Permit r
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A CITY OF TIGARD MECHANICAL PERMIT
►�� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00699
� I ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/19/2005
PARCEL: 2S1 10 BA -0 5200
SITE ADDRESS: 11755 SW WILDWOOD ST ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 013 JURISDICTION: TIG
Project Description: Furnace replace.
CLASS OF WORK: ALT 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:
LPG 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
KEVIN & JEN MCDONALD Description Date Amount
11755 SW WILDWOOD ST. [MECH] Permit Fee 1 0/1 9/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 10/19/20( $5.80
Phone: 503 0430 - 0427 Total $78.30
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97217 -2952
Phone: 503 281 - 0752
Reg #: LIC 8897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires •
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: Permittee Signature: d / / ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business • ay.
• This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,
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c M$:ctltnical Permit A t 1 • •, � FOR OFFICE USE ONI.x `
city of Tigard " Recei
Detd • o5 i l Permit No.: - / 5_00 / /'
13125 SW Hall Blvd., Tigard, OR 97223 b
Phone. 503.639.4171 Fax: 503.598.1960 a � i ; +i Pl RIwICW Permit: - other Pet:
1 1 y ,. Daleilty:
inspection Line: 503 639.0175 O rT 1 --1-14. . net I Date Ready /By: / ® Sec rage I for
Internet: u•ww.ct.ttgard,or.us 'V" us 1 6 Su pplementallnfurtication
• , I`TOr �F DIV 1g1(�l�
TYP �3 COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
❑ New construction ta Ad." on/alteration/replacement Mechanical permit fees* are bawd on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all ,
❑ Demolition ❑ Other: mechanical rruuerinls, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value; S
RESLDEN'TIAL EQUIPMENT F SYSTEMS FEES*
2 I • and 2- family dwelling El Commercial /industrial ❑ Accessory building
For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other.
Description 1 Qty, 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heatlae/cooling .
•
Job site address: ' r ` � Air conditioning or heat pump
111-55 Q W y "' •l` 1� requires site plan showing placement) 14.00
City/State/ZIP; PcAC ye, ()g 7J Furnace 100.000 BTU ( ducts/vents) 1 14.00 /'
1 Furnace 100.000+ BTU (ducts/vents) 17,90
Suite/bldg. /apt. no.: Project name: r Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiarof or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended. etc. _ 10.00
Subdivision: 1 Lot no.: Flue/vent for aty of above 10.00
Other, 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK J Water heater 10.00
' 1 • Gas fireplace 10.00
a. ► . Flue vent for water heater or gas
fireplace 10.00
Log lighterleas) 10.00
Wood/pellet stove 10.00 • W Wood fireplace/insert 10.00
Chimney/liner/flue/vent 1 0.00
® PROPERTY OWNER ❑ TENANT Other: 10.00
Name II _ ' ,\ -_g i 4 % , •C U . b c \ d Environmental exhaust and ventilation
Range hood/other kitchen
Address: r r_ "1/4 e IA . sent 10.00
City /State /ZIP: •r. _ (:)/ • 7gRI i • Clothes dryer exhaust _ 10.00
.- Single -duet exhaust (bathrooms.
Phone: ( p )4/30-- F a x: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ® CONTACT PERSON nttic /crawlspace fans 10.00
Other: 10.00
Business name: Illt ■ ` u % II i .kid ' • Fuel .1 . Inc!
1 Contact name: V VI. ∎ • • C i . (� r $5.40 for first four, 51.00 for each addittona)
Furnace. etc.
Address; Gas heat 'um.
City /State/ZIP:
( Water ��-
Phone: ) Fax:: ( )
_
Fir :lace
Ce
E-mail: Ranee
CONTRACTOR Barbecue _
Q Clothes d cr as)
Business name: \ %fit+ • C� C ‘ • Other:
Address: lit el L • , 4 VC,„./ MECHANICAL PERMIT FEES*
Cirvr StateZIP: Q ck1-0\T - ,_ Subtotal • I ,1
Min permit fee (572.50) ? .
Pho
n e: (S)12.4221L-_025g Fax ( ) ag ���� � Plan review ( 2 5 % permit feel 1
CC'H tic. • LO_1� .p��/� State surcharge (8% of permit fee) 5. -
TOTAL PERMIT FEE lg3_ .
•� _ .
This permit application aspires if a permit is not nhtained within ISO
;t11L•tttiicd <lgn:lGtrt:: days, after it has been accepted as complete. .... _..._. � q / / q • C (. Date_ /0' f8' Fee ,,rethudology tvt b. 'In - Cove. Building Industry 1crvt.e hoard
Pi tit) wine - Cs l 1. `S' L� L Id Wd617 :£0 S00Z 81 '1-°0 ZZLSZ8Z £0S : 'ON BNOHd 6uIIoo3 'g 6ullleaH OI10NU : WONd
CJTY,OF TIGAR r -
BUILDING DIVISION PERMIT #: MEC2005-00699
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/19/2005
Phone: (503) 639 -4171 ,c
Inspection Requests (24 Hrs.): (503) 639 -4175 I t
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM PAGE: 17
SITE ADDRESS: 11755 SW WILDWOOD ST CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 013 TYPE OF USE:
PROJECT NAME: MCDONALD
DESCRIPTION: Furnace replace.
OWNER: MCDONALD, KEVIN & JENNIFER PHONE #: 503 -0430 -0427
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503 -281 -0752
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021309 -01 503 -430 -0427 N
Corrections /Comments /Instructions:
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k r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspecto . 4 Date: 1 ( C Phone #: (503) 718-
Or