Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00569
,TI GARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/15/2006
PARCEL: 1 S133DD -02500
SITE ADDRESS: 12903 SW VILLAGE PARK LN ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 LOT: 064 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:
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
LARRY BETZ Description Date Amount
12903 SW VILLAGE PARK LN
TIGARD, OR 97223 [MECH] Permit Fee 11/15/20C $72.50
[TAX] 8% State Surchar€ 11/15/20C $5.80
Total $78.30
Phone: 503- 345 -9176 x813
Contractor:
ADVANCED AIR SYSTEMS INC OF WA
PO BOX 61569
VANCOUVER, WA 98666 REQUIRED ITEMS AND REPORTS
Contact #: PRI 360 - 693 -1757
FAX 360- 696 -9432
Reg #: LIC 129343
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 dwork 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 OU NC by
calling 503.246 6699 or 1.800 332 2344.
Issue By: ^ / Q AN � � Permittee Signatur ) i 1r �� ��
Call 503.639.4175 by 7:00 a.m. for inspections that business d y.
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.
11/14/2006 15:27 3606969432 ADVANCED AIR SYSTEMS PAGE 01
Mechanical p App�Ication , . Fill: 011 I( I: I .11'. (1\I.1
' ` of Tigard Recei
'� � 13125 SW Hall Blvd., Tigard, ��QQ Date/B i/ /(•J o & L.S+ - 1( Pert No.: NF(r�' cap 65
. Phone: 503.639.4171 Fax: 5 2006 Date Review
tither Permit:
I I (; ,l i c I Inspection Line: 503.639.4175 Date Read /B Array
Internet: www.tigard- or,gov Ready /By: See Page 2 for
.. - -�,. Notified/Method: ( a. Supplemental Information
TIT • r - "� , 9- Tr fZ.
OF Wttl '
. .. •. .. tv ..... _ ^ '0, �C, 1F� )�'l31<:�_=- 'fls�' T
❑ New constructionA (ddition /aiteration/replacement Mechanical permit fees* are based on the value of the work
❑ Dt mblition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
C/L'i`EtGr l't t1F COZti1 ticriolti .. ; • ,, . - Value: $ 399
t -and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building - i 1*§1-* ** ` g.s:00 .
1:1 Multi -famil For special information use checklist..
Y ❑ Master builder ❑ Other: Description
.7fit B SITE 1(N pt' I Qty. I Ea- � Total
OwIA'TION AN I) LOCA'ttitti ',' Heating/cooling
CI v �� t, l Air conditioning or heat pump
Job site address:
U) 1 R paw v`- Laik,_0 (requires site plan showing placement) 14.00
City/State/ZIP: b'2 7 1 - i Furnace 100,000 BTU (ducts/writs) 14.00 i /I .00
( �/PP000""""JJJ Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: 0 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
Subdivision: I Lot no.: Flue/vent for any of above 10.00
1 Other: 10.00
Tax map /parcel no.: Other fuel appliances
lw.sci101PI1 ot4 OF •bt Water heater 10.00
? 0 �0 1 i _, I� L (� c Gas fireplace 10.00
?t5 I V IC7 i L- n� e Q Flue vent for water heater or gas
b t&'i
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplac /insert 10.00
[i►l il1:ir )Wi I �] r 'Ilili4 ` -
Chimney/liner /flue/vent 10.00
... ...: - other: 10.00
Nye: Lei 11 h .l +.7 Environmental exhaust and ventilation
Address: Fl bo Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust
exhaust (bathrooms,
Phone: (0°) 345 911G Xf SS 13 Fax: ( ) toilet compartments, utility rooms) 6.80
1'PLI ,Ac1Wf 0, core ct °F4RSO1�1, : Attic/crawlspace fans 10.00
Business name: " Other. 10.00
K C O , f r S` n 5 Fuel piping -
Contact name: J $5.40 for first four; $1.00 for each additional
Address: r,0 n C Q 1 `7 i� `i Furnace, exc.
` /n^ C � I � . .� I )JA- 99La Gas heat pump
City /State/ZIP: U til.IV L Wall/suspended/unit heater
Phone: (at) (p n --- 7 I Fax:: (�?I i,) ! 9 ( Q �r-�
J �C! Q / l / � d., Water heater Fireplace
E-mail:
Range
COI(1TRA C TOR , Barbecue
Business name: (Lp p j �I C 1 -4 s dryer (gas)
Addt ass I Other:
City /State/ZIPP: Subtotal 0 ,
Phone: ( ) Fax ( ) Minimum permit fee (572.50) la ,1750
�
Plan review (25% of permit fee)
CCB lic.: (a_i 3 eF3 State surcharge (8% of permit fee) -1 I
Authorized signature: Thi permit application expires PERMIT FEE
gm r �'' p pp xpires if a permit is not obtained within Leo
/� n,� IVIL! o days after by has been accepted as complete.
Print name:
!r /�1 /' .J �.d /ljr(� /s � Date: ( • Fe e methodology set by Tri -County Building Industry Service Board
1:lBuitdingTenaitWMEC- PermitApp doe 04/06/06
440.4.17T (1 f/O?/COMAVHB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2000-00669
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/15/2006
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ''I L
INSPECTION WORKSHEET FOR DATE: 1218/2006 TIME: . 7:01AM PAGE: 61
•
SITE ADDRESS: 12903 SW VILLAGE PARK LN CLASS OF WORK:
SUBDIVISION: VILLAGEAT SUMMER•LAKE PA RK 2 LOT #: 064 TYPE OF USE:
PROJECT NAME: BFTZ
DESCRIPTION: G furnace •
•
OWNER: BETZ: LARRY, PHONE #: 503 - 345 -9176 x813
CONTRACTOR: ADVANCED AIR SYSTEMS INC OF WA PHONE #: 360-6931767
Inspection Request Scheduled For: Date: 12/8/2006 ° , Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 040695 -01 : 360-693 -1757 N
Corrections /Comments /Instructions: -
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
77 ❑ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/' Ze /
X
Inspector: Date: 1 2— U (� Phone #: (503) 718 -
i,