Permit ett. CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00515
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/29/2007
PARCEL: 2S104BD -04300
SITE ADDRESS: 13749 SW FERN ST ZONING: R -7
SUBDIVISION: ROSE MEADOWS LOT: 002 JURISDICTION: TIG
PROJECT: ROSENBLOOM
Project Description: Change out gas furnace and add a/c unit.
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: 1 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: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ROSENBLOOM, ROBERT H + SUE D TRS Description Date Amount
13749 SW FERN ST
TIGARD, OR 97223 [MECH] Permit Fee 8/29/2007 $72.50
[TAX] 8% State Surcha 8/29/2007 $5.80
Phone: Total $78.30
Contractor:
ALL FAMILY HEATING & COOLING INC
2315 -G PRINGLE RD. SE
SALEM, OR 97302 REQUIRED ITEMS AND REPORTS
Contact #: PR1 1 -503- 393 -4328
FAX 1 -503- 363 -4614
Reg #: LIC 171431
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 s fyji / f //
��, Permittee Signature: /, !l(a_-7 7 OY1
Call 503.639.4175 by 7:00 a.m. for inspections that business da
Y p 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.
Aug 27 07 03:12p ALL FAMILY HEATING 503 - 304 -7118 p.2
• 41002
'Meelanica1 Permit Apphcatfon FOR 91 1 1 i: E USE, ONO'
City of Tigard lteaemd S ZS SGN
i= .i tN o.:
l 13125 SA' Hall B1vd., Tiger4 OR 97223 Deorltiy; PI ���
Phone; 503. 639.4171 Fax 503.598.1960 c P1 Y , ■ ..
Dacil
Pennit
�.tc:tih;i, Inspection Llnc: 503.634.4175 Internet www.tigard- or.gov Nai sodadethod 0 See �scovEt
�thStitppkmeselL[etmatiaa
aim
::..,.......:::.:_i: .. .. - - ::4,, ..:. •.:.. . .. .. -- . _cal0 ':- :: s ®'vial: t;pgPcitiEtIc..
❑ New construction � ddition/ tiGgr l� k�� 1 Mechanical perm it fees ;are based on the value of the work
CD Demolition �.J Other. ��� �� pied Indicate the Ise (rounded to the neatestdol li r) of all
��0 medtanicalmaterials, imam. labor, overhead, and profit.
.. - •.0.- gGORY;OF;C,O,1winit1010 Value 60
and 2-family dwelling ..::.SFSIDE1176L• , i a *0/sifi iNtS:n.i .
izsr
y g 0 Commercial/industrial 0 Accessory building
Multi-family ❑ Master builder Othe r Far Tee inforznatton tar checklist
....
�c^P�n (qty. I Ea I Total
. . _ -. _ ::: JOB • SEE : IINFOBM&TION AND GOCATLON. :,.::'..: ; - .: - ; • : ::- :.: ' Hea6mt/enotlag •
rob site address: s 3 5 1A.) e_� n S . Air conditioning or heat . mp t
{moires me plan showing - -n 0 # 14,00 I t
Ciry /5tatelZIP: . 1. CO t ( - - 1 3 Furnace 100,000 BTU (. mt�+ona) 14.00 IL-1 cc.
Suitdbld�lept no.: Project name: Furnace 100,000+ BTU piactrt.•awl 17.90
Q_•YAp ct,, Cl•fY\ Gas heat pump 14.00 J
Cross stree /din:edema to job site: Ductwork - 10.00
F1 drone having= s systei, 14.00
Residential boiler (radiator or
ltydronic) 14.00 .
