Permit A
CITY TIGARD MECHANICAL PERMIT
I4 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00806
Ax. ? ° ' I "` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/7/2005
PARCEL: 25111 AD -02600
SITE ADDRESS: 14660 SW 89TH AVE ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 023 JURISDICTION: TIG
Project Description: Replace 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BRIAN SCHMIDT Description Date Amount
14660 SW 89TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 12/7/200E $72.50
[TAX] 8% State Surcha 12/7/200E. $5.80
Total $78.30
Phone: 503- 265 -9858
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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/, /v(1 Sp �j Permittee Signature: - C
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.
0
Mechanical Permit AROcati n t : , FOR OFFICE USE ONLY
City of Tigard H <r ,L I ' \�-'' :' _: j Received
13125 o Hall Blvd., Tigard, OR 9 22=
DatelBy :�� • / (/ //� ��� Perm tNo1' \Vl.�['U) �()�Qp
Phone 503.639.417( Fax: 503.598.1960 Zi.(' h��
'; Plan view
:
Phone 5 .63 503.G? 5 l l ' f� l i ',jig_ la Date/By: Other Permit.
Internet: www.ci.tigard.or.l : s
Notified/Method: � ^"7 " .�.. Date edA e t hod: y: ti's '` S See Page 2 !'ar
11/4;1 OF riGA IR ii
ed/Mt ��U Supplemeatal Information
.;`; .4 ; . i V ' ,bil+1n . , 61N4NiERCIAL; ?.FEE SCHEDULE - USE CHECKLIS'.
Mechanical permit fees' are base. on the value of the work
ID New construction OAdditio :t/alteration/rep:acement
performed. Indicate the value (rounded tc the nearest dol ar) of :
❑ Demolition ❑Other: mechanical materals, equipment, labor, overhead, ar,d prorit
r ' J ; „ : ' i aGeA`TE:GORy O)z.C6N$7'RU rION
and 2- family. dwelling ❑ Commercial/industrial :. - RE$ID E P TIAI. EQUIPMENT/ SYSTEMS FEES*
❑ A ccessory building
Multi - family For special inforrnn :ion use cnec Jis;
❑ Master builder ❑ Other
!� 2 Description Ory Ea Tcia•
301 S TE , IrF.o zz o� s D rI OC [ON
.. �. :• ....:... s .. .. I .. �_..r. .;?�.,.,, ..•�.�. _ , ..• . I .. ;.,.; Heating.'cooling
Job site address: /� Air conditioning or heat pump
4( 69 o 5 &) " (requi:es site olac showing placement) 14.00 ,
•
1 City /State/ZrP: Furnace 100,000 BTU (ducts/vents) i / .4 . J
Suite/bld is t. no.: Furnace 100,000= BTU (ducts'vens; • 17 90
S F Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 1 14.00
Hydronic hot water system • 14.00
Residential boiler ;radiator or
' hydranic) 14.00 ,
Unit heaters (fuel -type. not electric),
in -wall, ir. -duct, suspended, etc. 10 00
Subdivision: Lot no.: - Fluehven: for any of above l 10 00
Other: l 10 00 _
Tax map /parcel no.: Other fuel appliances
,�n
e6 t ,'"d i r >C ^ € WO , iii z:. .r Wa.er heater 1 10.00 i -
` _ : ,• Gas fireplace .0.00
-�� /: e _ !�-��° G ��,.Gt.L7 G� -��
-, Flue vent for water heater er gas I
/ fireplace 10 00 '
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10
1; H Q$k1 101' 0' ER ._'" { . :: :, r +�T: 1 r Chinuteyilin_r,,flueiveit 10.00
s * ... Ocher:
Name: ,( 10.0.0
41-.."(.../.2. -- 'l,...1..f i 4 ?' Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 1 10.00
C ty/State /ZIP: Clothes dryer exhaust 10.00
P'tone ?3) 4 9�'s ( F ( ) toilet co ma rtm (bathrooms, rooms) ,
� „z � Y T s R ( toilet compartment, utility rooms) 5.80
tJ 4PPx r
lr x .fir.. w. •. , - -. ;, 5; . y } C,G Atti ✓erawlspace fans 10.00
Business name: Other: 10
Fuel piping
Contact name: /7�/uI 619 ii S5.40 for first four; $1.00 for each additional
Andress: Furnace, ate. !
Gas heat pump
City /state /ZIP: \ValVsuspended:.utit heater i
f 03 .5-.?,/, I
e .3 1 .2 y 02 ,,? d , / ( J ) O,;(�0 Water heate
Phon
E -mail: T Fax: - Fireplace •
r r � �.., . 'y Range
g xi# , s '.Q'? t - r �S ><TCT a . ' +- r, ,
. Q.l�a4, � : ; !E: w° . Barbecue
Business name: f 6 �� /-/<...01-77,,,J4,, Clothes d; yen (gas )
r /r NA' Other:
Address: � D 60X 3 ° .3 ' 7
i4LECiwaCAL PERMIT 'FEES*
City/State/ZIP: Ti A-441 02. 9 J�a � . Subtotal
Phone: % g) 4, a ez7e Fax: O 3) . s 4 i . „,,,..2,,, Minimum pzrrrit fee ($72.50)
•J Plan review (25% of permit fee)
CCB tic.: ? 4 3 9 State surcharge (8% of permit fee)
� ��/� TOTAL PERMIT FEE - 7 .3' 0 Authorized signature: ,72 /.Gt�iKJ This permit application expires if a permit is not obtained ■vi thin 190
days after it has been accepted as complete.
Print name: /9i44 C1i4 4 .7,,9 // '`y / Date: `2 • Fee :methodology set by Tr` Co unty 3ai Id: ne !ncusrry Serv•cc Boa
is lBlildingTerm :0
itslMEC PeratitA7a. doe i 03 v .... --- ...,__.__.... -_.
Z'd 0LZ0869£09 6ui;eeH eigwnlo3 e60:01. 90 LO oea
CITY OF TIGARD
BUILDING DIVISION PERMIT #:i t,;jrat, i if - ;r,(,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 , 7 ., ! a:i?: I
Phone: (503) 639 -4171 i!l I '�\
Inspection Requests (24 Hrs.): (503) 639 -4175 �' 1-
INSPECTION WORKSHEET FOR DATE: "1i %1/2 :ic1C. TIME: I 0,: PAGE: I {w
y1° t: 9 x'
SITE ADDRESS: �r
..�� . , 1.3... f ; ! :��r CLASS OF WORK:
SUBDIVISION: f''1ht1'_I31F{ +)1.. TER Pd,.:1 LOT #: 0: TYPE OF USE
PROJECT NAME: c 'I 1i',111) I
DESCRIPTION: Replace gos furnace
OWNER: ,1't11111)1 ?I AN PHONE #: W. -'y! tt'b
CONTRACTOR: COI c:OI..tjtvv,39 4 IILA 111NI' _ & ( ;f )01 iNjG INC PHONE #: r ', Oil 71 i 1
Inspection Request Scheduled For: Date: =1,0 i!';..rt)+t€ Pour Time:
Code # Inspection Description Confirm # Contact # Message
+ .il P 1c h dni t :al fivsal 0284 2! 01 x,4fl -€i ,,:! 04 Y
Corrections/Comments/Instructions: J/ + A ^
t l'AIS / i, A- i5X1-1191 /S9"" v ---- nrS ( Z la trVi 7!i 4,4.4- ,0 -
/ f ,q/ r Gg-,62. -
ASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL F I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: — " —C Phone #: (503) 718-