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Permit n CITY OF TIGARD MECHANICAL PERMIT • COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00633 TIGARD 13125 SW HaII Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/30/2007 PARCEL: 2S102BC -00111 SITE ADDRESS: 12530 SW BROOKSIDE AVE ZONING: R -4.5 SUBDIVISION: WALNUT ACRES LOT: 010 JURISDICTION: TIG PROJECT: JONES Project Description: Replace furnace with like kind, line chimney w /5" liner. CLASS OF WORK: ALT FLOOR FURN: EVARCOOLERS: 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: Owner: FEES JIM JONES Description Date Amount 12530 SW BROOKSIDE AVE TIGARD, OR 97223 [MECHJ Permit Fee 10/30/20C $72.50 [TAX] 8% State Surchar{ 10/30/20C $5.80 • Phone: 503- 329 -5637 Total $78.30 Contractor: ANCTIL SHEET METAL CO. 4320 N WILLIAMS AVE PORTLAND, OR 97217 - 2952 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 281 -0752 FAX 503- 282 -5722 Reg #: LIC 8897 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 OU NC by calling 503.246.6699 or 1.800.332.2344. Is ued By: AO Permittee Sig /Pp �, _,j r�] /r� Call 503.639.4175 by 7:00 a.m. for inspections that business d. y. 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. •.. Nedra kAal Permit Application - FoRoFI•lc. l sI ()NIA - . City of Ti acrd Reooivoii . g Date /By: ', Ar .. /./ 0.0 / 13125 SW Hall Blvd., Tigard, c�y;'1_ HI EWED Plan Review • S • Phone: 503.639.4171 Fax: 5',''.' - 8 Date /By Other Pezmil; T I c; A R!? Inspection Line: S O 503,639.4175 ' r 7 q 9 `) �u, 15 Ready /By: El See rage 2 for Internet: www,ti and -or. ov 1 1 {r 4 Nottt"oc/htethod: Supplemental Information r *' _ t A " 4 rt, 4 )V Ma icip . p- Q - t � M ', i i gif t'Fjir 5 S i� :i Ina y � -:.. � , dti,' r tti 'p 0 N 4 I, ' �"P '' 918 t1 nr G4 it xl iQ1A , 7 4 Y /y v erv e' m ,, .. ., . p M ' < µrc ties'° 1 ,K. i , t r f+It(.. :�. , I TJ ; . , - "nt51F���[�'�, " � }! ., , I , ">�+ ' ? s� �� 4� ::. d��d�' I � rL �.F ?�. � ;• Me h a nica � tt fees are bawd on the lue of t r , tl ` ! ' alteration/replacement �a ' t i . r : m1 H � � r, r! rr, performed. indicate the value (rounded t the nearest �!, New construction 1� Addition c work t dollar) of all 0 Demolition ❑ Other: r d� j mechanical materials, equipment, labor, overhead, and. profit. 'r , /V 'k f Ian M� k4' vt t v yc�y F ', 1 rik' �d1 ,i '�y°y(iTr "r � "Vt F111 ,r(Nlr r Value: $ ,y mq pyq v , / '.)\ A 1 A ' , ." f A 2r`..'Sl '' n r "' '"� „NA. - vr inl¢�li ° ,i r`al,I fFaYlrw�v 1� * --- / la� g' t rt, a a iYr7 i ■ �� ';�'.�:��d 2- funnily dwelling -�,�� ! ,., .,:'.r,� „y,M � '1 �� ' .,.. rr �( }��Ir� d���.1' r:� lr,r �l,w�eS;�oln. t � r's&r a ,. .. 1- an ling ❑ Commercial /industrial D Accessory building For special information use checklist. ❑ Multi family © Master builder ❑ Other: p , Qty, 1 Ea. l Total ' Description Heating/cooling wr w •. Q� , r v Y f t 9A Y'. r q 97 '" o i S goer 'I tE "! `(" S t1l' v A f I n j i . Heating/cooling J� 6 yti r Ikt�/ ; ;Ifi>l�r. ,. .�ii(r'klia / SFr } ?i Il az, r. l ,�1 r ;`. 4 Job site address: I' Air cgnd Or ] ieat Dump j K.� 5/ �_.t? �° �.Q re uirr s ire Aan showi .inecmcet 14.00 City /State/ZIP: A di G] Furnace 100,000 BTU (ducts/vents) 14.00 9 dr ' Furnace 100,000 BTi1(ducts/ve,us) 17.90 Suite/bldg. /apt, no,: Project name: (0 a, (has heat .um. 14.00 Cross street/directions to job site; _ Duct work 14,00 " "' . .. Hydronic hot water system 14.00 Residential boiler (radiator _hydronic) . 14.00 _ - Unit heaters (fuel -type, not electric), in -wall, in - duct, suspended, etc. 10.00 Subdivision: Lot tie,; - Flue/vent for any of above r 10.00 „-_ Other; 10 . fax map /parcel no.: Other fuel appliances ru „r,�,.. . , ���',.,,,.AV'S.'^' ...�ar.: �....... ���.,.,. , " , I , re ir,,.,..� . .".':::.. r':r.r�,,'.(. .