Permit 1
A - CITY O TIGARD � MECHANICAL PERMIT
: DEVELOPMENT SERVICES PERMIT #: MEC2006 -00117
61 I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/23/2006
�.
PARCEL: 1 S136AC -02800
SITE ADDRESS: 10700 SW 72ND AVE ZONING: R -4.5
SUBDIVISION: METZGER ACRE TRACTS LOT: 004 JURISDICTION: TIG
Project Description: Oil to gas furnace conversion. Piping to furnace and water heater.
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: 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: 2
> 10000 cfm:
Owner: FEES
RUSSELL, NORMAN L Description Date Amount
8857 SW EDGEWOOD ST [MECH] Permit Fee 2/23/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 2123/200E $5.80
Phone: 503- 228 -3413 Total $78.30
Contractor:
COMFORT AIR INC
3634 SE POWELL BLVD REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Contact #: PRI 236 -6829
Reg #: LIC 00004307
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 Signatur-'
tzfrAZ6.d...)___ //1//-e-1/ ._
Call 503 - 639 -4175 by 7:00 a.m. for inspections that ' -.' - • 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.
M echanical _ Permit A 1 11' ...1 s 1-s Folz OFFICE USE ONLY - - - D
City of Tigard f:.i Date /Bye_ 0 • . Permit Na- z,�oob ' 6
13125 SW Hall Blvd., Tigard. O' 4 -'..' ''.' "- ''
Phone: 503.639.4171 Fax: 503.598.1960 DateB V 1e
Other Permit:
Inspection Line: 503.639.4175
Internet: www.ci.tigard.or.us FEB 23 2006 � 14III`I
y
- D Notified/Method: F ///. Supplemental p See Information
CITY 1
g T [q ! ' 1��j COMMERCIAL FEE* SCHEDULE — USE CRECKLIST
❑ New construction V ��i an a teration /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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
i and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
,vd Air conditioning or heat pump
Job site address: / 7 0L/ /� �7� .-� ✓r �/ / (requires site plan showing placement) 14.00
City /State /ZIP: 717: Crud Q� Furnace 100,000 BTU (ducts/vents) 1 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 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 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
DESCRIPTION OF WORK Water heater 10.00
• /,.y ,t, t Gas fireplace 10.00
( %/ / E t,' . "6. 5S - 1/f t/4Ce L'O�l/Nr.57d� — wel� e, Flue vent for water heater or gas
/ /' fireplace ' 10.00
!i Ake / 995 7O f t- L�r/q<' 11/y Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ❑ TENANT • Chimney /liner /flue/vent 10.00
Other: 10.00
Name: 4A -ma,/ -ma,/ A5.5e, Environmental exhaust and ventilation
' ,.sr Range hood /other kitchen
Address: /4 9700 1114 /3 --� equipment 10.00
City /State /ZIP: �/ G,r C.),--t clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ' j ) g jia, Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
/ r Other: 10.00
Business name: r3�,� _>f" /:— ���/. Fuel piping
Contact name: d `/� $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
1
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
•
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: /' r y� / ' Clothes dryer (gas)
r �^' `t O"' `i - Other:
L
Address: 367 5 - /Sv e 7/ ,5 /7d' MECHANICAL PERMIT FEES*
City /State /ZIP: / ", Li ^ - 619
Phone: tic/3 ) , G 5,/� � Fax: (56_,3) � 3 /3v3 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: (i 3i O7 State surcharge (8% of permit fee) S.�'D
/ TOTAL PERMIT FEE 7g q °
Authorized Signature: T his permit application expires if a permit is not obtained within 180
/ ,, days after it has been accepted as complete.
Print name: VP 5 q 4 Date:2� /o‘ • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440-461 7T (1 1 /02/COM/WEB)
CITY OF TIGARD i 1 GC
BUILDING DIVISION PERMIT #: 2_606, — 0 0 // 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Apr°
Inspection Requests (24 Hrs.): (503) 639 -4175 :.-4+L ;1.L.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 0 7 co 7 a 'md 'T " - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- i g - O co Pour Time:
Code # Inspection Description Confirm # Contact # Message
<s & 3CQ — (e g a-9 #
Corrections /Comments /Instructions: /
Fel-L .e, / : 0 0
?e,7 c ___ ___/
L/
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
4 ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,.
Inspector: Date: 3 V062 Phone #: (503) 718 - Iii`