Permit A , � `- CITY OF TIGARD MECHANICAL PERMIT
I& DEVELOPMENT SERVICES PERMIT #: MEC2005 -00716
c�' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/25/2005
PARCEL: 1S134DC-10400
SITE ADDRESS: 11512 SW CORNELL PL ZONING: R -4.5
SUBDIVISION: TIGARD PARK LOT: 020 JURISDICTION: TIG
Project Description: Replace gas furnace.
CLASS OF WORK: OTR 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: 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
WHIFFIN, SHARON K Description Date Amount
11512 SW CORNELL PL [MECH] Permit Fee 10/25/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/25/20( $5.80
Phone: 503 620 - 3147 Total $78.30
Contractor:
ON TIME HEATING & COOLING LLC
PO BOX 231057 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97281
Phone: 503 803 - 3829
Reg #: LIC 162675
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- - 332- 23
y �Ir�%i7 /� �,�
I sued By: / ( /�� Permittee Sig • : re: , /i —
}
Call 503 - 639 -4175 by 7:00 a.m. for inspec • ns 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.
11/23/2005 2:37 5036503898 3M MECHINICAL PAGE 02/02
,f
Mechavical-Perrnit Ai I . n
Received
gf!plVECA.- • 10
' ' .it OrFICI: tiSt: ()MI • City of Tigard Date/By. e A. tic 4 Perrait34°
.13125 SW Hail Blvd., Tigard, OR 97223
f .r // AIM Platt Review ,...G- - ..i
Phone: 503.639.4171 Fax 503.598.1960 ........ n r T 2 20 , . Dete/By: ' Other Permit:
Inspection Line: 503.639.4175 tit/ 1 14 ' ., II
„5, j Date Roady/By: M El See Page 2 for
Internet www.ci.tigard.or.us N Supplemental Information
' CITY OF TIGARD
. :.:•.'..,:•; ''...;;. kji/44itl•YARP:,. ':::466•00.1
13 New construction XAdclition/alteration/replacement • Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
o Demolition CI Other: mechanical materials, equipment, labor, overhead, and profit
'i?;:■,4;,,,k•-"(:.:•,:::;..:,;.::‘::R..;;',:',:•::.'•;•;.,..;;;;',:e.:4fieeliii*O.totSt§iirateOsf,.Y.;.744:;;:,1*":,:t..11;:';',0.i'i Value; $ _ , .
P .•',.:,,.::,,...A....
hi 1- and 2-family dwelling 0 Commercial/industriat 0 Accessory building
For special iriformaiion use checklist
0 Multi-family CI Master builder El Other: Descri ... _1Qt_ . jy. as Total
l',.. Beating/cooling
Job site address: 1 I n -..... 0 (, 1 i0L., . Air conditioning or heat pump
(requires site plan Showing placement) 14.00
0
City/State/ZIP: a r`
' ' 1 9 - 2 --3 Furnace 100,000 BTU j 14.00
,
' f k l f -
Suite/bldg/apt, no.: I Project name: Furnace 100,000i- BTU (ducts/vents) 17,90
Gas heat puum 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system , 14.00
• Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
. ' in-wall uet, suspended, etc. 10.00
Flue/vent for any of above I 1 i 10.00
Subdivision: . Lot no.;
Other: 10.00
Tax map/parcel no.: • • Other fuel appliances .
41.t Water heater 10.00
Gas fireplace 10.00
1600 (pta C-e_ 6eLS -E a Ge 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
''.::: . **4**0.*.t4,0i'. '.':,"..::'', ,'":::.. :,. other 10 00 —
Name: S\Aa r—, ("J_k ki r) Environmental exhaust and ventilation
Range hood/other kitchen
t
Address: .--- ( --p...._ S-.' eorKLA \ r.)1
equipment ' 10,00
City/State/ZIP: - a A (5a... ct-2 a.„)._--L Clothes dryer exhaust 10.00
f Single-duxh
ct eaust (bathrooms,
Phone: c..s5" ) ( 31 4 ') Fax: ( ) toilet compartments, utility rooms) 6.80
..:,..,:: 4':;A;;." ,,,,A. „.., „ ... Attic/crawlspne.eilns 10.00
Other: 10.
. Business name: Fuel piping _
• Contact name: ifitiASZIa-.),-.) . .. • $5.40 f firat four; $1.00 for each additional
— Furnace, etc.
Address:
Gas heat pump
• T Tle • rfrrii, • VW
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: ; ( ) Water beater
Fireplace •
E-mail: :.„ Range -
7:• .... :; 1 ,;:i?.: . ;:i4::!, , ,i;:4;j;' : i';.. : : :,4g;::;f:• : ,Y.:; Barbecue
, Clothes dier (gas)
Business name: C)n ) jyt Vt,..A.-CL 1V\
Address: ly 1 .. c .1% , V r A, i'..,i;1 . .. 0 . 7 % i .",:,.':.::',..'.-•'",!:
City/State/ZIP: ---Al a .,
f 09 - `i-7&I _ Subtotal
.....__ Minimum permit fee ($72.50)
Phone: &J3- Gq ) 3- "3c Fax! 6( ) ?,(..) 4 _(-- --- ph review (25% of permit fee) , 5 , Ir•
CCB ho.: • )6 r I State surcharge (8% ofpermit fee) 7 '' ;..7. •
-
r TOTAL PERMIT FEE
Authorized signatur - g . ilia p application expires if a permit '1 n ISO
et attained w ithi n
days after it has been accepted as complete.
_ .
Print name: 14 r 1/4 ,,,,, Date: 6 7 • Ao - Foo methodology sot by Tri-County auUding Industry Servite Board
i:tousainaNreorifistMEc-renompp.soo 11/03 44. , 617T (1 /01/COWV/E8)
I c
CITY .OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00716
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/25/2005
Phone: (503) 639 -4171 Ja i Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 59
SITE ADDRESS: 11512 SW CORNELL PL CLASS OF WORK:
SUBDIVISION: TIGARD PARK LOT #: 20 TYPE OF USE:
PROJECT NAME: WHIFFIN
DESCRIPTION: Replace gas furnace.
OWNER: WHIFFIN, SHARON K, PHONE #: 503-620 3147
CONTRACTOR: ON TIME HEATING & COOLING LLC PHONE #: 503-803-3829
Inspection Request Scheduled For: Date: 11/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020209-01 503-620 y ( ( . enj
C rrections /Comments /Instructions: CQ ��
Pil od /dam ,/ --e/›. 4...0 0A m /4147
.611111 °)ij RA -4
/1 • ( . •
„A 1
fi)(-7 .
i 1
PASS n PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
1 FAIL ^ I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i ��^- Date: 1 I / 0 Phone #: (503) 718 -
CITY OF TIGARD 7
BUILDING DIVISION PERMIT #: MEC2005-00716
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/25/2005
Phone: (503) 639 -4171 I��ipj�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 82
SITE ADDRESS: 11512 SW CORNELL PL CLASS OF WORK:
SUBDIVISION: TIGARD PARK • LOT #: 020 TYPE OF USE:
PROJECT NAME: WHIFFIN
DESCRIPTION: Replace gas furnace.
OWNER: WHIFFIN, SHARON K, PHONE #: 503-620-3147
CONTRACTOR: ON TIME HEATING & COOLING LLC PHONE #: 503 - 803 -3829
Inspection Request Scheduled For: Date: 10/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 019713 -01 503 - 803 -3829 N
Corrections /Comments /Instructions:
1/' Ix" • ` � cldti ' ESLi
•
❑ • PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
AIL • ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4' —40) Phone #: • (503) 718-