Unit beaters (fuel -type, run electric),
in wall, in- dugsi:cpended. etc 1
Subdivision: ( rot am:
for arty of above 6.80
Other. 10.00
Tax map/pasccl no.: Other tel &profiteers
_,.. - - ..., .. • ... QDi..,OR? ai'pitlC:'; _•.- water betlter
Gas fircytee 10.00
CA. �t t.trrr1 Cc C52- a{'OS Flue vent for wooer hesre^;ar ges r
o c fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Woodfireplace/insert : 10.00
: ::;- :: OERTY:OFVNI*. - :p .?.ENAWT.:._: :.• �evAilermuevent 10.00
Other 10.00
Nance: 1 o nn -� ( n C•Gh
2 � � L�kt`. r"+n Enrirtmmeodl exhaust and ventilation Address: l . ,L`1 ./. .. A 'r` 4''∎ Ran boad/onc�r kitchen equipment I O.OQ
Qty/State/213Lcc -(0 G2 S - / D ' Clothes dryer exhaust 10.00
Single-duct exhaust
Phone: (x - 9 L i -, _ c ( . t F ax: ) ioilct compartments, (batltllllo9,
. .::'43:j , _ 1
.:.:K...::-. .. ''. .. .. uhlitZroo� (x.80 ,
:. . ''....• : A110 .Lf1 •: ',k
L7 GgIVTA CT PERSON Anicrcrawl� ace fans 10.00
Business came: �. �n .Vti ` "� �� Other: 10.00
Fuel piping
Contact name : ( `
t era SEA for first fo t S1.00 for each iddidoata
Funu
Alddres L.4 - i � /� LJ _ " t lfle R p( Cray h tee, ere.
Gae heatpurnp
City/State/ZIP: ) c,,`ise"iv, 6
cl -73,C.). wall/9uspmdedluaitpcace
Piton: ( •I'' . j -`13 agi Fax:: Q F 63 - '4/e I r, Water bearer
p mai3: / Firepla
Range
..... CONTRACTOR ... : Hetbccue .
Business name: R-1. r , c . ] o0 Clothes Dryer (g$9 r
Add a �� ress: _ rn . .... e
GtyJState/7� 36 . Subtotal , w..
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• Phone ( -,�) > _ 4 3 fig- Fax: ic' 3 ' I • ' •. ' permit fcc 1572.50) , "7 3 5
,. 1 - 2 Platt [cvi ••. (25 °h 1.ERMI permit Fee) f
CCB lie.: t 12, - St are swab • ge (8% of permit fee) S - �}�
_ T • t AL T FEE '7 "- )
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Authorized signeN� , ) p *PP6 rys arrer it ._ ter soda& - - - Ito
rte d a a a mp within ISO
le
Print name: ti e.y l pate: - D-7_0- re, methodology set by r• untYBudding lens- i service Bead
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ill
Aug 27,07 03:12p ALL FAMILY HEATING 503 - 304 -7118 p.3
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ug+ 24 07 10:00p ria'mn Jacobson 364 - 829 - 5146 p.11
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00515
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED: 8/29/2007
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 '�' U..
INSPECTION WORKSHEET FOR DATE: 9/14/2007 TIME: 7:00AM PAGE: 54
SITE ADDRESS: 13749 SW FERN ST CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: 002 TYPE OF USE:
PROJECT NAME: ROSENBLOOM
DESCRIPTION: Change out gas furnace and add a/c unit.
OWNER: ROSENBLOOM, TRENT 8, MINELE3A PHONE #: 503 - 430.0031
CONTRACTOR: ALL FAMILY HEATING & COOLING INC PHONE #: 1-503- 398 -4328
Inspection Request Scheduled For: Date: 9/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 055574 -01 503 -430 -0031 N
Correct' ns /Comments /Instructions: k5f
Ki )t aeco,r1- e:-"A"-Q
7) /
/4 PASS n PARTIAL APPROVAL I CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ( I ADDITIONAL FEES ASSESSED
Inspector: \/(/k "e Date: ( -r 7 Phone #: (503) 718- ��Z�
CITY ,OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00515
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
- INSPECTION WORKSHEET FOR DATE: 9/70007 TIME: 7 :00AM PAGE: 56
SITE ADDRESS: 13749 SW FERN ST CLASS OF WORK:
SUBDIVISION: ROSE MEADOW S LOT #: 002 TYPE OF USE:
PROJECT NAME: ROSENBLOOM
DESCRIPTION: Change out gas furnace and add a/c unit.
OWNER: ROSENBLOOM, TRENT & MINELBA PHONE #: 503- 430 -0031
CONTRACTOR: ALL FAMILY HEATING & COOLING INC PHONE #: 1 - 503 393A328
Inspection Request Scheduled For: Date: 9/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 065147-01 503-430-0031 N
Corrections /Comments /Instructions:
!3/
/Rev 0.164-724---e C..45 ( - \‘ iwr G,ao
-'- (Xl�- GT -'O/L 44- 5-
•
•
n PA n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector:. Date: 9-7-6'7 Phone #: (503) 718 - 7A