Permit it CITY OF TIGARD MECHANICAL PERMIT
�IU DEVELOPMENT SERVICES
PERMIT #: MEC2006 00137
iiti I DATE ISSUED: 4/10/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S125DC 03300
SITE ADDRESS: 07105 SW BARBARA LN ZONING: R -4.5
SUBDIVISION: THE RAZBERRY PATCH LOT: 026 JURISDICTION: TIG
Project Description: FURNACE REPLACEMENT
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:
GAS 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
BLANCO, EDWIN AAND Description Date Amount
MARIE BLAKESLEE DE
7105 SW BARBARA LANE [TAX] 8% State Surcha 4/10/200€ $5.80
TIGARD, OR 97223 [MECH] Permit Fee 4/10/200E $72.50
Total $78.30
Phone: 503- 245 -5328
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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.
t
Issued By: 6 k,e Permittee Signature: � G
. 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.
Apr 03 06 11:1Op TriCount 5035570919 p.1
•
I i
0 .
Mechanical Permit Application V CE FOR OFFICE USE ONLY
' City of Tigard I R �. 13SWHall Blvd, Tigard, OR 972 ! D � Pet N Q Q� 7
.� P
Phone: 503.639.4171 Fax: 503.598.1960 4 ti . l .ri ` ;1 Date/Bv: Other Permit:
Inspection Line: 503.639.4175 APR 1 0 1 0 11 ,
ar d.or.us AF 1 V 28 = — + Date Ready/By: lu4j 0 Sec Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: •`� � Supplemental Information
.. -r- •,.::.'•'af+„r a -r•. •:. ., _ ?i' a .s :
.,n .
'1;,. .X: „4I` t.. ,. . �'.CO • }��, • . SCHEDULE' — t SE CX3:ECI{L1ST"
,��, _.:.• , ... - ...:
❑ New construction X Addition/ I erat o placement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
:.; #:y `'s`";•rvy `i:y'ePc E Qr�l) CON"STRE CTOIY:': .Gt:•. •, Value: $
AF O�' -' X .iii ��.,'.
1 - and 2- family dwelling ❑ Commercial/industrial Accessory building
y ❑ Master builder ❑ Other: " "' RESIDF,'rIFrXA;Z E Q'ClIE1VIE�IT /:SYSTE VIS. FEES*
For Multi p in formation use checidist.
i Description Qty. 1 Ea. I Total
"'''- -' O.B' A.T O_N .NII LOCXUO4 ::. Heating/cooling
Job site address: 9 lb Q Limo
�) Air conditioning or heat pump
LJ�� l"' (requires site plan showing placement) 00
Ci / State/ZIP: Fumace 100,000 BTU (ducts vents) 14. 14.00
ty
Suite/bldg. /apt. no.: Project name: •
Furnace 100,000 +BTL' (ducts vents) 17.90
Gas heat purru 14.00
Cross streeVdirections to job site: Ductwork 14.00
' Hydronic hot water system 14.00
Residential boiler (radiator or •
hydronic) I 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, susoended, etc. 10.00 •
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00 ,
Tax map /parcel no.: Other fuel appliances _
"` • r d !DESCKIPTIO N `i.OE:.: WORIC :: � : Water lease
- .., ,,, • . ' ..• . .;:.:_ ._._. -.. � 10.00 j ` p _ „ w „ Gas fireplace
i�"�'J'.%�.�(/]/(x,, Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) ' 10.00
. Wood/pellet stove 10.00
, Wood fireplace/insert 10.00
Chimney /liner /flue/vent 10.00
-'.❑: `EROEER'F*"',OWIcio ,it; * -,._ � ii 'r ,`2 ',Q :- TENN(ANT °'
Other: I 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen ,
equipment ' 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
c � Q Single -duct exhaust (bathrooms,
' E62,, I
Phone: ( Fax: ( ) toilet compartments, utility rooms) 6.80
-• craw ace fans
,,:. • ..: ':.. AEI'�:.IC'A1VT ';•: • b:�, • ' � • ` ,- ) a " ❑- '.CO �LT:Q:C���kERSON =. , :4;`;i:i ,Attic/ ispa 10.00
s.:. r .. , ..r: , . .:,....'. / . 1 _:._:. :d >'_,i - Other: 10.00
Business name: TO C)W T i'1 / L C (, j�
i F ue l i
Contact name: l l�lp ft4 II ' S5.40 for first four; $1.00 for each additional
('�� Y �t/i
Address: 0 i a) C. C CLCkfT C1f N v t l Furnace, Fuace, etc. 1
Gas heat pump
City/StatCity/State/ZIP: C1' C f (j C Q q 704_5 Wal /suspended/unit heater •
Phone: (50) 55 /290 I Fax:: ( ) 3 j 7- ! q ter
F replace
E -mail: Range I
r . , ,CONITR CTOR, '.-,- -,,,,, "r:: : ;.: -, :;; '" ':- ",_ Barbecue
i'
Business name: 1 I �L Temp } C 1 Clothes dryer (gas) .
l�J /, , '(' Other:
Add ress: / • . ' d( • D , ' lj P ,-. - :.,.-..: • ::, .I::' .:: ,. _ . ... . .. . -
L-S t l ; ?; :' :' .
:' - . . : .•; 111ECHr1N : PE721�%IIT:IEES��.
City /State/ZIP: Fes' 1 � , on 0 c k_ Ct Pip Subtotal
Phone: �j Fax: [�F Minimum permit fee ($72.50)
( 3 ` �� «—` �` (G� �/ / v l C Plan review (25% of permit fee) /
CCB lie.: "72110 1 State surcharge (8% of permit fee) rS a
TO PERMIT FEE
Authorized signature: a• � D �a0 This permit application expires if a permit is not obtain within
days after it has been accepted as complete.
Print name: bane Alum I Date: A ' Fee methodology set by Tri- County Building Indus y Service Board
is\BuildingTcrrnits \ABC -P tram App.doc 12'03 430 -46 I 7T (11102/COM/WEB)
CITYOFTIGAIP
BUILDING DIVISitA- ,
PERMIT #: IviEC2006-00137
13125 SW Hall Blvd., Tigard, OR 97223
14 DATE ISSUED: 4/10/200G
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/17/2006 TIME: 7:08AM PAGE: 87
SITE ADDRESS: 07106 SW BARBARA LN CLASS OF WORK:
SUBDIVISION: THE RAZZ PATCH LOT #: 026 TYPE OF USE:
PROJECT NAME: BLANCO
DESCRIPTION: FURNACE REPLACEMENT
OWNER: BLANCO, EDWIN A AND PHONE #: fiO3-245.f.i328
CONTRACTOR: TRI COUNTY TEMP CowrROL. PHONE #: 603-657-2220
Inspection Request Scheduled For: Date: 4/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 02812401 503-657-2220
Corrections/Comments/Instructions:
67 j 16/e_. Al/L5 Ilfe 5 5
/lac
•
PASS fl PARTIAL APPROVAL E CANCEL fl NO ACCESS
I I FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: 46— /7-6 Phone #: (503) 718- Z1