Permit iu.
CI TY OF TIGARD MECHANICAL PERMIT
*4'%`r,,. DEVELOPMENT SERVICES PERMIT #: MEC2006 00135
�.��I DATE ISSUED: 4/10/2006
__.. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CC -03100
SITE ADDRESS: 08080 SW CHURCHILL CT ZONING: R -12
SUBDIVISION: BOND PARK NO. 3 LOT: 059 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVE5:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
•
BICKFORD, GARY J AND Description Date Amount
HELENE M
8080 SW CHURCHILL CT [MECH] Permit Fee 4/10/200€ $72.50
TIGARD, OR 97224 [TAX] 8% State Surcha 4/10/200€ $5.80
Total $78.30
Phone: 503- 620 -4814
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.
Issued By: �� 4 Permittee Signature: 41 et...-p Li - ref 4,..„
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.
Flpr. 03 06 12: 28a Tr i Count 5035570919 p. 1
1
'i echan Permit Application
FOR OFFICE.USE ONLY :-
City of Tigard t Ey/ 13125 SW Hall Blvd. Tigard O • 2 - 2 .� D �� Pe t No.:M �� Phone: 50.639.4171 Fax: 513 �it„w•;0 "' ///
Inspection Line 503.639.4175 w � °� ''� Dace/By: Other Permit:
In
sp ' '
Interne[: www.ci.tigard.or.us C ��,"'� y ,. Date Ready/By: : E] See Page 2 far
11 ohFied/Mcthod. mental Information I 1
.. �� :!. { "�i�[..3�j£i';'as+- x,: n.PR.lto .. 1 � Supple
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-1../.. ''-. If ' = CON mE" sc
' nurjE -:U CIIEC1(I IST
11 New construction aM @r atijie µ l1: p c
o a� p Mechanic m:it Iees* are based on the value of the work
ED Demolition performed. indicate the value (rounded to the nearest dollar) of all
w; , ' ti •
;a I ^ r mechanical mat equipment, labor, overhead, and
' profit.
is `; ,, : A'I1 1 j'' "OF :, : ' Value: $
, .. r A , r i t is J: SID T :EQ: NLEtvT.a SYSTE'TVIS::EEES*
1 - and 2 - family dwelling ❑ Commercial/industrial
❑Accessory building . .
❑ Multi- family ❑ Master builder ❑ Other: i, For special information use checklist.
— . �I! .
Description
Qty � Ea.
i . . '.IgB t
. ._ yy: . . 1S' ITg'PlE: OR�#pcT-t0 ' .:AriA ' - -i._ Heating/cooling
'Y 'P,OCi�?TO]`t.;;�: :�.. ea[ing / cooling
Job site address: S O W 6W C t r t a r ' j(I Air conditioning or heat pump
Ti bl q o.j4 61 Furnace site plan showing placement) i 1 14.00
City/State/ZIP: � um 100,000 BTU (ducts vents) i 14.00
Suite/bldg. /apt. no.: I Project name: • Furnace 100,000+ BTU (duets/vent 17.90 1
Gas heat pump 14.00
. Cross street/directions to job site: Duct work
14.00 I
Hydronic hot water system I 14.00 ,
Residential boiler (radiator or
hydronic) 14.00
• Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00 ;
Subdivision I Lot no.: Flue /vent for any of above I I 10.00 1
Tax map /parcel no.: Other: l I 10.00
Other fuel appliances
...,._. -....: -t DESCRIPTIOY:VifoRRF ;; . = .. . " . ?:;f,;=: W heater
' � �t.' 10.00
r t • I 0 J Gas fireplace 10.00
Flue vent for water heater or gas
fireplace I 10.00 '
Log lighter (gas) _ 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
-+ BROPERT? OWNER. l:;i ;K.= '4 Chimneytliner /flue /vent 10.00
1l�P�' r Other: [ 30.00
Name: Re � ° . bic
_ A -- I _ l Environmental exhaust and ventilation
Address: atilt) hood /other kitchen
equipment • 10.00
•
City /State/ZIP: Clothes dryer exhaust 10.00
Phone: Bo?, VL -4.g1 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
: : :
Y 'S .... _
rt;cy :. :4 = =`® <11?P. LI(hNT ":i� ';-' • .
.
..:: - .....: - <.. .---_ ,:.� . :��•COYTA.CTcPERSON:... - ;.:;. • Attic /craw lspace fans
_ 't 1000
Business name. I rI C(Lxtrrr J mp CON-fro I Other: I 10.00
7 _ • C /1 (� ((,� Fuel piping
Contact name:
55.40 for first four; $1.00 for each additional
Address: 0 isa) a CiaCkC(iron 1 V Vor 1 UC) Furnace, etc.
City/State/ZIP: (irr Cf C0 7v e R e( 7045 Gas heat pump
" j Wall/suspended/unit heater
Phone: (f0?)) S5'7 _ 2220 I Fax:: (=fi/'1'3x, J l 7 ) 5 G•7 1 rte] Water heater
E -mail: ` L � Fireplace
i.: _ : =� ;`.1' s. -fie. 4 r z.l,�,.;:t;. Range 1
- ;.. Barbecue
Business name: I ri CAL refne COr fre J Clothes drye ( g as) •
l,Il'' 1
Address: {{ /� ( � �� Other:
l :� ( Jt f \ ? • t �
U �i t I f ll f� RI �i I;...'- °: VLE 11VIC?:I'PEIiiYllT FEES'
City/State/ZIP: oreco�.�'1 ( Ot_ C{''7 Subtotal
Phone: ( ) 55 �/ I Fax- 0Q 6S'7 •6�] 1�� Minimum permit fee (572.50)
CCB lic.: l 2 l.-. t Plan review (28°/ of permit fee)
I
State surcharge ($% of permit fee
I rl D � � I TOTAL PERMIT FE f
Authorized Signature: /-t t This permit application expires if a permit is not obtal • i
/ +�� ^' days after It has been accepted as complete.
Print name: Z)t;a/�.e mas.50d� Date: a � ` Fee methodology set by :'ri - Count B uilding I
y try Service Board
i: Bu ildingTcmus \tt.C- Pc 12/03 440 -4617T (I I /02/COM/WEB)
CITY OF TIGARD 0. ._ ,.
BUILDING DIVISION , PERMIT #: IVIEC200E; OM 3.6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/10/2006
Phone: (503) 639-4171 mairop lit
Inspection Requests (24 Hrs.): (503) 639-4175 .,.„.....fafr — ■...is
INSPECTION WORKSHEET FOR DATE: 4/21/2006 TIME: 7:02AM PAGE: 69
SITE ADDRESS: MN SW CHURCHILL CT . CLASS OF WORK:
SUBDIVISION: BOND PARK NO. 3 LOT #: 059 TYPE OF USE:
PROJECT NAME: BICKFORD
DESCRIPTION: FURNACE REPLACEMENT. 4/13/06: ADDED NC UNIT.
' OWNER: BICKFORD, GARY J AND, PHONE #: 503-620-4814
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 4/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Ms ...■e
699 Mechanical final 028452-01 503 allIP
Corrections/Comments/Instructions:
.i
I I Oft
PASS 7 PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS
I FAIL 1 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: CH f Date: 2 /2-/ 0 (.::D Phone #: (503) 718-Z 41/14/