Permit ' f •- V'•
CITY TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00594
DATE ISSUED: 11/27/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 103C D -07900
SITE ADDRESS: 13695 SW 118TH CT ZONING: R -4.5
SUBDIVISION: CREEKSIDE PARK LOT: 009 JURISDICTION: TIG
Project Description: Furnace install.
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:
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
BRUTCHER, JACK L + MARTI E Description Date Amount
13695 SW 118TH CT
TIGARD, OR 97223 [MECH] Permit Fee 11/27/20C $72.50
[TAX] 8% State Surcha 11/27/20C $5.80
Total $78.30
Phone: 503- 684 -9575
Contractor:
OREGON HEATING & AC(125185)
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815(SEE OHAC,
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: At .4 � /" Permittee Signature: 7 ��/ L► f �� — /� y` _
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.
Nov 2,7 06 08:54a MS Rentals, Inc. 503 - 537 -2172 p.1
- "Mechanical Permit Application r FOR OFFICE USE ONLY
City of Tigard hi; I° U Ai E J Received _ p f
-- Date/By: I ( 04. Permit No.(y\W1.491940 0 05917
13125 SW Hall Blvd., Tigard, OR 97223 7 Plan Review , `
Phone: 503.639.4171 Fax: 503.598.196010 V 2 f 2006 t_�, 1 thcr
`, Date/By: OPermit:
Inspection Line: 503.639.4175 Date Ready /By: rusis. 0 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGI. AE Notified/Method: r Supplemental Information
BUILDING DI \(ISIOi\l •
. . .. ' TYPE OF WORK •COMMERCIAL. FEE *• SCHEDULE USE CHECKLIST _
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.
CA TEGORY OF CONSTRUCTION ' _ Value: I
— RESIDENTIAL EQUIPMENT / SY. STEMS FEES*.
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other.
Description I Qty. I Ea. Total
• . •• JOB SITE INFORMATION_ AND LOCATION ' • . Heating/cooling
1 Air conditioning or heat pump
Job site address:
•. (Q f S S 14) I (E i C'T - (requires site plan showing placement) 14.00
City/State /ZIP: -11- 6,,tar OR , q- f)t Furnace 100,000 BTU (ducts %vents) • j' 14.00 1 ` ` " e
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: jA-ci'( is,arcFE2 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
,
.:.D , .
Gas fireplace 10.00
GY.t e. . Water Flue vent for water heater or gas
fireplace 10.00
• Log lighter (gas) I0.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
y iner /flue/vent • gJ: PROPERTY OVER . TENAik"I Other: 10.00
r
Name: J fi P4kb. C E(? Environmental exhaust and ventilation
Address: / j 6 $ 5 ui t (6 C-•r- equipment Range hood'other kitchen
equ 10.00
City /State /ZIP: (I Ca 2b G.(2 i -? a-K7)-4 Clothes dryer exhaust 10,00
Single -duct exhaust (bathrooms,
Phone: (5'653) ( 1(f,/. _ 4$7 ' Fax: ( ) toilet compartments, utility rooms) 6.80
.. .. crcm
❑ APPLICANT .. . , .. " ❑ . CO_ NTACT. PERSON" .... Atd wlspace fans 10.00
Other. 10.00
Business name: Oregon Heating and Air Conditioning
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: PO Box 397 Furnace, etc.
Gas heat pump
City/State /ZIP: Dundee OR 97115 Wall/suspended/unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2712 Water heater
Fireplace
E -mail: rasbelle@oregonheating.com Range •
.. • : CONTRACTOR • ••. •..•.: Barbecue
Business name: Oregon Heating and Air Conditioning Clothes dryer (gas)
Other.
Address: PO Box 397 •: I *. •• MECHANICAL PET2A� FEES
City/State /ZIP: Dundee OR 97115 Subtotal (1. -Gp
Phone: (503) 538 -2953 Fax: (503) 537 -2712 Minimum permit fee (S72.50) - 7..51
Plan review (25 %ofpermit fee) .
CCB lie.: 125185 State surcharge (8% of permit fee) . g-
f1/l. TOTAL PERMIT FEE 1 �Jw!`
i " " not permit application expires if a permit is ot obtained 18U
Authorized signature: days after it has been accepted as complete.
•
��/� set by Tri -Coup Building Indus Bo
Print name: % � ! Gi�fl�� L / � l �i'7 f>Z D a t e: � / /�� coo * Fee methodology d i; tiY Service
i:.F4di+ding'Pcmin EC- PermitApp.doc 12103 440-1617T (11i02/COM/WEB)
CITY OF TIGARD - .
BUILDING DIVISION PERMIT #: MEC7OO60O 4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2712006
Phone: (503) 639 -4171 it s- f.i
Inspection Requests (24 Hrs.): (503) 639 -4175 ' W A'__..
INSPECTION WORKSHEET FOR DATE: 1.I /30/2006 TIME: 7:00AM PAGE: 75
SITE ADDRESS: 13695 SW 118TH CT CLASS OF WORK:
SUBDIVISION: CREEKSIDE PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: BRUTCHER
DESCRIPTION: Furnace install.
OWNER: BRUTCHER, JACK L + MARTI E, PHONE #: 503-684-9575
CONTRACTOR: OREGON HEATING & AC(125185) PHONE #: 503 - 538 -2853
Inspection Request Scheduled For: Date: 11/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 040412 -01 503 -684 -3575 V
Corrections /Comments /Instructions:
0
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ' Date: /J o �-� Phone #: (503) 718 - �L9 /I