Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006-10029
Q.��I DATE ISSUED: 3/15/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 112CD -00700
SITE ADDRESS: 15940 SW 76TH AVE ZONING: R -12
SUBDIVISION: DURHAM ACRES LOT: 001 JURISDICTION: TIG
Project Description: Replace furnace, add a /c.
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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
CHARLIE ZIMMERMAN Description Date Amount
15940 SW 76TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 4/4/2006 $72.50
[TAX] 8% State Surcha 4/4/2006 $5.80
Total $78.30
Phone: 503- 267 -6407
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 235 -0454
PRI 503- 235 -9083
Reg #: LIC 50244
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: t Permittee Signature: a
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.
03/14/2006 13:18 5032350454 SKY HEATING PAGE 02
Mechanical Permit AJRAiicattiOfl Fok F 1 Ol II(Ir, t vi-: ONI,\
City of Tigard E C ! i t ® Dottie Received / lj ' Permit N. t
13125 SW Hall Blvd., Tigard, OR 972 2 Plan Review
Phone: 503.639.4171 Fax: 503.598,1960 NM Other Permit:
Inspection Line: 503.639.41.75 MAR 1 4 200 „Ii,!J �� l Date Ready/Psy; See Fagr 2 fur
Internet www,ci.tigard.or.us Notified /Method: Supplemental Information
!rip. .
�' e ° ' . • CCi11 h � ;. E �9L t1>Y : •=: USE'! [ln '1f 8T •
C Mechanical permit fees•' are based on the value of the work
❑ New construction ® Addition /alteration /replacement ., performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
• Value: $
. ' . CAflGORY OE cor teeRtlet)C T I- • . )lEkorsilt*:E ° [ , SS[9' .:1 Yi
® 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building — For specter[ information use check[rrf.
0 Multi- family ❑ Master builder 0 Other: Description i Qty. I Ea. 1 Total
. AA' SITE : lA`CtON AiiktoHLoATION Hentingkonlin5E
Job site address: 15940 SW 76 ST Air conditioning or heat pump 14.00
(requires site Ian showily¢ placement)
City /State/ZI T1 ARD OR 97224 Furnace 100,000 BTU (ducts/vent) ( 14.00 ,Li
Furnace 100,000+ BTU ducts /vents 17.90
Suite/bldg./apt. no.: I Project name: Gas heat pump 14,00
Cross street/directions to job site; Duct work 1.4.00
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. 1.0.00
Flue/vent for any of above 10.00
Subdivision Lot no.:
Other: 10,00
Tax map /parcel. no,: Other htel a • ∎ linnces
1r9C1<tifl pTq 00.. votRK • ' Water heater 10.00
Gas fireplace 10.00
REPLACE FURNACE, INSTALL A/C Flue vent for water heater or gas
fireplace 1.0.00
... log lighter (gas) 1.0.00
wood/pellet atove 10,00
Wood Fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
. ..: :�. k11tOrit Y. OV6N111 . • '. . . ' .C1 TENANT • Other, 10,00
• Name: CHARLIE ZIMMERMAN Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/ZIP-. Clotlics dryer exhaust 10.00
-- - Singlc-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments. utility rooms) 6.80
151 APPEICANT ' .: 0- 'CONTACT PERSON , Attic/crawI pace funs 10.00
Other: 1.0-00
Business name: SEE BELOW Fuel piping - _
Contact name: $.S.40 for first four; 51.00 for each additiona
Address; Furnace, etc. 1
Gas heat pump .
City/State/ZIP: Wall/suspended/unit heater
Phone; ( ) Fax:: ( ) Water heater
Fireplace
E-mail: Range • . .. COnmM roR _ Barbecue
• •
Business name: SKY HEATING & AC Clothes drycr (gas)
. Other: 1
Address: 1635 SE NEHALEM ST • . . • 1 IW12003C41kpt'1"' •..
City /State/ZIP: PORTLAND OR 97202 Subtotal ;"
Phone: (503) 235 -9083 Fax: (503) 235 -0454 Minimum permit fee (572.50) J- -.SO
_ . . -. Plan review (i5% of permit fee)
CCI3 lie -: 50244 State surcharge (8 "� of permit .%e) $,
TOTAL PERMIT FEE 3D
^ Thi per mit a expires If a permit is not obtaine wihi 180
Auth ignaturc days after It has been accepted as complete.
Print name: ),pea, L V I, 44/ i :Date: 3/06/2006 • Fee methodology set by - I - Di-County Building toduatry service Board
i :Taildiaa \P us \MhCPamltnap,doc 12/03 440
03/14/2006 13:18 5032350454 SKY HEATING PAGE 03
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CITY OF TIGARD EC--
BUILDING DIVISION PERMIT #:,2_ 0 0 6 — /0 oti
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 *41,,�l �1�+
Inspection Requests (24 Hrs.): (503) 639 -4175 ''!..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 5 g 6 7 4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: .
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Ti < � , 41 t .
Code # Inspection Description e Confirm # Contact # Message ` -.:. — L ,.. -�: -:
6 // VY\ jCL . - o . 3,C c o 87 3
Corrections /Comments /Instructions: //// ^//�'/
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e ___ Di s 0 k./k)-----c__L -- -- e- 0 ,i÷- tc- Fr. ,S C-5 (--,
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PASS TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
al FOR INSPECTION n
FAIL ` GALL ADDITIONAL FEES ASSESSED
Inspector: Date:` Z46 Phone #: (503) 7187Z�
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