Permit i s CITY OF TIGARD MECHANICAL PERMIT
,,,.�,.�^wi DEVELOPMENT SERVICES PERMIT #: MEC2005 -00091
,.�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/2005
PARCEL: 2S111 BB -01300
SITE ADDRESS: 14180 SW 103RD AVE
SUBDIVISION: ZONING: R -12
BLOCK: LOT: 014 JURISDICTION: TIG
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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Gas furnace replace add AC.
Owner: FEES
PROPST, MELVIN R ELAI NE Description Date Amount
14180 SW 103RD AVE [MECH] Permit Fee 3/8/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchaq 3/8/2005 $5.80
Phone: 503 639 - 2403 Total $78.30
Contractor:
ROSE HEATING CO
9945 NE 6TH DR REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97211
Phone: 503 283 - 5183
Reg #: LIC 2084
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 copie,s of these rules or direct questions to OUNC by calling (503)246 -6699.
Issued By: of ter. Permittee Signature: Ory(
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next 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.
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Mechanical Perini lit; FOR OFFICE; USE O LY /
Race ived
City of Tigard mte illy: ' 09 a /�
13125 SW Hall Blvd- Tigard, OR 971 DD O 2 0 05 Plan Review Other Permit
Phone: 503.639 -4171 Tax: 50159BO Ft::., i DatelBy:
u ' „ I l l oil it I0 0 See rev 2ter
Inspecoon Line: 503.63 ".4175 ci� �_-• �Y Y:
internee www- ci_tigatd.ii ui Nati rcd/Mc i sd: SupplemeMA Wog w aiIre
CITY OF TIGARD
' H :. jFEE *' RCHEDUL "
(thou/alteration/replacement lacernent Mechanical permit fees' are based on the value of the work
El New construction F performed. indicate the value (sounded to dm newest dollar) anti
C:1 Demolition 'ether: mechanical materials, equipment. labor, ovedlcod, and profit. •
Value: S • ;'.' •.: ' -' . ',GA'FEGORY. OF COLVS 10)CTIfON _ ., ..L ES
” '•.- fiRSIDBN QUIYMIG8i7:J,SXS'I'F a;..
d 2- family dwelling ❑ Commercialfindtrstrial ❑ Accessory building For spacial Information tae checklist.
• Multi - family ❑ Master builder ❑ Other: ,
pcscriptivtt 1 Qty, I tn. 1 Total
. : ' J0B':SITE INFORMATION AND LOCATION : • .' eating/cooing
A , , r Air conditioning or heat pomp t • 639
Job site address: V V � ' ` "� (requite. tire plan showing piecemeal) 14•QO
City/Sta!eJZlP: i latx-ri " °I '1 sa l••• - Furnace 100 000 BTU (ducWvents) ) 14.00 i 4 -cv
Furnace 100.000 1311)(ducts/ecru) 17.90
Suite/bldg./apt. vo.: rProj¢ct name: ` � t^C� Gas heat pow 14.00
Cross street/directions 10 Job site: Duct work 14.00
)lydronic hot water system 11.00
Residential boiler (radiator or •
- ydronic ) _ 14.00 ,
Unk beaters (fuel -type, not electxie),
in -wall. in -duct, suspended. etc. 10.00
Flue /vent for any of above _ 10.00 .
Subdivision: I L01,00.: Other: 10.00
Tax map /parcel no.: Oilier fuel appliances _
i. .. r
DE6C1i1PfMON OF V(4RK::; • 1000
_ W aler heate 1 Q �
Gera fireplace _
Flue vent for water heater or gas
/ a e fireplace 10.00
�� �� OeC, I Log lighter (gas) 10.00
Wood/pellet stove 10.00
erilue /vent
EI :T1 NANT ":'t :!' %: 000
Wood fireplace/insert Chimney /l;n 10 OD j . ce
OPE71e�Y• OWNER. +, ✓ -•�- puler: I• . •
Name: :G I / - A a E , _ 1 , r 0.-1- .Environmental exhaust and ventilation _ -
,� r4 Rangehpod/othcrtcitcbrn 1 I Address: 4 i'30 C.r= -� equipment 10.00
q --laa 1 Clothes dryer exhaust 10.00
City/State/ZIP: �j t 'i Singleductexhaust(bathrooms.
Phone: (t;c ) �'• — 0 Fax: ( ) toilet companmenta, utility room') 6-a0
It+ A nidcrawl prec fans 10.00
LdCAN7 i is •Fsti ,TACT! PERSON i':. i s? _
.._ . , P
.' : ® •' '�.' Other i 10.00
v ''�� ,
Business name: � ' C l� . ,b -) •^t 1 e2 • Fun piping
Contact name . 4' , A2 ., A -I lair '1111 $5.40 for Oran four; 51.00 (Or each additional
Address: C21 Furnace, do
l� 7 l Gas heat pump
City /State/ZIP: C/ y g�� -& 1 / ( -7a-i1 Wall/suspended /unit heater -
Phone (50 ) ` 5 I p5 1 x::(.t A8 )'.1 t) Water heater
t
E -mail: Range .
Barbecue
' • ' - ,y � , ^^ I C> Clothes dryer (gas)
gtttine "me: mt: � � � r Co. Co.. — Y Other -
Address: ea-R Q O uo e____.) , : 4.41
1.4iNFCAL'PERMJ '.If:•"' •' . •
Subtotal 1 3' O() "
City /SlntdLlP:
Minimum permit fee (77250) ' 7 -
pliode: ( ) I Fax: ( , P lan review (25y of petmlc fee) -
CCB lie.: 0 &LI Slate surchigge (S% of permit fee) C5 .5V
TOTAL PERMIT PEE -`($. ?
' ' 'moth h application expires If a permit B u
not ahMed widths $ Ito
Authorized signature: 1 _ �, days after It bus beam accepted as complete.
Print name:
�• Dote: MIMI • Pee me thodology set by Tel -Camty Building Indw ay Service egad
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LOT LINE:
2 _
FIRST NAME: VT\ 1 / 4 :- \ t- VW\ LAST NAME:
ADDRESS: CITY: STATE: ZIP:
J
INSTALLATION ADDRESS: CITY: STATE:
PROPERTY LINE
FI': Fr:
FRONT
LicA
PROPER'T'Y LINE
•
X = OUTSIDE UNIT
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CITY -01 TIGARD
BUILDING DIVISION PERMIT #: MEC2005^f0091
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/8/2005
Phone: (503) 639 -4171 � u dg m �� li
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/17/2005 TIME: 7:13AM PAGE: 119
SITE ADDRESS: 14180 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: LOT #: 014 TYPE OF USE:
PROJECT NAME: PROPST
DESCRIPTION: Gas furnace replace add AC.
OWNER: PROPST, MELVIN R ELAI NE, PHONE #: 503.639 -2403
CONTRACTOR: ROSE HEATING CO PHONE #: 503.2835183
Inspection Request Scheduled For: Date: 3/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 001985 -01 503-283 -5183 V
Corrections /Comments /Instructions:
41 I , linll i
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ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIO AL FE S ASSESSED
Inspector: �tael Date: 3 l ( " S Zne #: (503) 718 -