Permit ♦ N'
CITY TIGARD MECHANICAL PERMIT
4 DEVELOPMENT SERVICES PERMIT #: MEC2006 -00439
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/12/2006
PARCEL: 2S104DC -00500
SITE ADDRESS: 13398 SW BENCHVIEW TERR ZONING: R -4.5
SUBDIVISION: BENCHVIEW ESTATES LOT: 005 JURISDICTION: TIG
Project Description: Gas furnace change out, AC install, ductwork alteration.
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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ART CORNELIUS Description Date Amount
13398 SW BENCHVIEW TERR
TIGARD, OR 97223 [MECH] Permit Fee 9/12/200E $72.50
[TAX] 8% State Surcha 9/12/200E $5.80
Total $78.30
Phone: 661- 400 -4001
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 266 -3478
PRI 503- 266 -1249
Reg #: LIC 14008
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: 4t, Agal4 Permittee Signature: c.
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.
' • ,
,
• City of Tigard EC VED 40 Received /MEV ,
Pulpit No.: lUc ii".
13125 SW Hall 131vd„ Tigard. OR 97223
Phone: 503.639,4171 Fax. 503.59t1.1950Ep th n 47 0' 1 0114 'i i ` Date/Sy: Other Permit
Inspection Line: 503,639.4175 u 5 2006 41, i"'411 Date Ready/By; •lwiis: RI Seetge2 ro
Notified/Method: Supplemental Information ]
CITY OF TIGARn _
0 New construction CirAddition/alterati wf„...fRemp..1, D i Mechanical permit fees* are based on the value of the work —
pm Indicate the value (minded to the nearest dollar) 01;111
121 1- and 2-family dwelling 0 Commercial/induStrial 0 Accessory building
For special information use checklist
Air conditioning or heat pump
lob site addre_sr
Furnace 100,000 ETU (duets/veinS) 14.00
City/State/ZIP: - r _ A 0 7.- il 7 Z 2-3
Suite/bldg./apt_ no.; . Project name:
' Oas heat pump 14,00
Cross street/directions 10 job site: . , Duct work / 14.00 gli -..7" ,
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
— Unit heaters (lliel-type, not electric), '
in-wall. in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.:
Other fuel appliances
Gas fire, lace 10.00
4 , fireplace 10.00
Log lighter (gas) 10.00
Wood/ ellet stove 10.00
Wood fireplace/insert 10.00
10.00
Range hood/other Idtchen
— Single-duct exhaust (bathrooins,
toilet conrnents utili rooms) 6.$0
Business name;
Fnel piping
Contact name;
• $5.40 for first four; $1.00 for each additiolial
Address:
City/State/ZIP:
Furnace, etc.
- Gas heat pump
r w im at p e l r a h c e c ater
Business name: • b / _eot 0 Clothes dryer (gas)
—
A /1 F Plan review (25% of permit fee)
. State surcharge (8% of permit fee) c ,t7 a
/ 44:)z I I P . _ ,0, 0 ,0,0...
TOTAL PERMIT FEE 7g , 3 0
Authorized signature: , This permit appfigatiOn expires If a perbtllilled within 180
0 I% days after It has beep accepted as eomotete.
09/08/2006 l6:26 15032632513 ROTH MECHANICAL PAGE 03
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CITY OF TIGARD
. s f
BUILDING DIVISION PERMIT #: MEC200 &00439
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2006
Phone: (503) 639 -4171 �"s n�"
Inspection Requests (24 Hrs.): (503) 639 -4175 � "IL..
INSPECTION WORKSHEET FOR DATE: 2//2/2007 TIME: 7 :05AM PAGE: 52
SITE ADDRESS: 13398 SW BENCH VIEW TERR CLASS OF WORK:
SUBDIVISION: BENCHVIEW ESTATES LOT #: 005 TYPE OF USE:
PROJECT NAME: CORNELIUS
DESCRIPTION: Gas furnace change out, AC install, ductwork alteration.
OWNER: CORNELIUS, ART PHONE #: 661 -400 -4001
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-266/249
Inspection Request Scheduled For: Date: 2./ 1212007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 043235-0/ 503- 266 -1249 N
Corrections /Comments /Instructions:
f�c.4 c/
PASS 1 1 PARTIAL APPROVAL fI CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 -
•
CITY OF TIGARD u ;� •
BUILDING DIVISION PERMIT #:�;:„
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/7006
Phone: (503) 639 -4171
A i ,�i�llti t
Inspection Requests (24 Hrs.): (503) 639 -4175 '''f �..
INSPECTION WORKSHEET FOR DATE: 9/2&7006 TIME: 7:06AM PAGE: 7
SITE ADDRESS: 13398 SW BENCHVIEWTERR CLASS OF WORK: ,
SUBDIVISION: BENCHVIEW ESTATES LOT #: 005 TYPE OF USE:
PROJECT NAME: CORNELIUS
DESCRIPTION: G furnace change out, AC install, ductwork alteration.
OWNER: CORNELIUS, ART PHONE #: 661 - 4004001
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-266-1249
_ • Inspection Request Scheduled For: Date: 9/260006 Pour Time: 1
Code # Inspection Description Confirm # Contact # Message
610 Gas line 037170-01 503 - 5197115 Y
Corrections/Comments/Instructions:
x. 444.- Lbirs7,z ; , c:G ac. -L.- --- : Lii4s4G eirra.".7
iJ iP s
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L i ..............„. „,e' '-' ,
ASS [ 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ACALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: ' ' -2. DG Phone #: (503) 718- c'