Permit CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00472
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/22/2008
PARCEL: 2S 112CA -12300
SITE ADDRESS: 15579 SW 76TH AVE ZONING: R -4.5
SUBDIVISION: RENAISSANCE WOODS NO. 2 LOT: 047 JURISDICTION: TIG
PROJECT: BOHM
Project Description: Installing furnace.
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:
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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
CHRIS BOHM Description Date Amount
15579 SW 76TH
TIGARD, OR 97223 [MECH] Permit Fee 9/22/200E $72.50
[TAX] 12% State Surch 9/22/200E $8.70
Total $81.20
Phone: 503- 730 -4320
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 ---' - `` Permittee Signature: = 7/ 4-.4
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.
SEP /19/2008/FRI 04:19 PM FAX No, P. 002
a -- - Mechanical Permit Appl ,' O,, E USE�ONIY.
ci . City of Tigard Received
���
�� ' ertnitNo.
v 13125 SW lull Blvd., Tigard, OR 97223 Pl Review ,', /�
Phone; 503,639,4171 Fax: 503:59K-066 � re
1 l DatcB
Other Permit:
o y:
, i' c,' A,R. Inspection Line: 503.639.4175 r Date Ready/By: r�ut �� it See Page 2 for
' . - Internet: www.tigard- or.gov Notified )1ethod: i L, Supplemental information
c' C P A.'6 2Q
' r r, " t ¢ i b ' t I , ,, . 1 :i , I .dr i t 4p ' > IFEE , '�� ti 1 o1]ECKL18I:
0 ! ■ ' _ � Ap Mechanical permit fees' arc based on the value of the work
❑ New construction Addition/ 0 / - . ac �® 1 ` d performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: cl1400®114 mechanical materials, equipment, labor, overhead, and profit.
, 1- and 2 :iZ. it dwelling 0 oOF CQItt ? .00 I � ktk 3' I' ;,. 3i, l �� Va ue $ rr,1 . ,
1 l
:: ' O I'
y g ❑ Commercial/industrial ❑ Accessory building
For special I4f'ormation use checklist.
❑ tvfulti family ❑ Master builder ❑ Other: Description Qty. Ea. [ — Total
1' f l B .S C'; IifS) � � 3 �Q ltl l {I 1 f i. i; Air n diti oling
Job site address: — Air conditioning or heat pump ._,__
_ (requires site plan showing placement) 14,00
City /State /ZIP; Furnace 100,000 BTU (ducts/vents) i 14.00 / / =
Q Furnace 100,000+ BTI) (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: 1 - / Gas heat pump 14.00
Cross street/directions to job site: � t/ Duct work 10.00
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. 14,00
Subdivision: Lot no.: Fluc /vent for any of above 6.80
Other: 10.
Tax map /parcel no.: Other fuel appliances
F D C1k YY QFtvoiu ' I1 .1
1 ;11 t: , IY Il i'i:i W y 10.00
Gas fireplace 10,00
/ Flue vent for water heater or gas
C a .l.^s .� — Log fireplace gh 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert _ 10.00
1 n ., :, ! p 7q + y . Chimney Inner /flue /vent 10,00
N lnil v a O }W, 1 , �� , , ,i , t I, t, 1 ! f { ;j i,,�, Other: _ 10.00
Name: ` Environmental exhaust and ventilation
Address: Range hood/other kitchen
eeg uipment 10.00
City /State /ZIF: Clothes dryer exhaust 10,00
3 Single -duct C (bathrooms,
Phone: ( ) F ( ) toilet compartments, , utility rooms) 6.80
0 ; 0 `iT t . , ? „ CQN 6 hti:$6 i ; I ,, ,: !:11 Attic /crawispace fans 10.00
Other: 10.00
Business name:
_ - Fuel pipijg
Contact name: S5.40 for first four; $1.00 for each additional
Furnace, etc,
Address:
_ Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
- Fireplace
E -mail: Range
., ' :' l t 1 1 i. CQNk' -lii0TOR, 11 i , i i . I 1 p'.I i h: Barbecue
Business name: Specialty Heating and Cooling, Inc. Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Drive Suite #130 45 ,1' r i ; 0L* j( 0 Y :):
City/Statc/ZIP Subtotal 7),51) : Tigard, Or. 97223 —
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($72,50) ,5
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee) 7 <?0
TOTAL PERMIT FEE $1 • w0
signature: This permit application expires if n permit is nut obtained ,within 180
Authorized sl
gn 0,,i2--1--- days after It has been necepied us complete.
I
Print name: Andrea Dripps
— Date: ‘ 0 0 e , >< Foe mbthodology set by Tri County Builiing industry Service Board
I: Boadiogvettotta tEC- permitApp.doc 01/19/07 4404617T (11/02IC0M/4 )
CITY OF TIGAIiD -
BUILDING DIVISION PERMIT # :
INiEC2008 -00472
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/222008
Phone: (503) 639 -4171 � l ° 1!
Inspection Requests (24 Hrs.): (503) 639 -4175 A. ''f!,.
INSPECTION WORKSHEET FOR DATE. ' 10/6/2001 TIME: 7:OOAM PAGE: 39
SITE ADDRESS: 16579 SW 76TH AVE CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS NO 2 LOT #: 047 TYPE OF USE:
PROJECT NAME: ROHM
DESCRIPTION: Insialling furnace
OWNER: ROHM, CHRIS PHONE #: 503 730 - 1320
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503620.5643
Inspection Request Scheduled For: Date. . 10/6!2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 076297-01 603 -730 -4320 Y
Corrections /Comments /Instructions:
/ ' /
r" � 2- V —IT
.. '' / ,. L4. / - - ° 1Z � _ -' i —
PASS — PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: /! -6 e Phone #: (503) 718- *�. ----/