Permit CITY OF TI GAkb
DEVELOPMENT SERVICES MECHANICAL PERMIT
PERMIT #: MEC2005 -00334
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 6394171 DATE ISSUED: 6/13/2005
PARCEL: 1 S134CC -04300
SITE ADDRESS: 12318 SW WINTER LAKE DR ZONING: R -4.5
SUBDIVISION: CAPSTONE LOT: 010 JURISDICTION: TIG •
Project Description: Replace gas furnace, install A/C.
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:
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
GEBERT, LEISSA Description Date Amount
12318 SW WINTERLAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 6/13/200E $72.50
[TAX] 8% State Surcha 6/13/200E $5.80
Total $78.30
Phone: 503 -590 -2397
Contractor:
EASTSIDE HEATING + AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Phone: 503- 774 -3281
Reg #: LIC 3258
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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: 1-,;)&7-dirie... Permittee Signature:
Call 503 - 6394175 by 7:00 a.m. for inspections that business day. V
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.
Jurr 13 05 04:04p Eastside Heating 503 -- 774 -3057 p.2
t Mechanical Permit ; 3 - 1, EfEt ti i "''f rt>lz 1>r•r•1( I.: 1 •I.ON.1.%
City of Tigard ' s m Y l Ger--' Pmmithi � c ........ 2 AI ot133
13123 SW Hall Blvd, Tigard, OR 97223
VI® Review
Phone: 303.639.4171 Paz. 503.398.1960 Dare/By Other PenYt;
Inspection Line: 503.639.4175 I JUN 13 2005.4,x;'".. J.∎ to a /Br tier , Paw for
Interact www.a.tigard.us Nelo
or6�Mcthod v ,` l S.pplomstal4tforvtatios
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❑ New construction Addition /alteration/replacement Mechanical permit fees' are based on the value of the work
❑ Demolition El Oilier: performed ludi®te the value (rounded to the nearest dollar) of all
mechanical materIals, equipment labor. overhead. and profit.
-
.. " i- A�ar a. TECORY Or c rmauCTlofY'°t`i. • -, "' # ;'T w . ,sQ. _ Value: S
Arl - and 2- family dwelling 0 CommerciaV ndust ial ❑ Acc ssory building R 't'�F' P /sxscenls ',ti r;$j
For special information use checklist.
❑ Multi -family ❑ Master builder ❑ Other:
Description [ Qty. J En. J Total
., ',' .• rte. 1. t` -.' ` O$.S1Q'&•viiroR11 *noI YArn OCAT[ON i Head /eootina
0 '/ Air conditioning or beat pump
Job site address:
/� i U :::;1„. V`\ ' a.p t , - i,+
L ' , ) / Orquina Rte plan showing pieoeman) 1 14.00 /1/
City/State/ZIP: A. l A r ' G� / � j ??....2_7 , Furnace 100,000 BTU (dua,/vmm) j 14.00 1 L j fif Furnace 100.000 - FITUSducis/Vetm) 17.90
Suite/bldg. /apt. no.: 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
hCtheaic) 14.00
Unit heaters (fuel-type; not dirndls),
in - wall, in-dus ini5oendod. etc. 10.00
Flue/vent for any of above 10.00
Subdivision
I L ot no.:
Other. 10.00
Tax map/parcel no.: y Other feel applianeea
. "`. 1 . : `� ` .301 `' *`; DFS TION OF: 11k K'•rt : t `.'�'7Oa _ : Water heater 10.00
Gas fireplace 10,00
A € 1 71 1; c,e i a `� > 1 d f r 1 Flue vent for water beater or gas
fire
i' �•fe i ( a i ✓ C.:‘ r V rl ik_ i •I • 1 � r • ' Log
1 ri /{� lace 10.00
del Log lighter <>tas> lo.00
Wood/pellet stove 1 0.00
Wood fireplace inset 1 0.00
.-,i 01 PfoOPER Y •OWNER 1 5 :,,;w I •' - ; :'- . 0 TENANT ' ;i , _ Chimney/liner/flue/vent 10.00
Other: 10.00
/
Name: j D r `,'3 /Z I '7 t r t-- Mang hood/other meneite kitchen
ventilation
Address:
equipment 10.00
City/State/ZIP: Clothes d =hated 10.00
L 24 L - q6 ' 7 Fax:
Single-duct exhaust (bathrooms, Phone: utility �� � 1 ( ) toilet compmbrnmt� utility roans) 6.80
. '"'' '' APYLICANf• ; : - 'i^ ';: ;•`• `X coirrACi•PEIISON �+d :. Atbdaawt pace fans 10.00
/ 10.00
Business name: � � r ` , Other.
_ A
e
Fuel pipuu a
Contact name: i/ > 55.40 for first roar, 51.00 for each additional
Furnace, etc
,
. Gas heat pump
City /State/ZIP: Wait/suspended/unit heater
Phone: (.4),-... ` ) - r 7 ��� c f _ ,,.� I Fax:: ( ) 7 y 30 7 Water heater
-
Fireplace
Range
_
' ...1 , f: `, COI∎f RACiOR. * ' , ' • I' , xc, if . , . Ilarbecue
DLLSmeSS name: dryer (gas) .
4._c_ - : e /-1-(y! `I i . ) .f- A . , r ( i n ft A . )m'
ddress: \ r r C./ :) �,.. y rr,� y
�,�4 6_ '.' c 4. i j_s.L�t r
cam f. / rz '.1tt<Eatt lfJ►t : , !
A :.t?}I`
City/State/ZIP: - ' .. 7 - Subtotal
Minimum permit fix (572.501 _2 . ‘.;6
- Phone: (/, ^.? . 7 ?//..z. i ,c -/ F ( 5'f', 7,
Ilan review (23Y• of permit fco)
CC le•: j ) - Sate surcharge (8% of permit feel e , p
/ TOTAL PERMIT FEE _7,--. 2,0
The permit ■pplica0ma ex/siren a penult ta not obtained w ann ISO
Authorized signature: �tl 40,/re/e d o. days after it has frees accepted ea complete
Print name: 1 L , • t•' ` L� I Date: i i , J 1 I ' Fee methodology act by Tei-Couery y Building Industry Service Board
_. t L r _ C' !i '-
i 1 n ..'ldlnttu'eaminutffC-PqmitApy.doa 17/03 4444617r (I I/QVCOM/WF8)
STALLATION ADDRESS: 1 a 3 i Sr,� 0. et . -.{.,
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PROPERTY LINE A `
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LN 2 +
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oJ FT:
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FT:
� 5 FT:
FRONT
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X FT:
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4
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PROPERTY LINE
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00334
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2005
Phone: (503) 639- 4171 au�(d l r�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/27 /2005 TIME: 7:09AM PAGE: 59
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SITE ADDRESS: 12318 SW WINTER LAKE DR CLASS OF WORK:
SUBDIVISION: CAPSTONE LOT #: 010 TYPE OF USE:
PROJECT NAME: GEBERT
DESCRIPTION: Replace gas furnace, install NC.
OWNER: GEBERT, LEISSA, PHONE #: 503- 590.2397
CONTRACTOR: EASTSIDE HEATING + AIR CONDITIONING PHONE #: 503- 774 -3281
Inspection Request Scheduled For: Date: 6/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010181 -01 503-774 -3281 N
Corrections/Comments/Instructions:
I, - ASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL � LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
‘2
Inspector: Date: r one #: (503) 718 -