Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00119
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/10/2008
PARCEL: 1 S135AA -01900
SITE ADDRESS: 10250 SW 87TH AVE ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT: 037 JURISDICTION: TIG
PROJECT: NYS
Project Description: Replacing gas 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:
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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
STEVE NYS Description Date Amount
10250 SW 87TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 3/10/200€ $72.50
[TAX] 12% State Surch 3/10/200€ $8.70
Total $81.20
Phone: 503- 245 -6721
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -1950
FAX 503 -538 -0165
Reg #: LIC 97152
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: %// ,, i ,� Permittee Signature:
Call 51 ''.9.4175 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.
Mechanical Permit Application, CEIVE 1 U1; ( tI I It. I. I s r r\ I 1
City of Tigard Received 3 airChic 3
01 13125 SW Han o1vd - , Tigard. OR 97223 u
'' . Phone: 503.639.4171 Fax: 503.598.1960 M A R 1 0 Z U U 8 p1 y ew Pmt.
Y
1 , t Inspection Line: 503. 639.4175 CITY Y OF I UARD D ReadYBY: iiiR la Sas Pap 2 for
Internet: www.tigard or.gov BUILDINCD1'JISION NoufiedlMcthod: Supplemental Informatioe
+.fry MR ► ..n. n : n'4 ,. C g : a + i USE CRECICLIST
0 New construction XAddition/altcrstionheplacement M permit fees* we 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.
CxATEG .0g 016 . ,'.. _ ', • . •.. .;:w Value S
"t and 2-family dwelling ID Commercial/industrial ❑ Accessory building ; '.I l 'Fe�ii: AS SRiPEB►' - --
E Multi family ❑ Master builder ❑ Other: For special irlfonnatra we yheckli
......, ,� t .. _ _ � Total
Description Qty. Ea.
� To
. -:) SITE'dA17.01.4 •'•'� ,. , " . `' "' ; 'I" Beating/cooling -
Job site addt ass: pp .� ,� V .. Air conditioning or heat pump
r �r l .CJ 4, , (requires site Plea showing placement) 14.00
City /State/ZIP: I � ( 4 1 - 1 3 Furnace 100.000 BT (ducm/vcnts) 14.00 J �f a 00
j Furnace 100.000+ BTU (duets/vents) 17.90
Suite/bldgJapt. no.: Project name: S Gas heat pump 14,00
Cross street/directions to job site: work ork 10.00
,► Duct or hot avatar system 14.00
ti� Residential boiler (radiator or
*; r hn c) - - 14.00
Unit it heaters (het -type, not electric),
- 1111 in -wall, in -duct, sus pended , etc. 14,00 _
Flue/ventfor any of above 6.80
Subdivision: I Lot no.: . _. '
Other 10.00
Tax map /parcel no.: Other fuel appliances
Di :e . r ., "' < ;.. ; ;4;,1, Water beater 10.00
( Gas fireplace 10.00
- • 6 l a C.-� a _ ` . • - Flue vent for water heater or gas
.. fireplace 10.00
- log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
• j . Chimney/liner/flue/vent 10.00
V
: .,� ,."';,.:. ". w Other 10.00 •
Name: _S---1-€.v e_- '' Y` E nv}ronmenttl exhaust and ventfletlon
! Range hood/other kitchen
Address: / (� s $uT _ -^� { equipment 10.00
city/State/ZIP: q p, .. J a b � J -- sing es dtyer e x h aus t t( ( b 10.00
(bathrooms,
Phone; (5- 4., - (O'1 ' k Fez: ( ) toilet compartments, utility rooms) 6,80
.. " i ' • . p e tffits
Q,: .. .. , „ .:;; • ,, r . � AttirJcrawls ac LO 00
- Other: 10.00
Business name: -
Fuel piping
Contact name: FOUR SEASONS HEATI C $5.40 for first four: 51.00 for each additional
Address: - ` I ` - • 1 e I% , , , - ' Furnace, etc- I _ 3'54{)
1005 INN l Gas heat pump
City/StateJZIP: NEWBERG, OR 97132 Well/suspended/unit heater
Phone: ( 6 * - 5 +— —. Fax:: ( i , -S- g — ar ( E Water heater
Fireplace
E -mail: Range
CO TRi t :A41:,' ...... ., ,..." " : _Barbecue -
Business name' Clothes dryer (gas) - . _. _ ,
• • l • • 1 . t Other:
Address: AND AIR CONDITIONING, INC. '
City/State/ZIP: 5 INL.USTRIAL PKWY - Subtotal
•=
Minimum permit fee (572.50) V .w Q
Phone: ( ) Fax: ( ) Plan review (25% of pennit fee)
CCB le.: State surcharge (12% of permit the) ■ 7 0
TOTAL PERMIT FEE sy i , a.0
1 1 This permit application respires it a permit d net obtained wilMa 180
Authorized signature: «1 1 dive otter it has been accepted as complete.
Print nettle: lJ L . A 42._ A:. 1 ` /! 0 Date: 3 J `O d r1 _ — • Fee methodology set by 'Fri-County Building Industry Service Board
I: mawingwveshs\MEGi's 1Apo.dce 01/1457 440- 40171' (t i, 21C0M/WEB1
L0O /L001j X 8C Ll VLOZ /1.1./C0
CITY TIGARD
BUILDING DIVISION PERMIT #: MEC�200 500118
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/10/200E{
Phone: (503) 639 -4171 "' 1 l 1''`
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' IL. I
INSPECTION WORKSHEET FOR DATE: 3/14/2008 TIME: 7:00AM PAGE: 40 w
SITE ADDRESS: 10150 SW F37 TH AVE CLASS OF WORK:
SUBDIVISION: METZGER ACRE TRACTS LOT #: 037 TYPE OF USE:
PROJECT NAME: NYS
DESCRIPTION: Replacing gas furnace
OWNER: NYS, STEVE PHONE #: 503-245-6121
CONTRACTOR: F OUR SEASONS HEATING & NC INC. PHONE #: 503- 538.1860
Inspection Request Scheduled For: Date: 3/14/2003 Pour Time:
Code # Inspection Description Confirm # Contact # Message
618 Mechanical final 066710 -01 503 63f3 -1850 Y
Corrections /Comments /Instructions: / r �-
E/ i? 4-
� c —7 L GVL. Ltc 1i
y1 &26C_ C .— /gam 7 '4, rte. c/1-
74 - 1 3 9 1 SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION (4 0 ADDITIONAL FEES ASSESSED
Inspector: Date: — - r Phone #: (503) 718 - =4eZ
CITY TIGARD _
BUILDING DIVISION PERMIT #: ME 2009.00119
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10,2008
Phone: (503) 639 -4171 � . �r� 1 N t p ll� 1� ,� \
Inspection Requests (24 Hrs.): (503) 639-4175 __—
INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: /.02AIM! PAGE: 4
SITE ADDRESS: 10250 SW um AVE CLASS OF WORK:
SUBDIVISION: ME (2015 =U ACRE_ TRACTS S LOT #: 037 TYPE OF USE
PROJECT NAME: NYS
DESCRIPTION: Replacing gas furnace.
OWNER: NYS, STEVE PHONE #: 603. 6771
CONTRACTOR: FOUR SE.A ON => HEAI IN(3 & A/C INC'. PHONE #: 503`:' '0
Inspection Request Scheduled For: Date: 3/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 066610.01 503.47&6071 Y
Corrections/Comments/Instructions:
# 4 .', 4 - ' i' S - - - --- r _.-c'z----sr = 34 ,- , , r 45 •A4 1.(10'71=P
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 - //-107 Phone #: (503) 718- Z44