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Permit 41� • •CITYOTIGARD MECHANICAL PERMIT �� DEVELOPMENT SERVICES PERMIT #: MEC2006 -10032 ° '�I 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 3/16/2006 PARCEL: 1 S134CA -00720 SITE ADDRESS: 11460 SW 115TH AVE ZONING: R -4.5 SUBDIVISION: BURLWOOD NO.4 LOT: 018 JURISDICTION: TIG Project Description: Electric furnace, heat pump. CLASS OF WORK: OTR 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: 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: > 10000 cfm: Owner: FEES SAM & MOLL ARNOLD Description Date Amount 11460 SW 115TH AVE TIGARD, OR 97223 [MECH] Permit Fee 4/4/2006 $72.50 [TAX} 8% State Surcha 4/4/2006 $5.80 Total $78.30 Phone: 503 - 521 -0689 Contractor: KENTEC HEATING CONTRACTOR PO BOX 233 WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 982 -6082 FAX 503- 982 -6284 Reg #: LIC 63621 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: Lfj®7 Permittee Signature: j SZ1- Call 503 - 639 -4175 by 7:00 a.m. for inspections that business d'y. 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. Mechanical Permit A a s tj g n a - FOR OFFICE USE ONLY , City of Tiga►*d 'fi ; DateiBy Pem�tN.h 1 t % /) `' 13125 SW Hall Blvd., Tigard, OR 972 3 Plan Review Phone: 503.6 .4171 503.598.1960 Other Permit: 39 Fax: 1:_,.':' lilt Datc/By� Inspection Line: 503.639.4175 Mp 16 2 ;. ; Date Ready/13y: ININ H See Page 2 for Internet: www.citigard.or.us ® - Notified/Method: Supplemental Information Pii ❑ New construction ` '�� .'i• tion/replacenrent 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. ::> >'.;>:: ::`::::: >: >:: >: »::::::::: < > ><::<::4 e4hI: STR> tiC>' 1' T�' 1 1! �:;:": ?: < >::: ": >::::;:: >:<: >: >: >: >:: >:> Valu e: $ .. ......... ............ ,-- :- ENTTSY " 3z1V S;EEES . ; ::;:,: �l- and 2- family dwelling El Conunercial/mdustrtal El Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total Q13::SITt?`�� .1� ...x13i!I: r�hf . LQC T.. lV . -.:; :< >s ::;3>:< >:; >'i:::;- ::.. :::.:....:.:::.- . .. Heating/cooling Air conditioning or heat pump Job site address: /C'4 Q 5W f /�fN �V e (requires site plan showing placement) 1 14.00 Jy 66 City /State /ZIP: � F ` G � ) .W c?' 7 ,? - � 3 Furnace 100,000 BTU (ducts/vents) f 14.00 /I'M Suite /bldg. /apt. no.: Project name: r�� Furnace 100,000+ BTU (ducts /vents) 17.90 /� 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 heater .00 Water hea 10 RtI'`['30:: . % %tl4rt� Wiz::: > ::i:':; <: , `'' >' ><: >::<: t Gas fireplace 10.00 rttl/ *ear S yS f / /L //(, C I t-rfl4 gas vent for water heater or as l A ra -r`� f / 1 � �Ct•( Q / per , .e si'% fireplace 10.00 J e_ Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ;,...: :.::: :::... ..:.::::::::::::;:::<.:::.;:;:;:::::;:- :.: :::.::;:;:::;;:;:; ;:;:::.::;::::::: :: : :.:::::;;;::; >:::;::.;_::::: :::: Chimney/liner/flue/vent 10.00 IYFZ, �3PEIfI? Y:; Q�; 1�IL; R. ::::: : : . ::.::.:.::::: ©. . . E ; :_?51►Fi'«: >s< :. z >; :::: : -:. Other 10.00 Name: Sl�fi tf- /f4,d/y A V r10d Environmental exhaust and ventilation Address: Range hood/other kitchen S am- equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( 563) 5`,)- 1 f? Fax: ( ) toilet compartments, utility rooms) 6.80 is craw ce fans :A.l'P h T"::8i;7 C ;;:: >; >; zs>,: :;; »;ri ;;i A tf / ls 10.00 �- Other: 10.00 Business name: /11/".c.,/ /11/".c.,/ ' �1 e C #6 i J Fuel piping Contact name: frF / / r t t7 / r $5.40 for first four; $1.00 for each additional Address: ! 1 ( Furnace, etc. Gas heat pump City/State /ZIP: Wall /suspended/unit heater 3 ? { /? 7 q Water heater Phone: (�j� ) (/ � �/ / Fax: : ( ) Fireplace E-mail: Range B ar e <``:C1?I TR <••• z<::: . cue Business name: � 4.1 , ! Clothes dryer (gas) Other: Address: /� /� ' . :MEC' ICAL:YERM : :F1 E *'.:::::r» : * ::::' >;:ik �x X33 <; : < City /State /ZIP: L ✓ O © d , d u , y h o , / ?Q7 / Subtotal a - g, GO Phone: (5 ) 7f.). - � 7 Fax: ( .5?)" ) 7 a. - ).- ?� Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: 6 3 6 ?_ ( State surcharge (8% of permit fee) TOTAL pEmMIT FEE Authorized signature: 77rit#,/,.,._s____ This permit application expires if a permit is not obtained within 1511 days after it has been accepted as complete. Print name: Air // • k :tf(Gw I Date: 3-- O 1 * Fee methodology set by Tn- County Building Industry Service Board ,T /s . fF 111'160 'it) 1101 Alt IFY ci( f r / /S- /-6 CITY OF TIGARD [ L BUILDING DIVISION PERMIT #:a/76)6 C3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 .gN�m�iiJ�ll Inspection Requests (24 Hrs.): (503) 639 -4175 &W INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 1 Lf( /S _ - t,`� -- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: q- -06, Pour Time: Code # Inspection Description Confirm # Contact # Message ri/0-/g 7 '2 Corrections /Comments /Instructions: GG / / 1 << 9 (EL. L . r4 t 113 PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CA FOR INSPECTION . ❑ ADDITI NAL FEES ASSESSED 74/ Inspector: i Date: o4 Phone #: (503) 718 - I/(