Permit �4 0 � ryl! A
CITY OF `TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00356
TI 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/15/2007
PARCEL: 2S 102CD -03600
SITE ADDRESS: 13900 SW 100TH AVE ZONING: R -4.5
SUBDIVISION: SHILO LOT: 005 JURISDICTION: TIG
PROJECT: CAFFALL
Project Description: Replace existing 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:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
CAFFALL, VERION 0 TRUSTEE Description Date Amount
13900 SW 100TH
TIGARD, OR 97223 [TAX] 8% State Surcha 6/15/2007 $5.80
[MECH] Permit Fee 6/15/2007 $72.80
Reversal - [TAX] 8% St 6/15/2007 -$5.80
Phone: Reversal - [MECH] Perm 6/15/2007 - $72.80
[MECH] Permit Fee 6/15/2007 $72.50
Contractor: [TAX] 8% State Surcha 6/15/2007 $5.80
TRI COUNTY TEMP CONTROL Total $78.30
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: �, 2 Permittee Signature: ),(. gpp/ ( / 7 )')
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.
JUN -15 -2007 11:29A FROM: TO:5035981960 P.1
e • •
Meenical Permit Ap °'iI( i: (<. FOR OFFICE USE ONLY
City of Tigard Deatc/By: (0/150.
p tom /
15 - S r Permit No.: A i (� c %
13125 SW Hall Blvd., Tigard, OR 97223 JUN 1 5 2001 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / sI c + D a t e /B y Other Permit:
Inspection Line: 503.639.4175 CITYQF 1(p e- 7,44N.. `I {� Date Ready/B ® y: Juris. See Page 2 for
Internet: www.ci.tigard.or,uS �UI LDINC DJWSO IP bI. �ff
Notified/method: �/ fr Supplemental Information
4
I " " i''�i'' �:�`.;f ���•ra= , r`,,ti %�_ ;7 A,i !"'- n:kr... � i. „a - ^'1' ;,.t �; d 'fJ " -r ,�,.e :�. - ,.z;..
� :;_E,. r' S,.i.. ;:P,"r.:;�� ,',TYP ,W. RIC , ? +�:� i J� =r • � +�.. ti "�� , e': ��' "USEtCHEG1Q,IST
,`.,�., rt�5, t t.: . r% Y- t :K.�.fri��,i „r �'`.Q.� yQ;t •o., .��•r, = '�. .k.,) .. rE�= O.��`,`.,R�_ F�,. ,-
❑ New construction
.... Addition/alteration /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.
'r; $ °'- ':'ix'Y`:B';f''e'Jr� 1 ,,,1�L ± -. �a «nr, , v <w::,,; <:- +. •t••:r °.1 ;ca:• :a,• ,r.'t ,_ - . ' , Value' $
.
,
dddf,,,' i ".k�; �'.. ;' ha ; r "': CA�1,005 :.�p'R�yi«O 7IRTI. TItjN'' .. ' 1; - , ' - ' .
-, ..
�•:i �.'.�,... "' .. ��,..> ...� . ,.•6 a6.;ti+4- . rr,. ,:4 ,,..�,� �'.. „nf,,. >,;�,.. ,... ' �} r " i,. "` - , . - ,. ,
', 13; S;4DOM A :.EQUIPMENT /SYSTE'MS, FEES*
f 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family D Master builder 0 Other: il,.• } -, t,,� N LT ,�0Q t ,�= T Tl ��, Description , Qty. 1 Ea I Total
L;cl.t'� ;" W_�a<. :�. 1;., �'; `'t }ra :�M' - ;I "+ 11.O y QC' bi :'° ' H eatin
�z. , , ;. ....:,, H; �°.. ,•�:: 'I? r , , ,, ,, ,:.., ...;fk iii. ° 'a , . i`� P,/ coolin B
Job site address: a((�� ,nf ( Air conditioning or heat pump
' 1"" V tt ' OJV� (requires site plan showing placement) 14.00
City/State /ZIP: " l I Furnace 100,000 BTU (ducts /vents) 1' 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. nu.: ` Project name: ' .
