u rP ' t l l P 7 1 j a ,,! J n J i i Atticicrawl:. ace fens 10.00 MIN Obi 1illkY�li l 1m'to it! . itt. , -1 4, I, c.r,• .Y1 et ..�1�..1., .. F L •to , tihs 1 , .:.. ril a , 4 . WK31. L im,;J.L. r ,2 AtTS1 "� v4 .G,.I r l Other: 1 0.00 Business name: Fuel .1 Contact name: tie, (Z tA ._ (.. 7 V 55.40 for first four. S1.00 for each additional Address: Furnace etc MI MIMI MIMI Oas heat • u • City/ State/ZIP: Wall/su• • •nded/tmit heater Mil MIEN Phone: z al ? ._ /a 7 O I Fax. : ( ) Water heater -!e Fir • lace _�- E-mail: Ran ;e _ -MEI x iq�'I 1 1ut0 V ' noil�1:. ,, ,; > I f " r i 21� t� n.'1. 11irI lr. iiii iii 1 Il,l r 1 il l 1 -11 �1 l a il l'i all, r, r. ru• , r� ie' 'fi., tl B arbecue � 4111.1 Ir,.t x 1111 1 Ilu... N1.1,,. . .1 1 ,,.1 , N, J tln: N. ) 2 . li ] t ,. .. , d, !,ktd� Business name: i .rA ., _ b Other: 'If- j� l; r> aT I I i i ll.r, F : 1 ry l I''l'r ll rl gli i U r ' Ef . 1R� Address: P i C I /t I Oftiltu ,ni,l1fl1:;i�L niitii lliimic Thisi;ii i , s1t 147.! 0i City/State/ZIP. pn i Or 9 '7 Z b0 Subtotal J tapirroll 'one: (0,3) w- 01151 Fax. () (&' iii Minimum permit fee ($72,50) N �� i "tcB lie.: k 7 State surcharge (8 % 0 of •ermit fee) wf TOTAL PERMIT FEE C Authorized signature: v This permit d ys after It ass been accepted complet gog ` obtained within 180 Print name: , _ A 1 , ' Date: 1414 • Fee methodology set by Tri -County Building Industry Service Board ilnui141ny \Penh a aa.Pannlugpp.dno 12/o �' Oe 44e- 4417T(Il /0�/CCMM1VEB)