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Permit CITY TIGARD MECHANICAL PERMIT i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00638 Akot ,l I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/7/2005 PARCEL: 2S 102CA -00919 SITE ADDRESS: 13285 SW VILLAGE GLENN DR ZONING: R -4.5 SUBDIVISION: VILLAGE GLENN LOT: 019 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: 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 MICHAEL SWANDA Description Date Amount 13285 SW VILLAGE GLENN DR TIGARD, OR 97223 [MECH] Permit Fee 10/7/200: $72.50 [TAX] 8% State Surcha 10/7/200E $5.80 Total $78.30 Phone: 503- 639 -7920 Contractor: OREGON HEATING + A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS Phone: 503 -538 -2953 Reg #: LIC 125815 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. Oct O7 05 08:05a 503-537-2172 P • 1 . .. : Mechanical Permit .1 0 • - __ C -7. j VEI- ' FOR OFFICE USE ONLY City of Tigard Mk Received Datileov - 7 ....d 5.--,..7-c_ Permit No.V16c ( 75) 13125 SW Hall Blvd.. Tigard, OR 97223 PLIn Revicw Phone: 503.639.4171 Fax: 503.598.1960 OCT ' 7 2005_4-4,!!4k(it Date/By: Other Permit: Inspection Line: 503.639.4175 Date Ready/By: Juris: Si See Page 2 for Internet wvrw.ci.tigartior.us CITY OF T ARif . Notified/Method: Supplemental Information I6 BUYONENCY0004SICti*.4:;;;`..!...,:-.::_i':::":....;.;r: ;;..t..00**1-4:;E'#:***.+4*.;:.:P40#0440.::::1 Mechanical permit fees* are based on the value of the work 0 New construction Idditionlalteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit 6 .. >': : ;;")..' , .. : :: - ' ; ' - l' i , -.:'l_-."..•j,... - .T . :',..1pL' .i,ii6d,Ri::ok;0iigsfizijer•Oi■i'...',i;:a.-':..: : LM r.;:::-.):;:00041 :0zit0. 1- and 2-family dwelling 0 Co mmercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total 701i OTTE',..10:OR*Tike' HeatinWcoolina , Job site address: 13.2 C C Ill V I 1 ) u tift.it et. Oy-_ - Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State/ZIP: 4 11 1-e4-4-4 il ---- i13 Furnace 100,000 BTU (ducts/vent) 14.00 ( ' I Li - Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bIdglapt no.: I Project name: Gas heat pump 14.00 Cross 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-duct, suspended, etc. 10.00 Flue/vent for any of above 10.00 Subdivision: Lot no.: Other 10.00 Tax map/parcel no.: Other fuel appliances ... 1 , iA L Wrig§::90:0,kWOWKSW:Ki Gas fireplace 10.00 2iViiqd Water heater 1 10.00 i .. , ; - 4-4_ xci t/C ite-- i Flue vent for water heater or gas A fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 trAtial:414...f.1‘:.:•-;:q#,.11;;; ChiraileYilicergiudvent 10.00 r 10.00 Name: 7)j &h a .4_ „...--„ cv ,_ ke? Range hood/other kitchen Environmental exhaust and ventilation Address: l (1-3 it it 614z -)(Girty, tA-e equipment _ 10.00 City/State/ZIP: p q--g7 3 Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, PhoneS1) • - 7 1 '2,0 Fax: ( ) toilet compartments, utility moms) 6.80 . ii!-::::;' Attic/craw ace fans g: •t6 oth= 1sP 10.00 Business nameOte6 a auf 4_ ct,),/- Goya -.1 Fuel piping 10.00 Contact name: • V rt.541-6) -) $5.40 for first four; $1.00 for each additional Address: e 6w.L3ciil Furnace, etc. . Gas heat pump I City/State/ZIP: ( V- 0 1, n i L S- Wall/suspended/unit heater Phonegb3) 67-)S a0i I Fax:6 s3-7 z/--2... Water heater , ' Fireplace E-mail: Range _ - .ti r '..:4:6*i•r*:!i:::.:4;'.:;':,:::::.1,:r.,.::-:F:",:1):,';...:k:::i-i:,:::,.`;:', Barbecue _ Business name: alt• / , • R 4_ NA„--y t joyLd Clothes dryer (gas) other: e r Address: V ) 7 '4/ r) •,,,,,,:',:i:.:-s.i7j.',1.;:i: ' Eikg City/State/ZIP: it 6 V- C , ..I /I 1 Lc Subtotal t Minim permit f (S72.50) ---, Phone:63 3g c9146.5 Fax g0 r 6 . 3 - 7 Z 2_ P um ee - bz lan review (25% of permit fee) CCB lie.: ) d-V State surcharge (8% of permit fee) 5, vc, TOTAL PERMIT FEE w1 . z *b Authorized stare: .d...) 61/1m.-- l r This permit application expires ifs permit is not obtained thin 180 bare: La) . :L. days after It has been accepted as complete. In Print Liam= , •yt1/4 4L446--n Date: * Fee methodology set by Tri-County Building Industry Service Board ENBuildial0PermitsWIEC-PcruzitAoadac 17J03 440-4617T (11/02/0324/WE33) CITY OF TJARD BUILDING DIVISION PERMIT #: MEC2005 -00630 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2005 Phone: (503) 639 -4171 C f Inspection Requests (24 Hrs.): (503) 639 -4175 'ill., INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 60 SITE ADDRESS: 13285 SW VILLAGE GLENN DR CLASS OF WORK: SUBDIVISION: VILLAGE GLENN LOT #: 019 TYPE OF USE: PROJECT NAME: SWANDA DESCRIPTION: Replace furnace. OWNER: SWANDA, MICHAEL PHONE #: 503 - 639 -7920 CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503- 538 -2953 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 018583.01 503. 538.2953 Y Corrections/Comments/Instructions: =c.,- is ...go,e‘ „1rd. ax 6 3.¢(a 4- ' ic4 CI fed, 1r /�,e4-74-ci PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL p CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /41 aS #: (503) 718-