Permit •
C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00153
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2008
PARCEL: 1 S134CD - 03400
SITE ADDRESS: 11995 SW 119TH AVE ZONING: R -4.5
SUBDIVISION: LERON HEIGHTS NO.3 LOT: 065 JURISDICTION: TIG
PROJECT: SMITH
Project Description: Installing gas furnace.
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
DAVID & KARYN SMITH Description Date Amount
11995 SW 119TH
TIGARD, OR 97223 [MECH] Permit Fee 3/28/200E $72.50
[TAX] 12% State Surch 3/28/200€ $8.70
Total $81.20
Phone: 503 -590 -1689
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 670 -9064
Reg #: LIC 151847
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: • �s — Permittee Signature: / c
Call 503 .69.4175 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.
14- "MAR /27/2008/THU 01:36 PM THERMAL FLO FAX No, 5036709064 P. 002
^mechanical Permit A pp icatiOlr �8 �J � � . F OR O t SUS : ONN .
• City f Tigard �9 Re
tY g Darei.y, �� . ./ ' 1/ �i . •
13125 SW }let Blvd., Tigard, OR 97223
Erg , . • Phone: 503.639.4171 Fax: 503,598.1960 MAR 2 7 2008 IEEjillIllIllIll Other Permit:
•r t ri A R 1) Inspection Line: 503.639.4175 Date Ready /ay: ruris: Pl See Pape 2 for
Internet: www.tigard- or.gov F T0GA11D Notified /Method: supplemental Information
iilux n, ,.•, a,.,,,. na1 „� ;n,r nl",auBcG «.:hg•: :.�,1'rx h'. „,,, :'n•a, „ �p ,„ r _..�.+�. ,11
: ,4,,.s�,. 'a ml'ni�Ci�,7 ;3t!ii:i;4i''�' :mai ,�, 1 . : � Ynna,•:,G,E'Ct,i::`i':.;,,. , ..,. 1�ONI11�Ei'If !'.V�'S � E...: .:r ,.�, .., ,.
, ,,�, ,,,r. x „., ",P: .'7 4w „:, ; �,�r.� ; � iTT11P �k`� ;:'�. ,'” �., �'"' .,,:,,. .. '. '�lA '.S ''ykI(1�k�C } rt S�` �� BTr,,,,
. ..,,.,,, , n u y ' n,u r •vm r Y .., e.• ,..a. ,.,,,.,,,•,... �'valfrun a'a'na,, m ",. ", �. ., .. 1. .. .,.`..:"'�,.... ,....,`"i •, .�....iT'�° .Y�.
..'. r,., rl....!,.,... ..0 ' �� ....� ....� : .,.,....:..,�....: .] ... ... .. ...:. t- .,,N, alit. .� ... ... '
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/ alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
ISTi .; �5,.t; 6!'ac,1:'i " ' /:' r 'g' ::;'i -m:•: Ne i l l; ; , r ,. ,. , Value:
;�q ;� wGG. ��i����:'�..b a'oivsT:Re� raon �,, s.,:: air, ;�� ;gym i� ; ;. ;. ;i'
„. ^ Li4LT
�
.r •
t lro
:r;, 1:lj 1 '�F'j1V;Ii�ti � QJ1�,14�Iiht','I• j• , r�� ,i „n,
1 -and 2- family dwelling ❑ Commercial/industrial Accessory building
For special Info l ".:
Description rrrtalorruse checbhsS s ;; ;,,,:
El
Multifamily ❑Master builder ❑ Other: /
;; Qt Ea. 1 Total
n ;4 + 'alt.C �'' r':Rx l l ^ + :f'SIT i �, i!i Ory S1I1iI)N ;i;,aa p:,:i.,i
"; .sett , r , TN'F
,
..�OR1►�1Tti}fJ " Imo. ; ,.. ! Heating/cooling
t�/eool n
r , �/� /� /� Aar conditioning pl o heat pump
Job site address = (/y/ tsJ (/
(requires silo plea showing placement) 14.00 CC
City /State/ZIP: T ae ` (y q -i00 Furnace 100,000 BTU (ducts /vents) I.., 14.00 /4
Suite /bldg. /apt. no.: Project name: / [ e Furnace 100.000+ 871.1 (ductslvents) 17.90
Gas heat pump _ _ 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
o Residential boiler (radiator or
/124/n4 /� y 61u/de, 0 0 — C rL tic)
Unit 14.00
v� L-14 Unit heaters (fuel type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: 1 Lot no.: Other: 10,00
Tax map /parcel no.: Other fuel appliances
n��, «,,.,.r.•, ;:..., n.. i�, i�.i::,e,i.i ....,.,....,, ,...r, ., ......., ..,..r,,,,....,,•.,o,,..,.,.o,n . rrm n n v h r ,,,,,, ,, • , ib,onii.iii'ill! ' r ; !iii iff _. _
, ,,,.,•r•,rr,,,n,r,,,, r >f nrl,i, i .!a! ^:i;a ;i ,' i; li; a ': i ; ;, , , hr „ r,,: HI r a<„ �,,. r,r,,, : }, .
