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Permit ei CITY TIGARD MECHANICAL PERMIT 1 111 1 ` DEVELOPMENT SERVICES PERMIT #: MEC2006 -00347 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/27/2006 PARCEL: 1 S134CD -02400 SITE ADDRESS: 11965 SW 118TH AVE ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT: 053 JURISDICTION: TIG Project Description: Replace gas furnace & duct work. 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: DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES BRAD & PEN DIXON Description Date Amount 11965 SW 118TH TIGARD, OR 97223 [MECH] Permit Fee 7127/200€ $72.50 [TAX] 8% State Surcha 7/27/200E $5.80 Total $78.30 Phone: 503 - 590 -3607 Contractor: COLUMBIA HEATING & COOLING INC P.O. BOX 230397 TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 624 -2704 FAX 503 -598 -0270 Reg #: LIC 76359 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: 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. Mechanical Permit • 'a E ti'vtn, roK c)1 I {u l: l sI ()NIA City of Tigard D L ' I H Received _ 13 :25 S W Halt Blvd., Tigard, OR 97223 Datr,tir G/�Permit N e. /� a y 7 Pier, Review 1L_,.// NI ` v "V G i'' Phone: 603.639.4171 Fax 503.598.1960 JUL 2 Dare/9 Other Permit: erm Inspection Line: 503.639.41 75 200r i tty; =' Y lntemet: www.ci.tigard.onus NO I ,. Date Ready /By: c ®Sre Page l for nliediMethcd: Supplemental Iniurmabutt L EI Y u i ,ti i I FA tt 1 RI] ' 1 °i FITTO COMMERCIAL FEE' SCHEDULE — USE CHECKLIST D I\ : ew construction ❑ Addition/alteration/replacement Mechanical permit fees' are based on the value ui the tiork performed. Indicate the value (rounded to the nearest dollar) of all , ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ I - and 2- family dwelling Q Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑Master builder ❑ O ther: Description City. 1 Ea. 'focal ' JOB SITE INFORMATION AND LOCATION _ Heating/cooling / Job site address: �f / j/ f f r c- �1 f/f irequiressiteplan ;, placement i 14,00 Ci:y /State! "L Furnace 100,000 BTU ducts/vcnts ( ) I 14.00 Suite/bldg. /apt. no.: I Project name: Furnace I 00C BTU tdncts:veatsl ) 90 Cross stroet/directions to job site: Gas heat pump 14 00 Duct work ( 14.00 Flydronic hot water system 14.00 Residential boiler (radiator or hydronie) 4 -1(i) t:nit heaters (ILel -type, not eltectric), in -wall, in -duct suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 ' Fax map /parcel no.: Other: I 10.00 Other fuel appliances DESCRIPTION OF WORK Water heater I 1 IU OC f /��� � J Gas fireplace I O.00I 1 �! ":"..1.4 Fl vent for water heater or gas r=> l e-)lZk fireplace 1C.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 PROPERTY OWNER 0 TENANT Chimney /liner /Flue /vent 10.00 /J /��J / Other. 10.00 Name: t , «" 1 li1L�/l?'? ' Environmental exhaust and ventilation Address: Range huodlother kitchen 1 , • City/State/ZIP: equipment 10.00 . Clothes dryer exhaust 10.00 Phone: ( ) I Single -duct exhaust (bathrooms, . Fax: ( ) toilet compartments, utility rooms) 6.80 © APPLICANT I ,a CONTACT PERSON - Attic /crawlspace fans 10 00 1 Business name: f Other: IU.00 Contact name: /3j)` Fuel piping /3 tie /24 /b $5.40 for first four; S1.00 for each additional Address: , Furnace, etc. I I Ci_y /State /ZIP: Gas heat pump Wall /suspended/unit heater Phone '? ! i / q / V 1 I-ax:: { 54: - _ - . �� Water heater I E-mail: I* 7 Fireplace 1 • Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) ()`i /tiA, b/ 6 /74'a•-1,1-7 60 /)li r Address: /4C2 Ocher. [ � O/ 3 a 3 y MECHANICAL PERMIT FEES* City /State /ZiP: Phone: � � -g 7}-72/1 'f e9,17 � � c7'/ Subtotal 1 } r /t 7 ,�� 7 I Fax:) �� /+ „ ?� +ilinimum permit fee (572.60) CCB tic.; Uj 9 ✓ �- � Plan review (25% of permit fee) 2 State surcharge (B% of permit fee) TOTAL PERMIT FEE 75z, go .Authorized signature: This permit application expires if u permit is not obtained a thin i Print Warne: 1l /A // I days after it has been accepted as complete. z2� /O j� / r ' Fee methodology / { ate' /_ / I set by T i Count y Building Industry Se ice u E� :\ B uildingtPermiIsMEC :- ?ermitApp.dec 12003 ��// r� 4 46-46 iT(I Il07/COM/15'[8) Z•d 02.Z0969909 6 ui }t=aH eigtunlo0 R9C L L 90 9Z i CITY OF TIGARD • BUILDING DIVISION ' DAT EPERMIT ISSUED: # 7 P11 13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639-4171 lssz# & A ti Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: $1712006 TIME: 7:02AM PAGE: 51 SITE ADDRESS: 11965 SW 118TH AVE CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 063 TYPE OF USE: PROJECT NAME: DIXON DESCRIPTION: Replace gas furnace & duct work. OWNER: DIXON, BRAD & PENNY PHONE #: 503-590-3607 CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624-2704 Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 034477-01 503-624-2704 N Corrections /Comments/ Instructions: ( f I N-5--kj-- ) J 4 .11/4 C..;V\ - \ --- A A/ LA- LA)\---.. aj4 - c" Qet c -e 1' .-P .e_ce___ 1\\et_. A r UtAS • ....,------ ) - 1 i 1 i) r i l 12 1 - A7S ------ El PARTIAL APPROVAL 1 I CANCEL I I NO ACCESS I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED . Inspector: kY(,c/2___ Date: C Dt6 Phone #: (503) 718- 7 .-Yzy 1.__