Permit �� CITY OF TIGARD MECHANICAL PERMIT
• ill ' .• ' COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00591
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/22/2006
PARCEL: 1 S134CC -02800
SITE ADDRESS: 11965 SW 122ND CT ZONING: R -4.5
SUBDIVISION: YE OLDE WINDMILL LOT: 014 JURISDICTION: TIG
Project Description: Replace gas furnace.
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
RYAN MITCHELL Description Date Amount
11965 SW 122ND CT
TIGARD, OR 97223 [MECH] Permit Fee 11/22/20C $72.50
[TAX] 8% State Surcha 11/22/20C $5.80
Total $78.30
Phone:
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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: �� g Permittee Signature: (,
Call 503.639.4175 by 7:00 a.m. for inspections that busine — ss 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.
From: 11/22/2006 15:46 #536 P.001/002
. RPCFNED
CI of Ti and Keceived i -) �jl _. �/Q Permit No. <'
131 Hall Blvd., Tigard, OR 972234Ov 2 2 2006 Dnte/By: // ..4...".- /!C' (� 1 , C .t)t� C� 9 1
Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.19tiay &t
OF / ,, ' 1 1 Th.. p y;
Inspection Line: 503.639.4175 Q ��E1 nn 1_ ,:;. ? . 1.: ; ';y, D ate Ready/By: See Pa e 2 for
Internet: www.ci.tigard.or.us BhiLDI G IVIS - """- ` - ' ' "? /By' at Juru: g
Notified/Method: Supplemental Information
:: - > ;:t .- 6 TYPE OF WORK: .COMA RCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* arc based on the value of the work
❑ New construction Addition /aiteration/replacemettt performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
".' 4C CONSTRUCTION Value: $
:.:. :: RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
i� 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklisr.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Fit. I Total
.. ,... - Es „_.... :(, !: O*ISIT_ E 1NFQ TIOIY AND:LOCAT_ION, Heating/cooling
ii �y 1 I .1 Air conditioning or heat u
Job site address:
1 1 w S SI+J 4ZZ ,A___
(requires site plan showing placement) 14.00
City/ State/ZIP: T i S 6L. c/ 1 2,2:5 Furnace 100,000 BTU (ductslvenrs) 1 14.00 11
Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas hcatjiump 14.00
Cross street/directions to job site: Duct work - 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or I
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot Flue/vent for any of above 10.00
. Other, 10.00
Tax map /parcel no.: Other fuel appliances
:l, ';;= t ..iett , nei -:.b. R ifi Water heater 10.00
>a. - ,.o , .r �t�`., cDESCIP`TION ilQF,, , W.Olt7.
n / Gas fireplace 10.00
c. 5 r^ k ` c. r- ✓ ' V , 4 s / r.- // ` Flue vent for water heater or gas
ttt fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
�-
_,.:ai;,; QRO n, RTX U., Lt'r`: `_TENANT .
t,,..r�..- ... -...w: ::::";;::r'!:-::::r.:: .. _ Chimney /liner /flue/vent 10.00 Other: 10.00
Name: g e.,_ Aj ikit , `dLct. I Environmental exhaust and ventilation
� Range hood/other kitchen
Address: 1( (a 5 9,...) i 2-7 � r k equipment 10.00
City/State/ZIP: To , „ C . . . Clothes dryer exhaust 10.00
1 Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
:” ' += s:'`i; $ i j p X ,4.ir " CONTACT'. PERSON' . Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: !r LA" 514,-61.1-A-- SS -40 for first four; 51.00 for each additional
Address: 1 / Furnace, etc.
SA-- e oc..._i Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) 1 Fax: : ( ) Water heater
• Fireplace
E-mail: . Range
,, assn °; „';;'- s;.};tiTigi iRiM;:1 tM, . : .. - Barbecue •
Business MA � f t71/0/1)..16, Clothes dryer (gas)
/-� � Other:
Address:
c2415 / ! '7e !,7 L ti� . . , ,. MECHANICAL_ PERMIT FEES*
City/State/ZIP: /2j-/,1j1 B� r! 7�l2 Subtotal / y
�ftt77,. q i Fax: 53 Minimum permit fee ($72.50) - 2/ 5 .1 ) -
Phone:
(5' 3) � {! bf, l (� 217 so f_ E Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee) ce \,
TOTAL PERMIT FEE
-
Authorized Signature' This permit application expires if a permit Is not obtained within 150
days after it has been accepted as complete.
Print name: s \e .,2- Q_____ I Date: l ( � 2 I * Fee methodology set by Tri -County Building Industry Service Board
:an:::Ih,.,o p _wu,nan,.dne 12/01 440 -46171 (I I/0JCOM/WES)
CITY --OF TIGARD , -
BUILDING DIVISION PERMIT #: MEC?t 06 005 1
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/22/2006
Phone: (503) 639 -4171 A191, *OVA i Au
Inspection Requests (24 Hrs.): (503) 639 -4175 r
INSPECTION WORKSHEET FOR DATE: 1/4/2007 TIME: 7 :00AM PAGE: 30
SITE ADDRESS: 11955 SW 122ND CT CLASS OF WORK:
SUBDIVISION: YE OLDE WINDMILL LOT #: 014 TYPE OF USE:
PROJECT NAME: MITCHELL
DESCRIPTION: Replace gas furnace.
OWNER: MITCHELL, RYAN PHONE #:
CONTRACTOR: MA HEATING & COOLING PHONE #: 503.2342173
Inspection Request Scheduled For: Date: 1/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 8`41776-01 503-284 -2173 N
Corrections /Comments /Instructions:
!, EL c i Gq--L Gu.k ,e-- A-b i- 1* 5 le 6 7 2- 4 4re4 - �0/G1 e---1--/e r' z4
ASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
U FAIL n CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector:. Date: L— 4-- -4 7 Phone #: (503) 718 - 2- 447-,