Permit f ',� Y ��� �� GARD
j MECHANICAL PERMIT
- r
= - C OMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00543
:
at9, ,P, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/6/2006
'"' "= ' PARCEL: 2S102CB -04300
SITE ADDRESS: 13425 SW BARNUM DR ZONING: R -4.5
SUBDIVISION: BARNUM PARK LOT: 004 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: 0
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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
LOWE, WILLIAM M + SHIRLEY R Description Date Amount
13425 SW BARNUM DR
TIGARD, OR 97223 [MECH] Permit Fee 11/6/200E $72.50
[TAX] 8% State Surchar€ 11/6/200€ $5.80
Total $78.30
Phone:
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Is ed By: G _ ( Permiftee Signat j /�_ _ � - -
__. Call 503.639.4175 by 7:00 a.m. for inspections that business d" ay.
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.
From: 11/03/2006 13:54 #471 P.001/002
RE DateJvea / //I ' `' 4 y Permit No.: HE ciia,;p-GG EJ �
City of Tigard City pay:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Oilier Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ;�' (� .) r ® 2006 ° •°'Ri l „,, : r I' DateBy:
Inspection Line: 503.639.4175 r . ' , I Date Ready/By: ►drb 65 See Page 2 for
Internet: www.ci.tigard.or.us Gill( et TIGP p Notified/Method: Supplemental Information
�p� QQ.VI'10° 1ST
F• WORK 1 FEE* SCHEDULE - USE CHECKLIST
ULE
❑ New construction , ddition/alteration/replacement 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-
' CATEGO tY OF ;CQNSTRUCTION Value: $
i ..: s _..
� ' RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
l 1- and 2- family dwelling ❑ Commercial industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master budder ❑ Other: Description I Qty. I Ea. I Total
` 1 r . '. OBS E 1N?O TION AND LOCATION' Heating,/cooling
i- Air conditioning or beat pump
Job site address:
I'S i 25 5L. •(j�•,r it. w� (requires site plan slowing placement) 14.00
City/State/ZIP: `-,c `, D } - Gi `7 z Z. Furnace 100,000 BTU (ducts/vents) l 14.00 t y
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldgJapt. no.: I 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
hydronic) , 14.00
Unit beaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
` , Flue/vent for any of above ( 10.00 /e _
Subdivision: Lot no.: Other. 10.00
Tax map /peel no.: Other fuel appliances
:. + d 'e;11.Y+ e7 � . r , S .DESv ciNt.:OF.. {. ?g OPIK . F „ .... •. . - W a t er heater 10.00
��t_ r i .., _ .. ., Gas fireplace 10.00
e . S 41....... e .1 t'` 5k' /? (1 Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stave 10.00
. Wood fireplace/insert 10.00
k..:
Chimney/liner/flue/vent 10.00
1 ,RO t iffiA _ I. :',; 0 TENANT Other 10.00
Name: Z I 3 �a, «,, �. 5 �..n r t-z'\ L Environmental exhaust and ventilation
'Range hood/other kitchen
Address: t -3 4'L 5....> 9o• r in •,, --,. equipment 10.00
City/State/ZIP: 1--,, . .-,-r�{ i 7 1 j1 cil 7....z.."17 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartments, utility moms) 6.80
i r ' c is` t . O PERSON Attic/crawlspace fans 10.00
Other 10.00
Business name: Fuel piping
Contact name: t.„_1 5 ti.-z..-z. S5.40 for first four; 51.00 for each additional
Furnace, etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) l Fax Water heater : ( ) Fireplace
E -mail: Range
ice'. Jr /sl- riTi A 3 ,,; t ; o f. 4 CO N � '.: Barbecue -
MA A `' ea) l��y Clothes dryer (gas)
Business name:
�/'P nl' Other: -:
Address: '724 /5 E yrlt /< _7��e rily� :.. a CALPI FEES*
City/State/ZIP: a mid �i 7 J _ Subtotal Ly
Minimum permit fee ($72.50) 92 1
Phone: (53) /5 ` Fax: ( 3 3 ) 2Mf - .1 52_ Plan review (25'16 of permit fee)
cut sic.:
State surcharge (8% of permit fee) ,
TOTAL PERMIT FEE -7S 5
ThIs permit application expires if a permit is not obtained within 180
Authorized signature: days after It has been accepted as complete.
Print name: c • J . ;f ' Date//- - O
• Fee methodology set by Tri-Coanty Building Industry Service Board
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