Permit g I i i
)11 CITY O F TI GARD MECHANICAL PERMIT
'.``- COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00177
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/2/2007
PARCEL: 1 S134DC -05300
SITE ADDRESS: 11730 SW 113TH PL ZONING: R -4.5
SUBDIVISION: MUTTLEYS ADDITION LOT: 022 JURISDICTION: TIG
PROJECT: MILLER
Project Description: Furnace and AC, water heater.
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:
NAT 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:
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JULIE MILLER Description Date Amount
11730 SW 113TH PL
TIGARD, OR 97223 [MECH] Permit Fee 4/2/2007 $72.50
[TAX] 8% State Surcha 4/2/2007 $5.80
Total $78.30
Phone:
Contractor:
ANDERSON HEATING, INC.
6463 DAWN AVE.
LAKE OSWEGO, OR 97035 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 841 -0742
Reg #: LIC 168214
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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: Permittee Signature: _"' � 1 (_
. 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.
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Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard CEIVED Da a - d b ' Permit N ‘:::t, ZR, 7 -o0/ 7
a 13125 SW Hall Blvd., Tigard, OR 9
m Plan Review
Phone: 503.639.4171 Fax: 503.598.1 ,it R - 2 zoo/ Date/By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready/13y: Jam' H See Page 2 for
Internet: www.tigard or.gov
CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVI StON
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
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❑ 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 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND L ATION Heating/cooling
Job site address: -1 � �t-� � S� `� 3 p �' -e_ Air conditionin • or heat pump � requires site plan showing placement) l' 14.00 ( "M
City /State /ZIP: .7-- T " k c c , ev a Q 9. - L Z Z Z umace 1 1 , 1 1 1 t I (ducts/vents) 1 14.00 (.
1 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
�vAk, �t V1 Gas heat pump 14.00
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: 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 1 10.00 lO.cXD
/2 (.4:/ FU ait-ev A 1/2 Gc) mod` - vim Gas fireplace 10.00
Flue vent for water heater or gas
A._,/ e e a_ C .1 /- ` 0 e_cl j , 0_, 14 _Co' aa l fireplace 10.00
Log lighter (gas) 10.00
1-- Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue/vent 10.00
PROPERTY OWNER ❑ TENANT
Other: 10.00
Name: - i \(.. W\\ \ \ tn._ Environmental exhaust and ventilation
`
1Z.3� � `� L / `fie _ Range hood other kitchen
Address: equipment 10.00
• City /State/ZIP: -- 7" ‘ ( a,' 4 O ar1Zz -2_, Clothes dryer exhaust 10.00
Phone: ( ) Fax: ( )) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
❑ APPLIC 1 1 CONTACT PERSON Attic /crawlspace fans 10.00
�A� t. N C Other: 10.00
Business name: , Fuel pipes
Contact name: f S N -a S.0 - $5.40 for first four; $1.00 for each additional
Address: (0) �ctk -t.J• Q .2--- Furnace, etc.
Gas heat pump
City /State /ZIP: L_.je e (j x ..C(„ a Q f� Q -1 C3 S( Wall/suspended/unit heater
Phone: ( ' t/ o7 f 'L, Fax: : ( ) Water heater
/ ^�,�., Fireplace
E -mail: Q 12_, 0 4(t CA. eir2S V r Xi
Range
, CONTRACTOR Barbecue
Business name: N-- � 0 C \.`Q_s-..A1/4 L,../: t NC_ Clothes dryer (gas)
Other:
Address: (VC. ' 0 :k. .J i MECHANIC AL PERMIT FEES *'
City /State /ZIP: l- -_. OSL.kre. - l O (e., C ( - 1_0 ' 3 S ' Subtotal
Minimum permit fee ($72.50)
Phone: (4 ) a c-e(- OW z Fax: ( ) Plan review (25% of permit fee)
CCB lic.: r‘6,2 /e{ ._ � .L / State surcharge (8% of permit fee) �
1 TOTAL PERMIT FEE
Authorize gnatur This permit application expires if a permit is not obtai d thin 180
/ days after it has been accepted as complete.
1 - _t I T
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Property Line 11730 SW 113th Place
Tigard, OR 97222
— 24Ft
S AC Unit
6Ft .fin
Garage
^4 ►
33jt
House
26Ft
V4
• 0, 32Ft 4 t•
CITY OF TIGARD
BUILDING DIVISION /t z PERMIT #: MEC2007-00177
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2/2007
Phone: (503) 639 -4171 Mi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/512007 TIME: 7:04AM PAGE: 41
SITE ADDRESS: 11730 SW 113TH PL CLASS OF WORK:
SUBDIVISION: MUTrLEYS ADDITION LOT #: 022 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: Furnace and AC, water heater.
OWNER: MILLER, JULIE PHONE #:
CONTRACTOR: ANDERSON HEATING, INC. PHONE #: 503 - 841 -0742
Inspection Request Scheduled For: Date: 4/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 046091-01 503 -841 -0742 N
Corrections/Comments/Instructions:
M 54n49 9h4
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PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1/ ( 1 ( (
Inspector: Date: Phone #: (503) 718 -