Gas heat pump 14.0
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: I Lot no.: Flue /vent for arty of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
- t}�;:.,q„ -,; •;,,,
. , i ,�s<:�� ; - �,�,`. .a ��,�+�t��.•; , ,,,,vr ; ; Water heater 00
4 6 1 110N:('O a 111 + tti _ 10.
ipilk t !- t- �i�:tn „. .1 ';, t „ 4,1 V � F r :.. , ,,;;1
s: :.,,. l .r ,,�. a : iuw'. ; "" t°' Gas fireplace 10.00
Flue vent for water heater or gas
PCP C ' n fireplace 10.00
IIJ l.(,, Log lighter (gas) 10.00
Wood /pellet stove 10.00
Woad fireplace /insert 10.00
,,- - , Chimney /liner /flue /vent 10.00
r ; ' F„ ,„ l Y: <d,t . i `i y' i 1 r ; Q Al 'T' )., . + r • • Oth w ' a 't v,.:a 8. I .1 ' ri , t! . 1 " ,,, , - . •, , 1 Y ,1 i. 10.00
Name: ' (on 1,, - • Environmental exhaust and ventilation
Address: 14a f to Range hood /other kitchen
c equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00 .
Phone: )
: Vll Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
6 IP(i :i1, -, p•. •n:b c ,'. y + +!pi i; d)�6si ': """ 'X ' I ? J 1 :;:_%. ? Attic /crawlspace fans 10.00
1� ,' :' 1t �1�,k f: 1 a ^ ' {` -11ia irki, i ,, , .i .. .i / :i. o,ob r,i. �y ,* 1 , N : Q?Y ; ; ,- 1 ,:,.... ,,.
Tri (c U7 eI l L `C, i ito• i L Fuel piping
10.00 _
Business name:
Fuel
Contact name: bait m I 1 . 1` (�� r I $5.40 for first four; $1.00 for each additional
Address:
4 1,00 0 C lack1j� l4� Ri J ! ry VC�t Furnace, etc.
Gas heat pump
City/State/ZIP: 61'�•''t!.10�1 Of' < < F Wall /suspended /unit heater
Phone: (a);! j,� 7_2 J C.( I 170 -. �
� `�-• °/��y Water heater q Fax: : ( t) .J(5 f -L "'� j q Fireplace
E -mail: Range
^1 k r : :n r. y �' a. d,�r`r g,�� 1�� t • r L ,.� s. +,,;rf;, <r `a rr i +: _ +: iH n` tt.';.L .- n., - ', f
Barb
, ,� �Y ' f I e
f �, i. � y� � k {' }�T �'� � e&;'r ,v�� e�eka � # �{� �:p� �, " :: +'+,� '. r • � 'i !' }-
td e34 :�4 +:. i ..`..Jli'h w ar r . lr'�M , y . .r ;,.:r gun =e i
Business name: T r p 1 l( Clothes dryer (gas)
(r� �E -��� -r en t✓ l��Y��� Other:
Address: 1?) L 3O 6 (. (1C M n1.0s
City/Stare /ZIP: ce i ' .Nii G ; .. , .,. ..
( r ,Flit �`y �11�, ,.,.4,::,A"
A;1+11 '4= >i'�TiI�IT)' P S *'
) v • CU - C. •1 - i [`� t. t c Subtotal
( ���) G r r�' " Fax: (E)Q C5 ,..1 e11 l q� Minimum permit fee (572.50)
Phone: �� - �� Plan review (25% of permit fee)
CCI3 lie.: '7210 ZS State surcharge (8% of pemrit fee) +
f TOTAL PERMIT not FEE ' t
Authorized signature: a Z� i ?�� -r This permit day aft r it has a co plet within 180
Print name: pj a f ' Z ( 1`la s(l4) Date: . Fee methodology set by Tn- County Building Industry Service Board
CITY OF TIGARD _
BUILDING DIVISION , .. - PERMIT #: MEC2007-00356
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6//502007
, Phone: (503) 639 -4171 . ic
Inspection Requests (24 Hrs.): (503) 639 -4175 . ":_..
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 65
SITE ADDRESS: 13900 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: SHILO LOT #: 005 TYPE OF USE:
PROJECT NAME: CAFFALL
DESCRIPTION: Replace existing furnace.
OWNER: CAFFALL, VERION 0 TRUSTEE, PHONE #:
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503557- •2220
Inspection Request Scheduled For: Date: 7/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 052122 -01 503557 -2220 Y
Corrections /Comments /Instructions:
�l� & i GJ4'L Diu A.4 t d/LcsL 7td F — .t Z 2 o r4 / el/20_4...-z
•
F
PASS U PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I I FAIL ❑
A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7 —/ 7 -a2 Phone #: (503) 718 - 2_5/-4/5.
_/3 '