Permit „ `?d
CITY OF TIGARD MECHANICAL PERMIT
ar COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00067
O:IT,I 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/8/2008
T
PARCEL: 1 S 133DD -10100
SITE ADDRESS: 11782 SW 125TH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMERLAKE NO 4 LOT: 138 JURISDICTION: TIG
PROJECT: CROSBY
Project Description: no heat; replace existing gas furnace
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:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
CROSBY, RANDALL P AND GINA R Description Date Amount
11782 SW 125TH CT
TIGARD, OR 97223 [MECH] Permit Fee 2/8/2008 $72.50
[TAX] 12% State Surch 2/8/2008 $8.70
Total $81.20
Phone: 503- 803 -6069
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -5014
FAX 503 -557 -2990
Reg #: LIC 71878
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. 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.
02/08/2008 09:15 5035572990 A -TEMP HEATING PAGE 02/02
Mewhanicai Permit „ t n, y r r FOR OFFICE USE ON1,Y p �/����
.-% j ( ;, ri,�_,e ' • ..
- = ; 1 ep 0 0 D ,077 Pcrmlt No. :/l'j� �0 coca"?
*• City of Tigard >� ]J+,te�l3
1 11 q 1, 3125 SW HMI Blvd.. 'Tigard, OI2 97223 plan trcvicw other Permit.
a phone: 503,639.4171 Fax: 503. 98.}96( � 20 8 Dntc/liy _ -
Inspection Line: 503.639.4175 T' i. On Rendyl8y' hnid: 21 See Pate 2 for
1'IGATL13 Tntcrrlcl: www:lignrdor.gov, N 't,f,aUMcthod: tltl mcm 171c
al1nmntlon
c I r . 1 7 CIA1. 1,E': 5 G1ftDr.pit Lla:E'C;' tiZOK 1S'I
Mechanical permit fees* are basal on lbc value attic work
❑ New cottstroctiotl A .ddition /niteratton /reiplacemenl performed, indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials equipment, labor, overhearL and profit. -
t At`tG+OR1' : r cON5'1`1t *l'1ON' : i '
Value:
tttSiriti'TTIAL OtliVI I1NT / , ,01$10111:1,4"
E 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special ;nlilrmation r,,rc chcckllsr.
❑ Multi - family ❑ Master builder ❑ Other: DeRcription Qty. En, Total
: JOR SIfls iNI'CRMAflON AN1) LOCATION Iicntlnts /cuofnp • Air conditioning ar heat pump
.fob site nddress: 11782 SW 125TH CT. - (wires ..its plan showing pinrxmcnt) 14.00
City /State /SIP: TIGARD 97223 Furnace 100,000 BTU (ducts/ventr.) 1 14.00 14.00
Furnace 100.000' i3'f'U (deal/vents) 17,90
Suite/bldg./apt. no.: Project name: CROSBY- - Gan heat pump , 14.00
Cross street/directions to job mite: Tact work 14.00
��.• jydronie hot water system 14.00
Residential boiler (radiator or
hydronic) .^ 14.00
Unit heaters Mel-type, not electric).
in -wall, in -duct, suspended du. 10.00
- Flue /vent fo+' any of ;thrive 10.00
Subdivision: Lot: nu.:
YT Other: _ , 10.00
Tux map /parcel no.: Other inel applinnees _ ,
15F�arR PT1ON'OF WORK -
w 10.00
Water hcalot'
Gas fireplace
NO iiEAT REPLACE, EXISTING GAS FURNACE moo vont for water limiter or gm
fireplace „ 10.00
." - L,og+liplitcr(l;Ms) _ 10.00
Wood /pellet stove ,_ 10.00 -
-- -- - Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
i
,.
I� 1?ti(z>I'1.9fr tV OW 1 R Q T11 AN . • .. ' r Other _ 0,0
Name: RANDY & GiNA CROSBY Environmental exhaust and ventilation
-" Range flood/other kitchen
Address: 11782 SW 125T11 CT. equipment 10.00 _
Cldrth dryer exhaust 10,00 _
City /Sttitel %.11'; TIGARD, OREGON 97223 ... - Single -duct ex (bathrooms.
Phone: (503)803 -6069 Hex: ( ) toilet: compartments, utility rooms) 6.80 --
wwri IC,ANF CON't~AC i 1 EWitiK'' : Attic/crnwltp;tcc fans _. 10.00
W
... Outer: 10.00
13usincss name: - Fact piping
TE i-i n c & r +-'uui'I hi /Alt''' n5.40 Tor flrat fear, $f.00 . cacti eclJltfonal
Contact name: 1 E Evel}tn$tr.e,et ,
s , Oregon 97015 Furnace. etc. -
Address: Clackamas, GMs heat purer
-
City /State /7.1P: 1r Wall /suspendcd /trait heater -
Water Wiltcr 11catci
Phone :( ) Fax: : (503) 557 Waec
E - mail: Range - _ -
C O .TT 2 AGTO}t T3nrboeltc
Clothes dryer (g .,.
Business n t.mc: -T ih Olhcr ,
� ' M1tCZ[ANrr'Al PFRMt7' P! 5'• ` •
Address: 16000 SE Eltely P Street '
City /State /ZIP: Clackamas, Oregon 97 ®16 _ St+htnrnl 14.00
Minimum permit fee (172.50) 72.50
Phone: ( ) Fax: ( ) - Plan review (25% of permit fcc)
CC13 lie.: 71 state RurchargC (12% of permit fee) 8.70
°'° TOTAL PERMIT FEE 81.20
A . 1 TIt1a permit nppllcntinn expires If n permit Iv not obtntned within 180
Aut110rizcd - _nat c; 1 i! i� ' days niter It Ims been nrrepted na complete,
r Print nnmc; 1 o p o1/4...47=v-f..
1 1)nto- 2/8/08 ' Fc mclhodolagy sc rt by i'ii- County Building Industry Service 1Tenrc.
ftituatlIn \Prnnits\MPCd'CnnitnPP.doc ovoo /n6 440- 461Tr(11 /02 /COM/w1i13)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ME 02008 -00067
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/81 2008
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 �_'_ "'IL
INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:OOAM PAGE: 50
SITE ADDRESS: 11782 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMERLAKE NO el LOT #: 138 TYPE OF USE:
PROJECT NAME: CROSBY
DESCRIPTION: no heat; replace existing gas furnace
OWNER: CRO SBY, RANDALL P AND GINA R, PHONE #: 503.803 -606
CONTRACTOR: A -TEMP HEATING & COOLING PHONE #: 503-650-5014
Inspection Request Scheduled For: Date: 3/266/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
8 t3 Mochanical final 067161 -01 503 - 003.6069 N
Corrections /Comments /Instructions:
0 ' azeL i a I.,u_ /.�e - 4 AC L & =- 5 — /5'2. 3 `z 3- 2.---Cc-A
�' /r /4 I / 1 ,S' / � /" ✓ / G/i.DCP./.(1- 72 - G.L. 5! ne1.7_,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: -3 ��G—c} i Phone #: (503) 718 - 4z<-