�A.," ✓M1� t ., j'��r' ✓m. ., .. Ivies,:;•, rrie, it .h�. . ' p ,h ..,, , /w9 - :: ..i:ha ?i "j.`.i r..I.(,,1'fk::r�Yr��,.,r. w.l.l ;p ,, • : .,0 , . ; .4, Water heate' 10.00 r;�'.�', �IMYl;r���'vtr'Y.rur leer ".irY 4,:i �l,.i, , r 4 N��f� � Prf� �,vl:f�r"!; rrlX0wa,. r +�1 rl a Ji / 17 ��l� �; Y, nN + r „ Gas fireplace 10,00 ill• 2 • 1 if. Flue vent for water heater or gas tircPlace 10.00 A ' - .41 ,as. r . ..40 /, a .. '_-. 1.Ag (gas) 10.00 .. Wood/pellet stove 10.00 Wood fire. lace/insert 10,00 'v,,;,.�y'tipr. .r" q :5 d +? r .' r'.y" ny.. ;N n I ' ' J' . � y '; E{� 9 y ° 1 1 r �j Chimne /liner /flue/vent Mill 1 0- 00 a � t.� 1'AAli INri `A ! ' A 11nSp'l gr r' ti . p .9 .� / , (?' ,. `A��111�hYlQ!S r4 +Nhr�lk4�1a r ly":� !?y �'9M14'r1 � 1P �YA'k / 7;, Other; 10.00 Name; • i Environmental exhaust and ventilation Address; f Range hood /other kitchen 1�{' 1 1 iii G).= 1 / • L . equipment 10.00 City /State/ZIP: 'r^ ,,p !� f J yl� '� Clothes dryer exhaust 10.00 . Single -duct exhaust (bathrooms, Phone: (.. j , ��- „ ( j Fax: ( ) toilet compartments utility rooms) 6.80 s• e t + + r i / w I 1 r . {{t'Q I rr r' ,. , s . 4 ; , K+ X 1'6 4 4p :k : r �',� 4 ik61N + } , •� l ' ; : ,' " ?' Attic /crawlspace fans l . ().00 .).n.: ,,, , :; ),! h i, r4 .4A,, " ]i , r I.11)', YI' ' e' {',, q1 i Ai „ it;' ,S ', ... I alp ^i'F) ' , "'./'F^'"''' l , Y TI 10.00 1 r^ (� ti r�- 4 /� Other: Business name: � y) - 1 ' I e - /' ,4.:-'c' r 5 ., Fuel .1)11)1 Contact na me : r h •I } i -( w 55.40 for first four; $1.00 for each additional Address: T / t �00 �' Furnace, etc. r G as heat um City /State/Z1 ; 441 oe / �- Wall/ suspended /unit heater . - Phone:a�)�� ) . v Fax: ( mil a Water heater E S {` I / �� ircplacc E-mail: il ! L1 • I / L A 1. '! ang _ _ ' r' h !/ it . g: l iii • % J' A II' �- v " p \:v.VPY 1 , Iv ' + ` Gv " k riry ' vi�d'I J7v' i ,y 1, . i ` R - xv • r �+ d 1 v r iv' T 3 Y�rS(r , r', / +'FrS i die r�� �� -r � � Y. B a r b eCUG E ' � f 1 � d ' 1i4/ t v p , r�:lv M . v ay.0. v ' .,. ,,.. l4�li/ i Yurni,.r -01, �Ar�v ' ri ,6dµ 0 �, i t�+k r r r, ■ I fall ! ,vxxv�,r• r • Business name: �' 1 Clothes dr ay) 'i i: - � aw , S Y. Ir , . r 4 aU Mp 4 ;:r:'; a 1 Address > ._ Subtotal Minimum permit fee ($72.50) ' J City /Slate /711 - ..,.._ ,_ a i /d1 - �t�t7 � .'.. , , A i!` - r i „ ' a '' �;sn' ; ,y . " : „ ^ i�� �. Phone; ( ) Fax ( ) r Plan r eview (25% of permit fee) GCB iic.: State surehargc (8% of permit fee)U 1oTA1. PERMIT FEE 7 '9 -. 41 t This per'rntt application expires it a permit is not obtained wit to 1511 Authorized si nnturc: - days Deere it has been aceepr «i as compute, Print na Y1f 4n_ Date; 10 • �. Pee tnelhodoiogy::c[ by TA-count litilkling Indushy $■;rcrcr il,sad ! ZuiltIineV'crmn;,?,1I C Pc ern App rim 44/u10)„ n - In - ac, l , 'r (r I r1r2 /CQM/wv.e ) Id Wd9Z:SO ZBOZ 6E '4- ZZZSZBZ SBS : '0N dNOHd but 1003 2 6uII-te 1Il3NtJ : WOdd CITY TIGARD BUILDING DIVISION PERMIT #: MEC2007-00633 13125 SW Hall Blvd., Tigard, OR 97223 hAllytiptiphit,+\ DATE ISSUED: 10/30/2007 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ,..17VJAP-• INSPECTION WORKSHEET FOR DATE: 11/21/2007 TIME: 7:00AM PAGE: 68 SITE ADDRESS: 12;-:3o SW BROOKSIDE AVE CLASS OF WORK: SUBDIVISION: WALNUT ACRES LOT #: 010 TYPE OF USE: PROJECT NAME: JONES DESCRIPTION: Replace furnace with like kind, line chimney w/fTs liner. OWNER: JONES, JIM PHONE #: 503-329-5637 CONTRACTOR: ANCT IL SHEET METAL CO. PHONE #: 503-281-0752 Inspection Request Scheduled For: Date: 11/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 609 Mechanical final 060056-01 503-329-5637 Corrections/Comments/Instructions: ela=772/44/. 144 ih./ok. 9 7 - .V..0 7 6te.4.4C/4 PARTIAL APPROVAL fl CANCEL I I NO ACCESS 0 FAIL El CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: Date: //-/--a7 Phone #: (503) 718-