Permit CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00701
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/30/2007
PARCEL: 1S136CA-02000
SITE ADDRESS: 10855 SW 78TH AVE ZONING: R-4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: BAILEY
Project Description: Furnace replace.
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
CLIFF BAILEY Description Date Amount
10855 SW 78TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 11/30/20C $72.50
[TAX] 8% State Surcha 11/30/20C $5.80
Total $78.30
Phone: 503- 803 -9234
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 453 -4822
FAX 503- 968 -7224
Reg #: LIC 62196
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: / ; � - f/1 Permittee Signature: � r / -�
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.
ov 29 2007 5:38PM CLIMATE CONTROL INC 5039687224 p.l
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mechanical Permit A ➢ic
City of Tigard cg RE a i .. , t .�^ 1
13123 SW Hall Blvd., T egard, OR ' . Phone: 503.639 4171 Fax: 503.5:.1960 l N
Inspection Line: 503.639.4175 a �"� `i ar`iIi Dam 'a Pte
a , U
Internet: wH��.ci.tigard.tu.us �� Q - --'�� eitor
0 11 OF a \1�51V N ata Read y� RI Seep ottfied/Methna: Supplemental Iaformatioo
V � COMkMERCIAL TEE* SCHEDULE - . USE.CHECKLIST
❑ New construction rte dition/alteratian/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
10 Demolition III Other:
mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION '. Value: $
::: lit and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
mil Other: For special information use checklist
• Multi -fa
y ❑ Master builder ❑ Description p 1 Qty. 1 Ea 1 Total
JOB. SITE INFORMATION .AND LOCATION - ... Hearing /cooling
Job site address: ��8s3 .. ,r� Air conditioning or heat pump
ti g• (regimes site plea showing placement) 14.00
City /State/ZIP: 7 Z2 /
'� E,„..1.- 02 . - Furnace IOO.D00 BTU (durtshrnts) 14.00. Pt- OU
Suite/bldg. /apt. no.: 1 Project name: go-723.Z Furnace 100.000+ BTU (dnasiventsl 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
• Hvdronic 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: Lot no.: Flue/vent for any of above 10.00
Other. 10.00
Tax .map/parcel no,: Other fuel appliances
DESCRIPTION OF 'WORK Water heater 10.00
_
Gas fireplace 10.00
y Flue vent for water heater or gas
/7 .6- -- it'-'Nt9"Ct fireplace. 10.00
Log lighter (gas) 10.00
Wood/pellet stove 1 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER Chimney/liner /flue/vent . 10.00 . -
❑ TENANT
� Other: 10.00
Name: ( t' 3 � .54/4 7 l Environmental exhaust and ventilation
Address: / G CJL ?� r Range hood/other kitchen .
q r ye equipment L ( 10.00
City/State/ZIP:
I�ie CJGcizzo 0n .- Q �s Clothes dryer exhaust 10.00
Phone: ( ) Single -duct exhaust (bathrooms,
g0 - °I Z �y Fax: ( )
toilet compartments, utility rooms) 6.80
W. APPLICANT ICI CONTACT PERSON Attic/crawlspace fans 10.00
Business name: 1 . r Other: 10.00
67111tr • ! 1 P P g
ontact name o r �, FadJ piping
r.1t IBF� S5.40 first four: 51.00 for each additional
address: ` a. in ( Furnace. etc. I 1
aty /State/ZIP: � .�,► I Gas heat pump
��_ � � � Wall/suspended/unit heater i `
'hone: _ A / _ _ } IM.2 Water heater
mail: WWI Fireplace .. 1
Range
_ COATR4CTQR Barbecue
tusiness name t i r I Clothes dryer (gas)
.
ljilt r 1 Other:
,ddress: .. jr , r ,, s n
+ s _ MECHANICAL PER IIT FEES* •
'icy /State /ZIP: ',
W.1� .. 9 7eaa subtotal 1 >
hone: . ) . Fax (. - , ` Minimum permit fee (572.50) l i 2 • 5 - - .► - L- -- Plan review (25% of permit fee)
C$'lic.:
(?t n State surcharge fit%of permit fee) 5' -,), v
.f li f TOTAL PERMIT FEE 711, +
uthorized si etu : This permit application expires if a permit is not obtained within iao
days after it has been accepted as complete.
rint name: 4 p ' Date:
V Intl- _� / Jar Fee methodology set by Tri•County Building Industry Service Board
3uilding \Permits\MEC- PerrnuAno.do• '' • mfirRi 7r n 1 n n- PAAAvrn.
., .
CITf TIGARD
BUILDING DIVISION
PERMIT #: MEC2007-00701
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 11/30/2007
Phone: (503) 639-4171 a„„0 0911111
Inspection Requests (24 Hrs.): (503) 639-4175 A.-1,191-• i l.--. AiCC ; 200
INSPECTION WORKSHEET FOR DATE: 3/4/2008 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 10055 SW 78TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: BAILEY
DESCRIPTION: Furnace replace.
OWNER: BAILEY, CLIFF PHONE #: 503-803-9234 _
CONTRACTOR: CLIMATE CONTROL. INC PHONE #: 503-453-4822
Inspection Request Scheduled FOr: Date: 3/4/2008 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
699 Mechanical final 066028-01 503-4534822 N
Corrections/Comments/Instructions:
. El PASS n PARTIAL APPROVAL n CANCEL CC1
FAIL CALL FOR INSPECTION
7 4 \ n ADDITIONAL FEES ASSESSED
Inspector: / Date: .g - 4 1- - 6 13 Phone #: (503) 718-