Permit k f.
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00675
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/19/2007
PARCEL: 1 S133DD -07700
SITE ADDRESS: 12761 SW DANBUSH CT ZONING: R - 4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 116 JURISDICTION: TIG
PROJECT: GHIM
Project Description: Gas furnace replacement.
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: UNITS:
UNS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
MIKY GHIM Description Date Amount
12761 SW DAN BUSH
TIGARD, OR 97223 [MECH] Permit Fee 11/19/20C $72.50
[TAX] 8% State Surcha 11/19/20C $5.80
Total $78.30
Phone: 503 -310 -7548
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 - 598 -0718
PRI 503- 620 -5643
Reg #: LIC 66578
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: / v �/ �` - Permittee Signature: r --ti p J
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.
. = 1V, u07 /FRI 01:34 PM C FA.( No, P. 002
Me chanical Permit Application t 1(R ( fTiC'r 1� Sv`n I^ }TT ,,�I1 7 I ` ` i ` ti
Ci of Tigard Received /A ''_
131 SW Hall Blvd., Tigard, OR 9 - DateBy: 1 1 ct 01 Permit No� ICJ! - 7 _ 0 C.. .►
Plan Review
Phone: 503.639.4171 Pax: 503.59 frill. ., ET,A,N,A(„,‘ y , Other Permit: Ins ectionLine: 503.639.4175 t ± >.. / „J, r Date Reed Page l for
Internal; www,Ci,ti tsrd,pr.us ,,. 1• y B y' El S P a
g N 0 V 1 6 7 11(1 / Notified/Method: Supplemental Information
.r �-'"'�,1T,. +,� >rt'!.t+f . } rr 4 1"9L•' f- 6 �' �y `y� 5 4 r - Ny*mxnii' r rt '�� i '13`7: j . i ..-... it, -
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❑ New construction U a: ; .uarrrttrNN Cement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other, mechanical materials, equipment, labor, overhead, and profit.
a s i �i .i a 7; t7
i .tG:t' 11.3 l a ^ti },��.5i �w c� `1 .•': :f,, ,4),'r! 6. tl 4 - 4) U 3 ful l �q*r; rIttr 41• 4 i�n,�n +,,� b ` ` i value $
�1 -and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building r r "ir y't P �v11+. 5o ::::"7..,11'-
industrial Accesso rys J �� " ' 3`r'.4Gf
For spec_ ial information use checklist.
❑ Multi family ❑ Master builder ❑ Other: �y Description Qty, Ea Total
f: ,.�1�r%:. A1. i.,.;� ` 1 0A,�.Y �e��'t'�"F, 1 -fti T k a st l t `:.c:� ' i ;..... N7 Headnglcoollng
1 01 7 6 / Job Site address; k t Air conditioning or heat pump (requires site plan showing placement) 14.00
Furnace 100,000 BTU (ducts/vents) t 14.00 1 «.
Furnace 100 BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Ductwork 14.00
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. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
i ;. y : ` tP, +ru �Tk1"�.01 •-.�.. g. li, S y S W'�. T t ..- J r ..
' " 4 at,. �';': "� � 1 o ant_ uf'�t a} t > rv,... Water heater 10.00
1 .�, 7 �•H.:�rtN.+w .: ,fi , n _ �1' , �.1 a t�_1 � � t� nr,�f
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
rid '',.. q tr •, Y 74.7 ,,, J e irz �:W r�r r '""r3 r1 :a.rnL Chimney/liner/flue vent 10.00
- �`" n(Ii ' a U4 ^ o t x 1 :rr.' :1 �5x� 61 k:N r <:l < pa „ V n Y i ~
a =,.. ,.. - t - ^ i L. rca.:r�.�. r uS..a �t:t �.. ,n!:..� by o�`a... w"�ti�r.: D iller: _ 10.0{)
L1 Environmental exhaust and ventilation
Address: •-■ Range hood/other kitchen
- - /.1 l • _ . equipment 10.00
City/ State/ZIP: i { e tra L el 701 Clothes dryer exhaust 10.00
r Fax; Single -duct exhaust (bathrooms,
Phone:
4 j' A, « 7 ( ) toilet compartments. utility rooms) 6.80
"'' , ;:r !' / �, e,,Tiq �� ji itil rt 2 11? :' q C :R.'roLl'0l l i. v; "' ' Attic%rawlspece fans 10.00
,t4ttN, , ,. td §i,r.: * yes ,,o f„ ;:1 f M. i ; u ; :..J 2 `1,-.. , , 47 n.., ..”Tr rr1 ;.t „i.: :6;;; ∎,
Other: 10.00
Business name: _ . r J - I _ ‘,0 ' *I . L A y Fuel
piping
Contact name 55.40 for first four; $1.00 for each additional
Address: Furnace, etc.