y ..,, , 6 .. a w, Water heater 10.00
fap,r� .: ;: ,,,,,,r,,,,.� , ; ln„ f,.,,,,,,„ fw. f,,, a+,:,,, r,, ,,.. }f „a�a� ":',;�?�a��._'.,^ t01�fli�7iF',.;�,OR•'K•Pdfl •. ,• �;, ,.I,thi "..nE,�•I,E�,•,,,,...,rl I ,6J',lf��:,,sp',•r ;' +:f
��l P�� lSi} �riSi l e�„ ad,., �.,.,,, e, y �� ye< ". •,: ,o�� „>v�., ........:.... ,..,. �.,, n�.,.:...,.,,, �:,.... iL, f,, � �l, t r..,, ,... ;'YY�! IeA'�
Gas fireplace 10.00
Flue vent for water heater or gas
' Ota.-// 90 f rho ca- react ' fireplace 10.00
—
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10,00
.. ,5r�',ru •Un „, ' °•,..>, ••s.rr', ',a:: { {._, . „ •I,�,,, �.r„� „,, ;,,,,, 5': ;�/,': Chimney /liner /flue /vent 10.00
l l Gi 11,•e, «alt x.6.,$6 :„ m i .. f'r $ , «, . j , 4 ..... , d r l i q,r.rr,,..„ 11 , 6,.,..g,,,,i i } t
nr ���xo, n n,ho ” �, R�' ���1. 1'; �I�}, �� r � 6 „rrn,nn�,,,,�, � ,,, ���.' p�Oih, x, nn „rr „!'i''aMU,d(�41'� ;I +!°I:”'
`�: ,,.,w,�.,,,x,,, ., . ,n�.h,,,�lii : fn�1, ,,,•'n „xrr . "� � � , .,.� �� „! ?� ,,.,.y ,.l� „ +, ,'' o
10 "00
Name: h(lL( .i 4 f Y L car s inz - �,/� Environmental exhaust and ventilation
y Range hood /other kitchen
Address: .
(, L• ( h cf
� ~r equipment 10.00
City/State/ZIP:
(� Ef Clothes Myer exhaust 10.00
) 69 flag ) toilet Sinet compartments, rtme (bathrooms,
utili ty rooms) )
6.80
Fax: ( corn rtmn roo
w
OePnntil. ; fi ,„,,, ., ' . ;: .. ,.r..,...,::.o.. do ,,,,,,,,...:.n,u:.r,,.. ;! . ;'„e „' . ,.•..°,. rt fi ;F S�,ijpa
i,., „ ,. • r ,;,. r,,, li, �: l d1i,„' a,. n„,. �":,,,.
, ” „ f ,I�,,.����•,,:�.P'a,!
,,,,'
� "r „r. ; r , : <'h,"T�: T'Y• �i,r ; ; °i•r,,!,r,:r.r,. „,r Attic /crawlspticefans 10.00
. ",ii; % i�,,.,1, .:IA,: fAa , N•. 1 1116 ;,Iu61o'1, , , ;,i8di, ; ? 4' N ,,..n,,, ,,t3b IG ''JyR .Qflt(
'15,�',18I•E:I$'�1'rriU,l.r.,• .�'.�'• !���, � E dJ, r ,.,.,.,,,v..... ,... ",��,..', �. , .hai9f5'611D• .:�rbdf
Other:
10.00
Business name: Fuel pip
Contact name: $5.40 for first four: 51,00 for each additional
Address: A Furnace etc.
;(/� Gas heat pump
City /State /ZIP: 41'all /suspended /unit heater __
,
Phone: ( ) Fax.: (( A) �I,y Water heater
E-mail: , i /e,r ' r a nV iI [• Li Wlm e
Fireplac
Ranee
..Lu ;�ri; YS;i :;i „ ",i i .;i i) �', " ��� ':7:i.7i ;'i ',y �_. ,
'lig'p lr.S .ii ;i `6F.iu' ;In,n•, :' ; ; ;L i, : "F..v, ::;1.. �'a,,q ;'l..i l'
{,.: Gr!ili,,..,'¢ {. ..ir barbecue
„,,,,' .,rs. .,,'. '.13P ' "'ll �'.. ,.,5,,,,,,;; �i,��•
" iness name: , 7-"' ,.,, , I , /, .r.76, .r.76, Clothes dryer (gas)
Bus
Other:
Address: [Y V g // .,:, :,.: ,, .4'il Y idlE ?CNt , TI'iirE
City /Stale/ZIP: "irt . 4 17 % Subtotal ar-
Minimum permit fee ($72.50) 2, dI/
Phone: / / ■ / 41,p Fax ! ) / " f/
Plan review (25% of permit fee)
CCB lie.: ii5134 State surcharge ���...w±++ . of permit fee) 6471- - ;:a j� '. IT FEE ern 1'.O
r no$1,.rml . 1x � ji tit nOt obtnined within OM
Sr
Authorized signatur �4� ; ;S�" t Q ns comt
re 9 f f,1 2
g /e j/e y Date:--21-0c3 * F ee d
• Print name: ! � .... _ .._ - ✓ - , -Cot • y B , mg Industry Service Board
CITY OF TIGARD
BUILDING DIVISION P ERMIT #: M E C200&00153
13 SW Hall Blvd., Tigard, OR 97223 ,� DATE IS SUED: �s.X001
Phone: (503) 639 -4171 ��i lli�l� .11/
j!/
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_s
:_.. G
INSPECTION WORKSHEET FOR DATE: 4/25/2008 TIME: 7:01AM PAGE: . 25
SITE ADDRESS: 11995 SW 119TH AVE CLASS OF WORK:
SUBDIVISION: LERON I•I[.:It,HTS NO.3 LOT #: 055 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: Installing - gas furnace,
OWNER: SMITH, DAVID & KARYN PHONE #: 503 - 590 -1609
CONTRACTOR: THERMAL FL:.O PHONE #: 503670 -83413
Inspection Request Scheduled For: Date: 1125f2008 Pour T VA-/
Code # Inspection Description Confirm # Contact # Me- .age
699 Mechanical final 088887 -01 503610 -343 Y
Corrections /Corn ents /Instructions:
b iliS‘r; c4..Q, ( lAit'LL'friC ,It.)
4 ). / . \, ,,/\ 4:15-- ')
`BASS . n PARTIAL APPROVAL n CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED / lir/6 eC Inspector: Phone #: Z
p Date: (503) 718 -