Permit CITY F T I G A R D MECHANICAL PERMIT
u,, I DEVELOPMENT SERVICES PERMIT #: MEC2006 -00004
= ., . ..�� - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/4/2006
PARCEL: 2S103BB -12100
SITE ADDRESS: 12105 SW ANN PL ZONING: R-4.5
SUBDIVISION: YE OLDE WINDMILL LOT: 040 JURISDICTION: TIG
Project Description: Furnace replacement
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:
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: 1
Owner: FEES
LON WILLIAMSON Description Date Amount
12105 SW ANN PLACE [MECH] Permit Fee 1/4/2006 $72.50
TIGARD OR 97223 [TAX] 8% State Surchar€ 1/4/2006 $5.80
Phone: 503 - 590 - 6696
Total $78.30
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact #: PRI 503 -579 -2250
FAX 503 -579 -9104
Reg #: LIC 108535
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This pen will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -001 -0100. Yo may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issue By . Permittee Signature: .$ // PL/ C4 7/0 ,../ Ca ll 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
is 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.
503- 579 -9104 P _ 02
Jatr -03 -06 10 - ° }• � {Li HEATI•NG & COOLING
1 , ,
Mechanical Permit Application , tut l 7 l It I ,i f ►� 1 ti
City of Tigard 1 JAN 0 3 2000 e,; / C4?O0‘ - dUDJ
43125 SW Hall Blvd., Tigard, OK 97223 Ds te /I ;y: y D6 V.. I 'w,nit No.: f 5
Phone: 503.639.4171 Fast: $ 3;5
Ilan Review
��91# 960 t �..:4. e' I Iinie/B t hherPcrir,li•
Inspection Line: 503.639,4175 1j u} "U °;' Y
Internet: www.ci_tigard.or. �y s�1 ^*� - . Date Ready/By: Jura See p ®g 2 tar
Ul�D � r" s: f(t7 I � �Ncvifed/Melhu T / supplemental InPora�„tlua
TYPE OF WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
❑ New construction 0 Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other
mechanical materials, equipment, labor, overhead, and profit, _
CATEGORY OF CONS'I`RIICTION _ Value; $
—
® 1 -and 2- family dwelling [] Commercial/industrial ❑ Acce Accessory building RESIDEN11AL EQUIPMENT /
SYSTEMS FEES"
111 Multi-family ❑ Master builder ❑ Other: f or special irtf e e checklist.
Description Qty. Ea_ I - Total
JOB SITE INFORMATION AND LOCATION _ IIeatinfficooling
Job site address: 12105 Sw, Ann PL Air conditioning or heat pump
(requires Rife plan showing placement) 14,00
City /Slate /ZIP: Tigard, OR 97223 Furnace I00 000 BTU (ducaNdmR) I 14.00 j °/ DtI_
Suita/bfdgJapt_ no.: _ 1 Project name; Furnace 100,000+ wry ((ducts/woo) 17,90
M
�! IA Gas heat pump - 14.00
Cross strect/direcl. to job site: Sw ran P1. & 12Ist _ ions work 14.00
•
iiydronic hot water s 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel - type, not electric), -
in -wall, in -duct, suspended, etc. 10.00
Subdivision: L - Flue/vent for @k
- w '- •- _.� Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10,00
Furnace Change out Gas fireplace 11100
y Flue vent for water heater or gas -
fireplace 10.00
Log lighter (gas) -' 10.00
� - -, Wood/ list stove 10.00
Wood fireplace /insert _ 10.00
[] PROPERTY OWNER Q TENANT - - Chimney /liner /flue /vent - 10.00
Name: Lon Williamson
.` O thcr: 10.00
Environmental exhaust and ventilation
Address: 12105 Sw Ann Pl. Rinse hood /ot},er kitchen -°
equipment 10,00
City /State /ZIP: Tigard, OR, 97223 Clothes dryer exhaust 10.00
Phone: (503)590-6696 Fes' ( 1 Single -duct exhaust (bathrooms, —
APPLICANT toilet compartments, utility rooms) 6,80
CONTACT PERSON Attic/crswlspace fans 10.00
Business name: Able Heating & Cooling, Inc Other 10.00 Fuel piping
Contact name: Pat Gates -
_ SS.40 for first four S1.00 for each additional
Address: Furnace etc.
City /Blatt /Z1P: (laa heat pump
Wall/su heater
Phone: (503) 997 - 4347 Fax: : ( ) Water heater -
f. -mail: Fireplace
Range S
CONTRACTOR Barbecue _ •
Business name: Able Heating & Cooling, Inc. Clothes dryer (gas) „_
Other.
Address: 12420 Sw. Summcrerest Dr.
- MECHANICAL PERMIT PEES"
City /State/ZIP: Tigard, OR. 91223
Subtotal •LNt:t)
Phone: (303) 579 -2250 Fax: (503) 579 -9104 _ Minimum permit fee 1.$72.5(1) 2- .St.,7
CC'S lie.: 140333 Plan review (25% of permit fee)
Suite surcharge (8% of permit fee) 5 • a p
TOTAL PERMIT FEE D
Authorized signature: This permit epp1Iearloo empires If • permit is not obtained within 180
d■ys after Ii has been accepted as compkte.
Print name: Pat Gates I Date; 1X116 I - Fee methodology set by Tri4 'nunty Building Industry Service Hoard i• UturldigglPemmstmi .U_•Perme,A 1 ? /03
440.4t17T 1 /COM/ WEH) -
CITY OF TIGARD { .,.., /r) e_--c- /
BUILDING DIVISION PERMIT #: , , 006 - 40
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �n iii i
Inspection Requests (24 Hrs.): (503) 639 -4175 ��! v tll - ''
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: is lo5 / 41/1'U "- _ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: •
CONTRACTOR: a c-Q__ PHONE #:
Inspection Request Scheduled For: Date: )– /3 6k Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 9? friee r cat g C/1 o C,2q,
Corrections /Comments /Instructions:
i
I
flI
r
, • /
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FE ES ASSESSED /
Inspector: Date: I/ 0 Phone #: (503) 718-