Permit y i , .,
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yi CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00638
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
\(1 SITE ADDRESS: 13495 SW 74TH AVE
DATE ISSUED: 11/1/2007
PARCEL: 2S101 DC - 05700
ZONING: R - 3.5
SUBDIVISION: PACIFIC RIDGE LOT: 009 JURISDICTION: TIG
PROJECT: WALDEN
Project Description: Gas piping to outdoor heater and BBQ, replace furnace and water heater, AC
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: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm:
GAS OUTLETS: 3
Owner: FEES
WAYNE WALDEN Description Date Amount
13495 SW 74TH AVE.
TIGARD, OR 97223 [MECH] Permit Fee 11/1/2001 $72.50
[TAX] 8% State Surcha 11/1/20W $5.80
Total $78.30
Phone: 503 - 620 -6842
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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 Signature: W4,eidt,741—
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.
,,ACT-711 -2007 02:07P FROM: TO:5035981960 P.1
4
Mechanical Permit k� • t• k ati n ly FOR OFFICE USE ONLY
City of Tigard l Received/1 I r
1 3125 SW Hall Blvd., Tigard, OR 97223
7223 C O F C IS► , A ;), eivY ' - � �� Plan Revtcw Phone: 503.639.4171 Fax: 503.598.I9� i ® �P ® �j�® ' dy.e,.0, I D ateBy: Other Permit:
Inspection Line: 503.639.4175 pp�A 1 \V _ Date Ready/By: El See Page 2 for
Internet: www.ci,tigard.or.us ��IW Notified/Method: Supplemental Information
rt r e-i . l t ti u ,M e',i' v .0.*`. ijkO r Cs r _;: ' ti CO) . 1#CIAL 'FEE'f 'LE ; TJSEiCRE'CKLIST
❑ New construction Addition /alteration/replacement Mechanical permit fees" are based on the value of the wort(
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: g mechanical materials, equipment, labor, overhead, and profit.
t r•!k ',, r ,:i J f, ''i is CAi':EGt ` I.2 ION S . ,: r` . ... Value $.. .... ,
,21'<S4D) $,'TIAL EQUIPMENT /'SYSTEMS FEES*
Aj 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: '
Descrip[ion 1 Qty, Ea. Total
t' d" � 9 9 Cwl' l PL t9, I -
l t A td .t i..Wl Q �S l �1rri�q? 10... rt( `f OCATLQ l,a _ Heating/cooling .
Job site address: 0 l i 5 ow 94-i tl OC.) Air conditioning or heat pump `
(requires site plan showing placement) 1 14.00
City / State/ZIP: T' 9� (Al22,3 Fumace 100,000 BTU (ducts /vents) 1 14.00
V Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
. Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above I 10.00
Other: 1 1 10.00 ,
Tax map /parcel no.: Other fuel appliances
�' 7. a Iq' ii k : i v r a �+ }- Ft a r S I �G
tt� �7p�y , ' n t � 9Ny','c ,'.41.4.' ,�� ar . ,1,"- ffely4' �^',I t; )., a jt
l : �.�.h � � � � t ,� R�.F��.r�l�f i �Y'("�� +r � i' Sx .. I It ti *�l�i ' Water heater I 10,00
r Gas fireplace 10.00
O ao f 1 la.) I OCOth all% f9 Flue vent for water heater ur gas
A 11I „ ► � fireplace 10.00
VV(�(,L y iLl6lit, rf Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10 00
t, Chimney/liner/flue/vent 10,00
4. i •_ . ,i ` , ' a � U + :l a i . A' 11 t E9a ` .,, l',1.' 1 ' a jI Other 10.00 ■ ,
Name:
d . I I w. , iat a n� W ` a n Environmental exhaust and ventilation
Address: �1Q Range hood /other kitchen
equipment 1 0.00
City/State /ZIP: Clothes dryer exhaust 10.00
(654V..--. Single -duct exhaust (bathrooms,
Phone: ( ) (Oa Fax: ( ) toilet compartments, utility rooms) , 6.80
Autc /crawlspace fans 10.00 •
6,,y.�iP,R.114f� ALIP s4 ' . f r i a r "hTi r pNl A I r ), R$ O N • l i .
,vi /� _ o i f Other: 10.00
Business name: in C ul - v T` I'Yp ((..1I �t f Fuel to
7 piping
Contact name: 85.40 for first four; $1.00 for each additional
^� y`' (�� �} t Fumce, etc.
Address: (•� I FJLJ e) OlacktU f (U.� T v r-1 �� f uc
Gas heat pump
City/ State/ZIP: �`r 'CJ�, 1 CI t I L c(704 Wall /suspended /unit heater
Phone: (a!;5) �) �'-- ` Fax:: (t�j) 3 7-(Y(1 el Water heater
Fireplace _
E -mail: Range
* l „r.: t , a n Barbecue
yR4 9 .$ i f 't3 1 , dt : ; F 1., t 7 y
F it . B a t [.'i,t r . 7 � O - , . 1r . 1 I Gt '
lei a. tt:)., i��. .�•�1�} y , Z.a �Jtt�.i �, isit^+r� JY � d .�' . �r' lkw � r .. , ,
Business name: T(1 (C: U 1L )�� (0) r
Clothes d er as
y- Other: ther
Address: c t , y � /� f + t+ ;l ' 4IL. P. ilAc., LR: F EES. ' . • i 5C� , � W k[ I r 1.03 •i
City /State/ZIP: () *'
I L ; ,�-1 ��k C{ fl.r- Subtotal
�� I1 Minimum permit fee (872.50)
Phone: ( } C��` - Fax: (Fj +( j �� 1 �!l� �'1 Plan review (25% of permit fee)
CCB lie. �r24 State surcharge (8% of permit fee) 1 szo
TOTAL PERMIT FEE
. • ( /ZL' d ral0�?L --,.._ Thts permit application expires if a permit b not obtained within 180
Authorized signature: 5 ' days after it hat been accepted as complete.
Print name: Nan( /I143(l1') Date: ID! ilpri Fee methodology set by Tr - County Building Industry Service Board
S . OCT j,1 -2007 02: 08P FROM: TO: 5035981960 P. 3
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CITY OF TIGARD .
BUILDING DIVISION
. *4 PERMIT #: MEC2007-00638
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11t1/2007
Phone: (503) 639-4171 l'ill Wilt
Inspection Requests (24 Hrs.): (503) 639-4175 La4 11-i
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AM PAGE: 78
SITE ADDRESS: 13496 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: PACIFIC RIDGE LOT #: 009 TYPE OF USE:
PROJECT NAME: WALDEN
DESCRIPTION: Gas piping to outdoor heater and BB .0, replace furnace and water heater, AC
OWNER: WALDEN, WAYNE PHONE #: 603-620-6842
CONTRACTOR: TRI COUNTY TEMP CONTROL. PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa e _ 114
599 Mechanical final 059324-01 50-557-2220 Y r
Corrections/Comments/Instructions:
0 4 - A ---- z5e--- t 7v1 (rq 0 IZ (- A4 6,-- S 1-,2_, 2 - - /
_4-7-/Al / i'll
(...-
• - A • TIAL APPROVAL l] CANCEL El NO ACCESS
El FAIL • CALL FOR INSPECTION l] ADDITIONAL FEES ASSESSED
Inspector: Alr.....- Date: Phone #: (503) 718-
or
41116 /