Permit vas;; CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00013
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/8/2009
PARCEL: 1 S134CB - 11800
SITE ADDRESS: 12183 SW MILLVIEW CT ZONING: R-4.5
SUBDIVISION: MILLVIEW LOT: 018 JURISDICTION: TIG
PROJECT: BARNES
Project Description: Replace furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 0
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:
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
JEFFREY & SUSAN BARNES Description Date Amount
12183 SW MILLVIEW CT
TIGARD, OR 97223 [MECH] Permit Fee 1/8/2009 $72.50
[TAX] 12% State Surch 1/8/2009 $8.70
Total $81.20
Phone: 503 - 590 -3158
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -0220
FAX 503 -557 -0919
Reg #: LIC 72623
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: r Permittee Signature: Q �C ,[o ()Mon
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.
l
7
JAN --2009 03:29P FROM: TO:5035981960 P.1
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Mechanical Permit Applic t CEIV ED t n n FOIL oFI l('r: USE ONI.\
City of Tigard JAN 0 ? Date/By • • r — • 2_.1 111= IN n !� _ r v 0 ■
201,1
v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.59. Date Other Permit:
I, I c A R D . Inspection Line: 503.639.4175 �Y OF TIGARD Date Ready/By ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* arc based on the value of the work
❑ New construction X Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1 -and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
Multi- family ❑Master builder 0 Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/� � �p / ' / ��� Air conditioning or heat pump
Job site address: LI �y�/ +�`y, y
W V (requires site_plan showing placement) , 14.00
City /State /ZTP: 1 n q1L.! Furnace 100,000 BTU (ducts/vents) 1 14.00 ,
"`' Furnace 100,000+ BTU ( ducts/vents) • _17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue /vent for any of above I 6.80
Subdivision: L0t no. Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
• F eTi 1f I Flue vent for water heater or gas
t �"f / ' `^^ r fireplace 10.00 _
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
PROPERTY OWNER I ❑TENANT Other: 10.00 _
Name: ( OlU /IO Environmental exhaust and ventilation
Range hood /other kitchen
Address: a equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (60) 640 ,3 (Og Fax: ( ) toilet compartments, utility rooms) 6.80
%APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00 _
Business name: Fuel piping
IV
Contact name: Va Ma i $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: - ,
- Gas heat pump ,
City /State/71P: Wall /suspended/unit heater
F x:: Water heater
Phone: ( ) ( ) Fireplace
E-mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:`r1 al? p i ��/�f'�� Other:
Address: (O e. i ' • I 1 �/y� O 5 V T l • MECHANICAL PERMIT FEES*
City /State /ZIP: Or on of- q -/LJ"5 Subtotal I
Minimum permit fee ($72.50)
Phone: (SO 55 �b Fax: ( 6 � OA '1 Plan review (25% of permit fee)
CCB lie.: 1242 State surcharge (12% of permit fee) (I • A ^
q � :u/`!. PERMIT PERT FEE
This permit application expires if a permit is not obtained within ISO
Authorized signature: -- 1 • days after it has been accepted as complete.
Print name: • rJ iQJ rl Moat Jt/ t Date: 1iq1ts ' Fee methodology set by Tri -County Building Industry Service Board
11BuudineermitamEC- ParmiiApp.deo 01/19/07 440.4617T (I 1/02/COMWEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ME C2009-00013
fl.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: I/g /ogttrj
Phone: (503) 639 -4171 lr��� ��i
Inspection Requests (24 Hrs.): (503) 639 -4175 r ��
INSPECTION WORKSHEET FOR DATE: 1/2RJl009 TIME: 7 : 00AM PAGE: ,c!
SITE ADDRESS: 121 t:1 Slw1 MILI..VI DV CT CLASS OF WORK:
SUBDIVISION: hvil1 I VIE LOT #: 018 TYPE OF USE:
PROJECT NAME: BARNES
DESCRIPTION: Replace furnace
OWNER: BARNES, JEFFREY & SUSAN PHONE #: cj3•E,90- j
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: '503-557-02.20
Inspection Request Scheduled For: Date: r
118f �0 9 \\ P r Time:
Code # Inspection Description Confirm # Con Message
61 :6 Mo hanical final 079987 -01 E03 r:,h7 2220
Corrections /Comments /Instructions: •
l I 1,\, - (----------
i i '1.(*.4 \
PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (P Date: 1/ Phone #: (503) 718 -