Permit 1,
CITY TIGARD MECHANICAL PERMIT
* DEVELOPMENT SERVICES PERMIT #: MEC2005 -00568
'--�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/13/2005
PARCEL: 2S 102CC -05100
SITE ADDRESS: 13595 SW CRESMER DR ZONING: R -4.5
SUBDIVISION: BEREA LOT: 012 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:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
THOMAS, DORENE L Description Date Amount
13595 SW CRESMER DR [MECH] Permit Fee 9/13/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/13/200` $5.80
Phone: 503 639 - 0826 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 - 538 - 2953
Reg #: LIC 125815
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: gn,G( ./b Permittee Signature: 41 7L
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.
Sep 12 01:05p Oregon Heating and Air 503 - 537 -2172 p. 2
Mechanical Permit Ap i E EIVED FOR OFFICE USE ONLY .
Received 1 Permit No.: 0054
City of Tigard Date � �O's ! , ''�`
13125 SW Hall Blvd., Tigard, OR 97223 SAP 1 2 200 Plan Revi • Other Permit:
Phone: 503.639.4171 Fax: 503. 598.1960 far . � E I Date/By. 0 See Page ?for
Inspection Line: 503.639.4175 Date Ready /By:
Wri Supple rental Information
BUILDING Internet: www.ci.tigard.or.us CITY OF TIGA'�� Notified/Method.
TY 1� o' woliie DIVISION .. : ,.:
..
COMME1tCIAL FEEx. °S CHEDULE 'fJ
Mechanical permit fees* are based on the value of the wodc
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, c verhead, and profit.
Value: $
Gel £EGOI2]' . . NSTRLICTTON ' ., ; , :: '' . :,
... OF CO
._, % ". •YS FEE . S * ' 1 `
V end 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other. Description I C TT Ea- I Total
- : _JOBSITE INFORMATION. , :. TLOCATIO1sI - Heating/cooling
— � r ' Air conditioning or heat pump
Job site address: ' c n .�5� �tiL4 (requires site plan showing placement) 14.00
G �1 Z Furnace 100,000 BTU (ducts/vents) ( 14.00
City /State /ZIP: 17.90
t i./Vvedt Suite/bldg. /apt. no.: Furnace 100, BTU (ducts /vents) I Project name: Gras heat pump 14.00
Cross street/directions to job site: Duct work 14.00 14.00
Hydronic hot water system
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10 -00
Subdivision: I Lot no.: Other 10.00 Other Tax map /parcel no.: Water heater a appliances -
10 00
=•; - ?DE$CRLPTI ,. _ . , . _ 10.00
...:..:'.;.'z:._ .: .... . ... - __ _ .. . . . ..... ..... . .. ... • . . . Gasfrreplace
PLIA t --- 1 1 i a/ a LQ_ Flue vent for water heater or gas � � fireplace 10.00
Log lighter (gas) 10
Wood/pellet stove _ 10.00
Wood fireplace/insert 10.00
r , , _ _ Chimney/liner /flue/vent I 10.00
_' ; ,- .PRnPRT,X, ,O - _ 'Oh
1000
Name: n A �� ^ Environmental exhaust and ventilatit: n
X C-t/ ` Range hood/other kitchen
Address: ] 7j i` f t\ ,5 7. , equipment 10.00
:l � 10.00
� ��/ Clothes dryer ex
City/State /ZIP: ! lN/� Single -duct exhaust (bathrooms,
�� �j
��Y�`-' � (,) V 3 , 7 _ _ _ ( ... ) toilet compartments, utility moms) 6.80
. _ ..;_. <:;•:r
Phon ) �. .� � Fax: _.. 10.00
:.... - A .,..\ cra sp ce fans
Attic/ 1 a
;c y PL CANT . _- C ONTA . C 'l ' : EERSOhl : ;;` ± - 10.00
�-- Other.
Business name lotJ I �- �`� Fuel piping
c � first four; $1.00 fo each additional
Contact name:�� �� J ` 55.40 for
Furnace, etc.
Address: e ° n Gas heat pump Cit /ZIP: 41111) ( . 01 n a s- Wall/suspended/unit
` n Wall /suspended/unit heater
�7 Water heater _
Phone. _I ) . Fax.. — ) I �I �
• .■ � ` Fireplace
E- mail: a g e
Business :_ :: � .:..:' :'CO ue
►\ I`7TRACTOR ..
s e `"v' n C , Clothes dryer (g
name 4/ /�' r� b f�Q r�(AJy Other:
Address: & A . y, • I Jai J McHAN1'CAX.: PERMIT FEES *i: =' :::'''r','` City/State /ZIP: 1/� ! Subtotal Cl / I 1 L`) ( ) ' . �1 6I-L- 1 Minimum permit Fee $72.50 `J �� t/
Phone: 613 113 s � I ra / r � 3� v 17 Plan review (25% c Eperrnit fee)
CCB lie.: ' State surcharge (8% c f permit fee)
111 • t TOTAL, PE I MIT FEE
I ` / f This permit application expires if a permit is not obtained ithin 180
Authorized sI attire a ` • S •) , 1 II / _� ( ��u 5 days after it has been acre ded as complete.
c 1 :: 7 �'y/� - Fee methodology set by Tri- County Br .lding Industry Service Board
Print name: - , It ' t SN I, Date r
ft
l: \Buirdine\Permits\MECPermiLADD. doe 12./03 440-4617T (t vo2/COMrwra)
CITY OF TIGARD
, BUILDING DIVISION ?_ PERMIT #: MEC2005"00568
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 /inN�i��ll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:01AM PAGE: 122
917-1.- L� ter-
SITE ADDRESS: 13595 SW CRESMER DR CLASS OF WORK:
SUBDIVISION: BEREA LOT #: 012 TYPE OF USE:
PROJECT NAME: THOMAS
DESCRIPTION: Furnace replacement.
OWNER: THOMAS, DORENE L, PHONE #: 503 -639 -0826
CONTRACTOR: OREGON HEATING + A/C INC PHONE #: 503-538-2953
Inspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # M- : - • -
699 Mechanical final 018116.01 503- 538 -29553 Y
Corrections /Comments /Instructions:
1A!c1C-. 60 "
I I
rr�� PASS [ APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL /CA FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: > Date: / l Phone #: (503) 718 -