Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00263
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/23/2008
PARCEL: 1 S133DD - 16300
SITE ADDRESS: 11957 SW 129TH PL ZONING: R - 4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT: 199 JURISDICTION: TIG
PROJECT: CLANCY
Project Description: Installing gas furnace with fent
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MICHAEL & MARINA CLANCY Description Date Amount
11957 SW 129TH PL
TIGARD, OR 97223 [MECH] Permit Fee 51231200€ $72.50
[TAX] 12% State Surch 5/23/200€ $8.70
Total $81.20
Phone: 503 -579 -6672
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.
r
Issued By: Permittee Signature: ci��cr
Call 503.6 9.4175 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.
'` 4` From: 05/23/2008 09:51 11899 P.001/002
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Mechanical Permit Applicat CEIVEE
i7pit 01:1.1 CL CS:E C /NIl
'
City of Tigard c� Received
• 13125 SW Hall Blvd., Tigard, OR 97223M AY 2 3 2008 Daffy' Are-, " ' rmit No.: r .. , O p ,,•
' a Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
T I GA R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Read /H ]tais: ® See Page 2 for
- Internet: www.tigard- or.gov l.il i Ready /By:
BUILDING DIVISIO Notified/Method: Supplemental Informedon
.:era • ? 4 ,.1. '" t W O tt i* W W �. ,
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 0 Other:
_ mechanical materials, equipment, labor, overhead, and profit.
h - � j�7P��v9QY di4
:���' dei t 4T&GOBI OF, , 0a.: S t ,4 N k t ! Y (, , w, _„,_.,..�,., „
�I- and 2- family dwelling El Commercial/industrial ❑ Accessory building w A» d...�.�r'
❑ Multi For special information use checklist.
Y ❑ Master builder ❑ Other
.
_ _ Description I Qty, I Ea. I Total
' `� ' 0, ':f. ' ., JOH"�BTr$ l i I,; ,q T I t ,---, : ' t * ", } t'" * s' 1
,ar. � , „ : > if Heating/cooling
Job site address: lack-7 S l 'ZGt fi„ Air conditioning or heat pump t r l (requires site plan showing placement) 14.00
City/ State/ZIP: ; t p t - � Furnace 100,000 BTU (ducts/vents) i . 14.00 t
Suite/bldg. /ept. no.: Project �vrQ P 012_ () 22.3 roject name: ` /: r . Furnace 100,000+ BTU (ducts/vents) 17.90 .
lk s-�� t Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: I Lot no.: .. Flue/vent for any of above - , _ 6.80 LP $t7
Other: 10.00
Tax map /parcel no.: Other fuel appliances
se `. .' '',44 > , F 311, ` r ,, a u:I T O 0 o l i
1ii, . .:, lf` 3 '1 Water heater
.,.. kYa��e.: -c:Si ,. .,� _ ... t � Wat 10.00 i
s f--. (I 71 �.c Floc , J � ., Gas vent for water heater or gas
foe � 10.00
4 LCitC Flue vent
l� 5t1„ v n ,a (-- fireplace 10.00
d t `'a vC Log lighter (gas) 10.00 •
Wood/pellet stove 10.00
_ Wood fireplace/insert 10.00
C �`, . ), t, t.l.1:00". �f *10Wl*H rT l g n J R a , K t 4 W W ;Aa nh r7 47 Chimney/liner /fluelvent 10.00
•
10.00
Name: ; ' Environmental exhaust and ventilation
Address: `k \ J S LL.,. 1 C ] _ Range hood/other kitchen
1- 1 � l G equipment 10.00
1 City/ State/ZIP: (�A �- -�� 3 _Clothes dryer exhaust 10.00
Phone ( ) ! 1 Z F ( ) Single -duct exhaust (bathrooms,
_. : ( toilet compartments, utility moms) 6.80
4 V . 4: x ,: ®, . W ,,,�: k .T " `,- .1; 4 F 1., s t j 5 .v.: Attic/crawlspace fans 10.00
Business name: 10.00 _
Contact name: Fuel piping
$5.40 for first four; $1.00 for each additional • '
Address: _Furnace, etc.
Gas hest pomp
City/ State/ZIP:
Wall/suspended/unit heater
Phone: ( ) + Fax: : ( ) Water heater
E -mail: Fireplace
r.ae� >�.. ,�,, Ka., ,
Range
-ti � k,4 - . ,. ',..? . �, . ',.�`�` •S�M �<%�k,� Barbecue
Business name: p IN I A e `ar- top _ 4 ` lw � Clothes dryer(gas)
Address: 7_40k `5 V\S L• ` � I � D \ v� Other.
�{.} FF-�J . . 'c t i` Y.u� k
9 �4
City/State/ZIP: ?- l l 6k1 ,. , .., .� �F
(�• '‘):1,) Subtotal p,
Phone: ` °Z a-4 1 _- ur7 1 F'2. Z 'y ax: (`�jr,� 2 $'^t + r / t Si; inimum permit fee (572.50) `'� IG p
7 I y Y 4 1�a9 2
Plan review (25% of permit fee)
CCB l ic.: - 2 . .•4•2_
State surcharge (12% of permit fee) V .112
TOTAL PERMIT FEE 5'1.,,2,c,
Authorized signature: T his permi application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: V 1 ( 1G- lik«t Date: Cj - - j7 ' • Fee methodology set by Tri -County Building Industry Service Board
t:+ Building /Permits /MEC•PennitApp,doc 01/19/07 440 -4617T (11/07/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
MEC2008- 00263
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2008
Phone: (503) 639- 4171L 4�Ihu�iy l ° �
Inspection Requests (24 Hrs.): (503) 639 -4175 i "I ..
INSPECTION WORKSHEET FOR DATE: 7/31/2008 TIME 7:00AM PAGE al
SITE ADDRESS: CLASS OF WORK:
11957 SW 129TH PL
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT # : 19C3 TYPE OF USE:
PROJECT NAME: CLANCY
DESCRIPTION: Installing gas furnace with fent
OWNER: CLANCY, MICHAEL & MARINA PHONE #: 503.579 -6672
CONTRACTOR: AAA HEATING & COOLING PHONE #: 503.2134.2173
Inspection Request Scheduled For: Date: 7/31/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 073415-01 503 -284 -2173 N
Corrections /Comments /Instructions:
7 /a-= o CD
r C Em C/4-L L .Uj A4 446 #- 5-- G � a—.s 4-ca- 6,..,,a- G -,Ar
ASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL FOR INSPECTION Il ADDITIONAL FEES ASSESSED
Inspector: Date: 7 —3 / --- " Phone #: (503) 718-
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