Permit v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00586
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639A171 DATE ISSUED: 11/26/2008
PARCEL: 1 S134AC -02625
SITE ADDRESS: 11165 SW BOXWOOD CT ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT: 182 JURISDICTION: TIG
PROJECT: KING
Project Description: Replace gas furnace.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
EVELYN KING Description Date Amount
11165 D, OR 97223 [ MECH ] SW BOXWOOD CT
TIGARD, Permit Fee 11/26/20C $72.50
TI
[TAX] 12% State Surchai 11/26/20C $8.70
Phone: 503- 830 -2604
Total $81.20
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 -681 -0793
PRI 503- 620 -5643
Reg #: LIC 66578
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.
Issled By: O 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.
.NOV/26/2008/WED 09 :17 AM FAX No. P.002
ti r:1„ m•' •
Mechanical Permit A ) lication :.; ' FOR OFFICE USE ONLY .
City of 'Ixgnrd l �1R• 1 Rt.-•:- r � =-`� Received I � a � O p ; Permit No.: }-��-(,/v(/b l i/5g6
1 ii ' � � � ati Date/Sy: ! D
I
q 13125 SW Hall Blvd., Tigard, a'1 70,, _ . c' t. 4 , .' Pl an Review
l 11 Phone: 503, Fax: 503.598,1960 Date/Bey Other Permit
TIGARD Inspection Line: 503.639.4175 NOV, 2 ?r- S bate Ready/By: (r7 See Page 2 for
Internet: www,tigard- or,gov - Notified/Ivlethod: Supplemental Information
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t � :` ' ) , ' T`' n 4 1 _l r x.9.1\ 1' (t� X ., FE 5 P`C a 7.''''118. u
!`.:. :; i.. '. , t , � l 4i.,, x I ,:5� S S, ,: �' : .; ��i r,. 4 l�� c I �: �' - ...I .. ..: I.., ��:,. .. ,.
9 : _ I I' t ' Mechanical permit fees* are based on the value of the work
❑ New construction /alteration /replacemen performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit.
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,(,�., (�{ []7�}` � °,e,;,i- ;t .,;1 .,�. _rl;:,', � 'Value: $ _
J,� Iiff•' :1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building ', !:',' IT u'I ! :: ,. 5-. *,00 o,:q*:f 110 � 11rl=-P.y, �C '� „! ;, l tl:� �I - 3 .- , I- ; �,: I , r r i ! ' H la'I
[4 �1 1 ��
. Or special information use checklist.
❑ Multi family ❑Master builder r] Other: Description I Qty. Ea. Total
.; 4 ;',1 f .. .'a ! ,l JQB R i * .'TQ Q 1 k., P. ; i ! ; r::: ,H Heating /cooling
\ ` I Air conditioning or heat pump
1
Sob site address: i �� (. � J C 1, 1 � ( h e c (requires site plan showing placement) 14.00
City/State/ZIP: ` o 7--{•�l6..tt�,Q E +� , L Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 100.000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 0, 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
Flue/vent for any of above 6.80
Subdivision: Lot no.: I O.U4
,. Other: - _
Tax map /parcel no Other fuel appliances
I W ater heater 10.00 1 I
1 . r . ? . " „ ...... l Il i s I ” ' .:
. .�'I ,�i I ! ,'. l I, ! ,.. - Gas fireplace 10.00
'Flue vent for water heater or gas
✓ T - fireplace 10.00
i A..” L r 4 ' • Log lighter (gas) 10.00
M Wood/pellet stove 10.00
Wood fireplace/insert 10.00
f . i ... at k ' i . ' 1 t I ! A l r i I I , Chimney /liner /flue /vent 10.00 v
,L f ;t � t 11,'.., Q ER L I' Q '', ' � } ' , l . , :: •I I:, , l , l t 4 ,1 :,, ! w Other 10.00
Name: Environmental exhaust and ventilation
J , (NS
Range hood /other kitchen
Address: _ equipment - 10,00
City/State /ZIP: Clothes dryer exhaust 10,00
Single -duct exhaust (bathrooms,
Phone: ( ) 4 1 b-.-, , 014 Fax ( ) toilet compartments, utility rooms) 6.80
! 1 . 1 , 1 �' y-''� I I j� p F {: 1':C: Attic/erawlspece fans 10.00
. I ,.1.0.11.∎ L ! . . ' I',Ir'lCe.!i,;L :1 ;.. E 1 ! 1. - . , ,l, tad Y � tC Vf� i ..'i:l:::l. 10.00
Other: ,
Business name: Fuel piping
Contact name: 55.40 for first four; 51.00 for each additional
Furnace, e, etc.
Address: Gas heat um
City /State /ZIl': waii/sus ended/unit heater
Water heater
Phone: ( ) Fax: : ( )
Fireplace
E -mail: Ran c
--ri. ` 4; ! ' ,I c0.19.1 b.CTOR ! 1 'i 1 ' „ ' .,; .,..1. „' Eialbcue
Clothes dryer (gas)
Business name; Specialty Heating and Cooling, Inc.
•
Address: 7500 SW Tech Center Drive Suite #130 T''I i1 i LpE t�iiit§i !,',
City/State/ZIP; Tigard, Or. 97223 Subtotal
- Minimum permit fee ($72.50)
Phone; (503) 620 - 5643 Fax: (503) 681 - 0793 Plan review (25% of permit foe) -
CCB lie.: 66578 State suroharge (12% of permit fee)
TOTAL PERMIT FEE
6 . 2 .... 9 O_� , ` ,, • This permit applic expires if a permit is not plot within 180
Authorized signature: . n -- � i ' f ' l / J days After it has been accepted as complete
6
Print name: Andrea Drtpps Date: p/ 0 4 — • Fee methodology set by Tri- County Building Industry Service Boyd
t;1Building\Pertrl tWEC- PermitApp doe 01/19/07 440.4517T (I I /o7 /COM/WIoB)
IIIIROPPr
i
CITY OF TIGARD A
1 BUILDING DIVISION PERMIT #: IvIEC2008-00586
,
45
I 13125 SW Hall Blvd., Tigard, OR 97223 / ) DATE ISSUED: 11126/2008
,.._. It
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639- t(
4175
INSPECTION WORKSHEET FOR DATE: 1212Y2008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: i 1165 SW BOXWOOD CT CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO3 LOT #: 182 TYPE OF USE:
PROJECT NAME: KING
DESCRIPTION: Replace gas furnace.
OWNER: KING, EVELYN PHONE #: 503-830-2604
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 603-620-5643
Inspection Request Scheduled For: Date: 12/2612008 Pour Time:
Code # Inspection Description Confirm # Contact # Me .age
699 Mechanical final 079209-01 503-830-2604 N
Corrections /Comments/ Instructions: t.
/7(Ku \r-- (,/,,,, r - L77,‹ i
r / 9
\
\
ASS fl PARTIAL APPROVAL
CANCEL L I NO ACCESS
fl FAIL II CALL FOR INSPECTION lii ADDITIONAL FEES ASSESSED
Phone #: (503) 718- Lyz-cr
Inspector: Date:
____., _ . : , ,, . . , , . \ , l • '