b I 1 n ' . / Gas heat pump
City / State/Z1P: /un
_ Wall/suspendeditheater
Phone ( ) Water heater
5 Fireplace
E -mail: r _ S Range
E"Cg M, - ,,SI �t ASE= -c44-" ,0 3 P B - ] t .�i �, .t w� t l ... s !.. x . i i .� 1
Barbecue
Clothes dryer (gas)
Other:
r^' ,n- p u- r n f i '•kKJ t.5 a,1j9']•1
Address: e , 4 - . 1, 1 *ii ° e :1 +J :: Phil r� KJ v� t a M m sf"sr to , .
.L ,fir ,.
City/State/ZIP: 012. 9 7. . Subtotal
Phone: � ) _ 1 Fax: A • IN O r Minimum permit fee ($72.50) �' ;2 ,51)
Plan review (25% of permit fee)
State surcharge (8% of permit fee)
TOTAL PERMIT PEE 7 g, 3D
F.4. This permit ap t If a permit Ls not obtained within 180
Authorized signature: \-(1114171
J 7 / days ys after ft t bas beta een accepted as complete.
Print name: ) i / t 6, / 67 Date: ii /l L 11) • Fee methodology set by Tri- County Building Industry Service Board
i:\B uildinplPermits \MEC- PerrmitApp.dee I/O 77 440A617T (11IO2JCOM/WGB)
CITY OF TIGARD
BUI J NG DIVISION PERMIT #: MEC2007- 00675
13125 414 Ha'1I Blvd., Tigard, OR 97223 DATE ISSUED: 11/19/2007
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 s
INSPECTION WORKSHEET FOR DATE: 5/9/2008 TIME: 7 :OOAM PAGE: 43
SITE ADDRESS: 12761 SW DANBUSH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: 116 TYPE OF USE:
PROJECT NAME: t,HI
DESCRIPTION: Gas furnac :e replacement.
OWNER: I3HIM MIKY PHONE #: 503 - 310 - 7518
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503620.5643
Inspection Request Scheduled For: Date: 5/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 Mechanical final 069578 -03 503310-7548 N
Corrections /Comments /Instructions: G
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL O ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: S — .�z_ —G 2, Phone #: (503) 718- Z4-
u CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -006 ?5
TiGARO DATE ISSUED: 11/19/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD - 07700
SITE ADDRESS: 12761 SW DANBUSH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 116 JURISDICTION: TIG
PROJECT: GHIM
Project Description: Gas furnace replacement.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
MIKY GHIM Description Date Amount
12761 SW DAN BUSH
TIGARD, OR 97223 [MECH] Penn it Fee 11/19/20C $72.50
. - [TAX] 8% State Surcha 11/19/20( $5.80
Phone: 503- 310 -7548
Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 -598 -0718
PRI 503 -620 -5643
Reg #: LIC 66578
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.
i L -� Issued By: j r ,2�;C� /,- Permittee Signature: 1 12 p C'' [;c. ?\rL
Call 503.639.4175 by 7:00 a.m. for inspections that business day. d �
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: 111\5L jDo7 - obI i5 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I nspection Description PASS Date B ✓,` Code In "specs n;D'escripiion PASS "Date B
BUP - Building Permit ELC - Electrical Permit . •
405 Excavation 105 Underground /slab cover •
410 Fill . 110 Temporary electrical service
415 Grading 115 Electrical service •
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls • 130 Ceiling cover
•
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation • 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit .
255 Wtr proofing basement walls 135 Low voltage •
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar) •
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical •
285 Drywall nailing / ( 610 Gas line
287 Suspended ceiling >( 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
J\ 699 1 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan •
330 Water service
• 335 Rain drain
340 . Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin •
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing _ 399 Plumbing final
210 Foundation walls
215 Footing drain •
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection •
•
\Building \Forms \InspCard- AOP- Blank.doc 02/02/07