Permit CITY TIGARD MECHANICAL PERMIT
I j. DEVELOPMENT SERVICES PERMIT #: MEC2006-00516
~' e 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/23/2006
PARCEL: 1 S133DD -09900
SITE ADDRESS: 11756 SW 125TH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 136 JURISDICTION: TIG
Project Description: Replace 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:
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
HARLEY KEICHER Description Date Amount
11756 SW 125TH CT
TIGARD, OR 97223 [MECH] Permit Fee 10/23/200 $72.50
[TAX] 8% State Surcha 10/23/20C $5.80
Total $78.30
Phone: 503 - 524 -3650
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 235 -0454
PRI 503- 235 -9083
Reg #: LIC 50244
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: � d a � 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.
10/23/2006 10 :14 5032350454 SKY HEATING PAGE 01
+ Mechanical Permit Application - -- HA( 'I.1•i6 li. I sr: O\IA
City of Tigard Received ■
III 4 137 SW Hall IIlvd., Tigard, OR 972 � �� 7 Flan R y' v �. Pcrmii No„ _ ��
• l� �
' Phone; 503.639, 417.1 Fax; 503.5981960 ' ` �� ovicw
Other P
]ns don Line: 503.6 39.4175 Dstealy. t r*nit;
T I (;A I. I 1 Date Rnady/By;
Internet; www.tigsrd or.gov OCT .r 2006 Notificdimetbod: ee PnRa z fF °r
Ste, /�{ I` S i 3appcmentnl reformation
Rat u v u 111- C'i Sba,
,
. ,.. 44 i:isa'•`.'�' lit /)sJP..'.' . �
_'.���tIC��' : �EftEb:� "' ''U�t�'It41�'`t:'
❑ New construction .
Mechsnica[ the value ofth ,1 „ ,
® Addititftl /ttlteratinnlrep[itccment permit fees* are based on the value of the work
[] Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
.r' , ;xrx ':iii `.,; 01Vt 11j* Value: $
CO l- and 2-Family dwelling Commercial/industrial w.• l Ac t
g ❑ dustria Q cssory building
❑ Other: --- For.rpectal /rlformariorr us' checklist"
❑ Multi - family 0 Master builder
Dcscniption 1 Qty. I Ea, j Total • 1.:,...4.::',•::,..; ' ; ' ''; RcaHnR/coolink
Job site address; 11756 SW 125TH CT Air conditioning or heat pump
(requires site plan sl'OWinpylaccmont) 14.00
City /State/ZIP: TTGARD OR 97223 - Furnace 100,00013TU (ducts/vents) 1 14.00 14 -00 _
Suite/bldgJapt. no.: Project name:
^ Pomace 100,0004- BTU (ductslvcnty) 17.90
- Gas heat pump 14.00
Cross street/directions to job site:
.Duct work 14 "00
drtmic hot ware, r system 14.00
Residential boiler (radiator or
hydronic) 14.00
• -" '-- - Unit heaters (fuel -type, not electric),
in -wall in -duct, suspended, ctc, 10,00
•
Subdivision: J Lot no -: Flue /vent for any of above 1 10 "00 10.00
Tax map/parcel no_: Other: - 10.00
Other fad appliances •
•••:..:. : 1E1 3&'b0*. k • ' • Water heater 10.00
REl?1f, CE .b 1 TRNACI? Gas fireplace 1.0,00 '
Flue vent for water heater or gas
fireplace 10.00
-- Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fircplace/insert s 10.00
) {� :i: Chimney er /flec✓vent 10.00
Other
Name: 1:1ARLEY .KEICH.ER
Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City /State/7_IP: Clothes dryer exhaust ^ 10.00
Phone: (503)5243650 Fax: Singlc -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) - 6.80
r )^ ;::i iliott *t ,, -" r : os''I`'.1tlC�`.i.: __ Attic /crawlspace fans 10.00 •
Business name: SEE BELOW Other: 10.00
Fuel piping
Contact name: $5.40 for first four: 51.00 for each a dditinna
Address: Furnace, etc.
Gas heat pump
City /5tate/7_1h: Wall /suspended /unit heater
Phone: ( ) Fax:: ( ) Water heater
E -mail:
. Fireplace
Range
-
o1w1
.., 11 .., IItvbeeue _
Business name: SKY BEATING & AC Clothes dryer (gas)
Other:
Address: 1635 SE NEHALEM
1YtXu,'; .'ttyy w
City /State/City/State/ZIT': PORTLAND OR 97202 t .' ,y., ;. Subtotal 24.00
Phone: (503) 2359083 Fax: (503) 2350454 Minimum permit fee ($72,50) 72.50
Plan review (25% of permit foe)
CCB .lie.: 50244 • /� State surcharge (8% of permit fec) 5.80
`Jf TOTAL PERMIT FEE 78.30
Authorized signature / [ Thix permit 4 p v iicatlon expire iifn permit is not obtAtned within t80
I da7s after it ban been accepted es complete.
n..;,. -.n�.n• TV A Al I /vbfxxnr•ii 1 ru...., 1 ni”m4 1 • Fri' teeihednlnev tM' i„r T.;.r. n,mty Rnikiinn harl,.H. ,v Cr*yiri' Rnarri
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MEC2006-00516
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10123/2006
• Phone: (503) 639-4171 t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1111/2006 TIME: 7:03AM PAGE: 58
SITE ADDRESS: 11756 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 136 TYPE OF USE:
PROJECT NAME: KEICHER
DESCRIPTION: Replace furnace.
OWNER: KEICHER, HARLEY PHONE #: 503-524-3650
CONTRACTOR: SKY HEATING & AIR CONDITIONING PHONE #: 503
Inspection Request Scheduled For: Date: 11/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036978-01 603-235-9863
Corrections/Comments/Instructions:
/Ai Scii-Arr ( - 71. /4/J S
I PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
I FAIL fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: 44, Date: //—i-- Phone #: (503) 718-