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Permit t v a CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00058 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/6/2009 PARCEL: 2 S 103 B D - 00 301 SITE ADDRESS: 11770 SW WALNUT ST ZONING: R-4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: WILLIAMS Project Description: Replace oil 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: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: OIL 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: W DSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES LENA WILLIAMS Description Date Amount 11770 SW WALNUT ST TIGARD, OR 97223 [MECH] Permit Fee 2/6/2009 $72.50 [TAX] 12% State Surch 2/6/2009 $8.70 Phone: Total $81.20 Contractor: CARSON OIL COMPANY INC 3125 NW 35TH PORTLAND, OR 97210 REQUIRED ITEMS AND REPORTS Contact #: FAX 503- 222 -0186 PRI 503- 471 -4365 Reg #: LIC 8388 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: Vi Permittee Signature: hp IA Catial 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. NI. 02 -1J5 -09 04:23PM FROM- Carson Oil Co 5032220186 T -424 P 001/002 F -670 Mechanical Permit A lication EcEivED,,, I of Tigard Received l.Q/� Permit No., n�,�'�r�J� /��CCf `J Date /By. Q� • 5 .,..--1 g.6 (� l6 ! r 05 • O "Vss '1 13125 SW Hall Blvd., Tigard, OR 97223 F E B 5 � 0p Plan Review Other Permit: Phone: 503 639 4171 Fax: 503 598 1960 zap Date/By: 7• I G A RD Inspection Line: 503.639 4175 r +� Date Ready /By, furls la See Page 2 for w y .. Internet. ww.tigard- or.gov CITY OF I IGAKD ,_ Not:fied /Method -1. 1(.. Supplemental Information - JILDING DIVISION , 1 �-( �/ TYPE QF WO 'COMMERCIAL FEE* SCHEDULE - - USE CHECICLIST E=1 New construction Lhsi Addition /alteration /replacement Mechanical penult fees* are based on the value of the work / /�� performed. Indicate the value (rounded to the neat•e: t dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit k i " „CATIFGORY ;OF CONSTRUCTION , ;,,, I : Value: $ • : • • . ' RESIDENTIAL I � QUIPMENT / SXSTEMS�FEE�” ,�; - . • 1 and 2- family dwelling ❑Commercial /industrial ❑ Accessory building For special information use checklist Multi - family ❑Master builder ❑Other: Description 1 Qty. Ea Total . `•' :;',,, ; d •JOB; ;S1T INFORMATION_ •AND •L O(ATION ' % -' Heating/cooling Air conditioning or heat pump Job site address: j/ .7 a •. �51.1 f, � �' (requires site plan showing placement) 14.1)0 City/State /ZIP: 7764 Ro i a R 97223 Furnace 100,000 BTU (ducts/vents) / 14 00 , iq-_ _ Furnace 100,000+ BTU ( ducts/vents) 17.'10 Suite /bldg. /apt. no.: Project name: Gas heat pump 14 00 — Cross street/directions to job site: Duct work 10 00 s Hydronic hot water system 14.110 /2/ - Ave. Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue/vent for any of above 6 80 _ Other: 10 00 Tax map /parcel no.: Other fuel appliances '% >•.`c'' °' ,;''k1: •''i', DESCIt1PTION'OF WORK: - ;-Y '' =..: , Water heater 10.00 Gas fireplace 10.00 Di Ir 4r' o't\ t"1) R(/A c - RF L_A� mew' Flue vent for water heater or gas 1 fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10 00 Wood fireplace/insert 10 Chimney /liner /flue/vent 10 00 ; _• ' '. ,;�' ' OPE_RU:.. :OWNER ±`;" "• -• i ,-�.Q TEtyANT ' : i > ' Other: 1000 Name: 1--F `At (ti 04,r-k5 Environmental exhaust and ventilation - + Range hood /other kitchen Address: // 77n i id Um 4.a, e,r equipment 10 00 _ _ City/State /ZIP: Ti,AR 0 OR Q' ?, 5 Clothes dryer exhaust 00 Single -duct exhaust (bathrooms, Phone: (5 )3 )5q0-3L to Fax: ( ) toilet compartments, utility rooms) _ 6.30 r P " t Attic /crawls fans 10 00 .�. �'5 5 I'I14.cANT• : - : 11 .COI�T,AC'T„PER :P� t r'.t _ - „ "•n`_.i `n.i>.., r t:`l 1000 (c ,,. .�'. _ '' Other: Business name: (A RSD tiI () i /'Orry)AA.a y Fuel piping Contact name: Rut- li A I iI I.l L4 $5.40 for first four; $1.00 for each additional Furnace, etc Address: 3 I Z 5 1,16.i ) ASE Gas heat pump City/State /ZIP: POr,�I srstQ OR 912/6 Wallsuspended/unitheater 4 Phone: ( 5 3 4'7 / , Fax.: (5Q-3)22,2_, or 86 Water heater - Fireplace E -mail: ' 0 A • d • • ; L , - .. Range c,, ,, „1. - :CONTRACT R •, ,a t.. •''i. i.,,•,■• Barbecue • Business name: n © Clothes dryer (gas) igIQ,sa,,, / O pigm Other: Address: 3 /2 5 A l I,/ 1 e ` E.. 'c.... „! :,, r.;,, : :. n � p MECHi 11VVICAL PERMIT ),,1FES •r � ,,'a :��' �, , r` -• P City /State /ZIP: ne,T.W �1�. Il 2 1 6 Subtotal / — • , R ` Minimum permit fee ($72 50) 7,,L 0 Phone: (503)4'1 I - 43 (. 5 Fax: (563)22Z., Of � ( d Plan review (25% of permit fee) CCBlie.:c3X'8 State surcharge (12% of' permit fee) . 76 OTAL PERMIT FEE /, a Authorized signature: This permit application expires If a permit Is not obtained within ISO g /J I�� ` da after It has been accepted as comp!, te. Print name: U� 14/ A7i� Date: R / 0 9 J • Fee methodology set by Tri -County Building Industry Service Board . . CITY OF TIGARD • BUILDING DIVISION PERMIT #: MEG2009-00058 13125 SW Hall Blvd., Tidard, OR 97223 A A: DATE ISSUED: 2/60009 Phone:. (503) 639-4171 ' - ASA 1 14111t1 Inspection Requests (24 Hrs.): (503) 639-4175 4.• V 'P. . .. ' , = INSPECTION WORKSHEET FOR DATE: 2/2412( 19 TIME: 7 PAGE:. SITE ADDRESS: 11770 SW WALNUT ST GLASS OF WORK: SUBDIVISION: LOT #: TYPE OF .USE: . PROJECT NAME: WILLIAMS DESCRIPTION: Replace oil furnace. • . OWNEI9: WILLI AMS, LENA PHONE #: CONTRACTOR: CARSON OIL COMPANY INC . PHONE #: 503-471-4365 Inspection Request Scheduled For: Date: 2/24/2009 Pour Time: • Code #. InspeCtion Description Confirm '# Contact # Message 699 Mechanical final 080786-01 503-590-3610 -------- 'Corrections/Comments/InstruCtions: Q/L) -. / 76 it3"-S43 _AN • . • . . . . . . . . . . . pA n 'PARTIAL APPROVAL 0 CANCEL • fl NO ACCESS fl FAIL - CALL FOR INSPECTION : , ,---- n ADDIT ONAL FEES ASSESSED 2 .tli 0 Inspector: 'N. t ) Dat _iZz;/ e: Phone #: (503) 718- ----' ,