Permit •
CI TY. oF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00327
�=--� 13125 SW Hall Blvd.:Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 6/9/2005
PARCEL: 2S 103AA -01909
SITE ADDRESS: 12385 SW 106TH DR ZONING: R -4.5
SUBDIVISION: COTTONWOOD PLACE LOT: 012 JURISDICTION: TIG
Project Description: New furnace & A/C system w/PVC venting thru chimney.
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CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
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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
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FLATTERS, JAMES G Description Date Amount
LORAINE M
12385 SW 106TH AVE [MECH] Permit Fee 6/9/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 6/9/2005 $5.80
Total $78.30
Phone: 503- 639 -1435
Contractor:
AAA HEATING & COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Phone: 503- 284 -2173
Reg #: LIC 222
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: j' Permittee Signature: Q
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.
Mary Spezza 503 - 284 -1552 p. 2
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E O V E r, tcecc,vea C /1 R� � Ycnuit No..
��CZ 065 Q6 ,
City of Tigard LLL��� ttt��� Date/By: l ( IJ
13125 SW Hall Blvd., Tigard, OIL 97223 Plan Review Other Permit:
503.639,4171 Fax: 503.598.19 f�pp 9 i wrtilrt(,rl (e Date
JUN i` V t7 20 w 0 1 Da te Ready /By: furls: I i � El See Page 2 for
Internet: www.ci.tigard.or.us Line: 503. rd.or. 75 1 V I Supplemental Information
rd.or.us Notified/Method:
CITY OF TIGARD
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.t' 1411- 1 W'VJSJON COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction •Addition /alteration/r performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit.
Value: $
• CATEGORY OF CONSTRUCTION • RESIDENTIAL EQUIPMENT / SYSTEMS FEES* •
and 2- family dwelling ❑ Commerciahindustrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
� -L Air conditioning or beat pump ) 4.00 1 4 J u
Job site address: / Z 3 t4 S S / D f/o 742 40 (requires site plan showing placement) I
� q Furnace 100,000 BTU (ducts /vents) f 14.00 , -.f. c
City/State/ZIP: ` I lwF?/�Q ° j/2 / Z �-� - Furnace 100,000+ BTU (ducWvents) _ 17.90
Suite/bldg. /apt. no.: Project name: ,Liy?�i0T -,2-1 Gas heat pump 14.00
/ � Duct work 1 4.00
Cross strceUdirections to job site: �����— cu- D 4 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
Flue /vent for any of above 10.00
Subdivision: , Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
Water heater _ 10.00 • DESCRIPTION OF WORK Gas fireplace _
e 10.00
` - $ � Flue vent for water heater or gas I
`Ll (� 7 r /f G ...„5-1.4 � fireplace 10.00
� P c... d/ � - ,t hrN, el; Log Wood/pellet (gas) ) 10.00
Woo
— 10.00
d/pell stove
Wood fireplace/insert 10.00
Chimney /liner /flue /vent 10.00
PROPERTY OWNER. ❑ TENANT
• Other: 10.00
T L �, 7 7- �� Environmental exhaust and ventilation
Name: L U �.4 �/ / /
- - Range hood /other kitchen
2... 3-1? s ) / e) 4g, 7 ' �-- Z, equipment 10.00 _
Address: ts /
/ Q 7 - Z-Z --3 Clothes dryer exhaust 10.00
City /State/ZiPi / �), �7 )'L Single -duct exhaust (bathrooms,
Phone: ( � toilet compartments, utility rooms) 6.80
Z i - 3S Fax: ( ) �
Attic /crawlspace fans 10.00
❑ APPLICANT 0 CONTACT PERSON
Other: � 10.00 1
Business name: Fuel PiPinR
l $5.40 for first four; $1.00 for each additional
Contact name: A
Furnace, etc.
Address: Gas heat pump
City/State/ZIP: - Walllsuspended /unit heater
Water heater
Phone: ( ) l Fax: : ( Fireplace
E -mail: Range
CONTRACTOR Barbecue
� n / Clothes dryer (gas)
Business name: Mil. �a %r75 t ! ef Vey! Other:
Address: a q /5 - yy E j'J f g T e i L � MECHANICAL PERMIT FEES*
U /� q 7, / Subtotal -^1..-5 7 --: , `.:._
City/State/ZIP: Minimum permi fee ($72.50)
Phone: (543) �� Lye_ ( `7J Fax: ( 57* 2l let: — 1 M. Plan review (25% of permit fee)
State surcharge (8% of permit fee) j • SS L
CCB lie.: TOTAL PERMIT FEE -- Vg . 3(
Authorized signature
�„ _ J�L This permit application expires Ir a permit is cot obtained within 18(
I.1 ;� u L1 .L�� - days after it has been accepted as complete.
U� r"' 1 • Fee methodology set by Tri- County Building Industry Service Board
Print name:)/ \C� qL>,.4 �,� .A � S ULiI J 1 l; ! � Date: � -V�
ta, dw :..esp..,,,aancer.p..,,d rine 12/03 440- 1617T(1 t /02ICOM /WEB)
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CONTRACTOR AIC4iEAT PUMP --.. UNIT SITE PLAN
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1 CUSTOMER INFORMATION .
NAME o{- j ;V . • •
ADDRESS .1 2? "3 s Sc... I D D 711..- 40'■-• i • •
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PLEASE REFAX APPLICATION WITH $ TE PLAN,
Sb7. Lo3F. I Y3.7
• G.ee2 '. $ 11, 3 S3 - . • •
CITY OF4TIO,.ARD '
BUILDING DIVISION PERMIT #: MEC2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/9/2005
Phone: (503) 639 -4171 Aaiv i1 @t�q@ i,r,
Inspection Requests (24 Hrs.): (503) 639 -4175 '__..
INSPECTION WORKSHEET FOR DATE: 9115/2005 TIME: 7 :03AM PAGE: 86
SITE ADDRESS: 12385 SW 106TH DR CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 012 TYPE OF USE:
PROJECT NAME: FLATTERS
DESCRIPTION: New furnace & NC system w1PVC venting thru chimney.
OWNER: FLATTERS, JAMES t3, PHONE #: 503„639.1435
CONTRACTOR: AAA HEATING & COOLING PHONE #: 503.264 -2173
Inspection Request Scheduled For: Date: 9/1512005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 015728 -01 503 -284 -2173 Y
Corrections /Comments /Instructions:
LAG o, E ; L ,� L tia g ' L SSv c�
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❑ PASS I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: �' /5 Phone #: (503) 718-