Permit r , f
'' CITY or TIGARD MECHANICAL PERMIT
IN
`- COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00358
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2007
PARCEL: 2 S 103 B D -03800
SITE ADDRESS: 11865 SW FONNER ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: ADAMS
Project Description: Install a/c unit and 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: 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ADAMS, PAUL T /PATRICIA Description Date Amount
11865 SW FONNER
TIGARD, OR 97223 [MECH] Permit Fee 6/19/200i $72.50
[TAX] 8% State Surcha 6/19/200i $5.80
Total $78.30
Phone:
Contractor:
CLAWSON HEATING
PO BOX 899
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 618 -9646
FAX 503 -665 -2375
Reg #: LIC 173219
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.
1 ,1 Issued : : h / Permittee Signature: / 'C/Z 6C?71
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.
,06/17/2007 23:43 5036652375 CLAWSON HEATING PAGE 02/03
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r tic `<>�ical Permit Applica� k 4
Received _
` City of Tigard R Permit No.
• 1 3125 SW Ball Blvd., Tigard, OR 97223 ,I, : :'`13 1 MR � "" ��G2� -- Co? Pl R eview
Phone: 503,639,4I71 Tax: 503,598.t960 Date /By' Other Permit:
1. c; ,i.,0 Inspection Line: 503.639.4175 l,6 CV OF T ( ni •
Dale Really /rty, lurk: Sec Page 2 for
IInternet: www,tigard- or.gov B t I D 1,G DLV $t®�K Notified/Meihod; I] & I ®
Supplemental information
" , ' ' T IE t�1)�' ~�ti1'ty1 K COfW�iiV)tliChdi1C. }',C'f t, rlc)ibI 1JS ottEck[,TsT
D New construction 0 Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
❑ Demolition E] Other: performed, indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, andprofit.
. - CA'l` tsO t'I/tiF'''COi' 7fRttCT1ON ' - Value:
,al 1- and 2- family dwelling ❑ Commereial/Industrial 0 Accessory building rh 1C ' 1 I 1�T' /.S'1'S71F'llIS S} -
For special informal /on use checklist.
0 Multi- fatrtily [] Master builder ❑ Other: Description Qty. I Ea. I Total
.Ail) X;iii .tl'vPOItM:� LOCA11 lv Heating/cooling
Job site address: / r Air conditioning or heat pump
�! t � �s !/ (requires site plan showing pt� cement) 1 14.00 I I`
City /State/ZIP` - dlf r 1 0 . 0 i f , 42- c' Furnace 100 000 BTU (ducta/vente) I 14.00 1
Suite/bldg. /apt - no.: Project name:
Furnace 100,0001- BTU (duets/vents) 17.90
this heat pump 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, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: F lue /vcnt-for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' tit' cit1niti -OF ' o• Water heater J 10.00
Gas fireplace 10.00
,. Flue vent for water heater or gas
fireplace I 0 -00
A /. AI i i . I_ . 1 Log lighter (gas) 10.00
Wood /pellet stove 10.00
-- Wood fireplace/insert 10.00
ri�m:wo TY'O 1L�'1t` - Q'7'Llv;�ll9''I Cltimncy /liner /tlue/vent 10.00
Other: 10.00 ('""
Name: ,/ ter_- -- Environmental exhaust and ventilation _
Range hood /other kitchen
Address: /` � j .�), p 't . ,.� equipmcrtt 10.00 - .
City /State/UP: /(T L c _. - d d'. C9. 7 -L 2 - -`J ('clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: •0 Fax: ( ) toilet corn attments, utility rooms) 6.80
' ❑ -AIPP .IC N7t f T; li CONtA Ets Attic/crawlspace fans 10.00
° " Other, 10.00
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Business name: Fuel tcl P i i -
Contact name: 55.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /Sotto /ZiP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Wafer heater
- Fireplace
E -mail: flange
, _ CONTRACTOR . , ' Barbecue •
Business name: t7_ 7 7421 Other:
Clothes dryer as
Address: "..d - /I e)
7 . '` 'li1tEeltAN''ICAL ll ttivillt EtS ' -
City /State %7I1 S /C..---1,-^ __ -_ Minimum permit lie ($172.50) 5]
Fax: ( �-
Pltonc :) - >,., ..v. Fax: ��p �� ?� Plan review (2.5% of permit fee)
CCR lie.: / 7u a /9 State surcharge (8% of permit foe)
, _ TOTAL PERMIT + + E '7 .,�j
ature` This permit application' expires If a permit is not obtained within 1116 Authorized si
/�� .:4d. . / / __ days after it has been nceeptri qa cnrnptete.
Print name: / •"157/-7Z- Date: gi / Fee methodology set by Tri- County Banding tnduglry Service Board
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CITY OF TIGARD'
BUILDING DIVISION PERMIT #: —b035"
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 / iaau�l�� � ii d" (I
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' 1 11.
INSPECTION WORKSHEET FOR DATE: 7�� 3 /o 7 TIME: PAGE: .cp
SITE ADDRESS: / / Q 4 c F 017444 ev 1 CLASS OF WORK:
SUBDIVISION: v OT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
� �,,�1 s CtE)R b ' �� v goo
OWNER: PHONE #:
CONTRACTOR: 'tj),,, ,i `14 PHONE #:03 o/f f' f/6
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspec Description Confirm # Contact # Message
34-14/ r v
Corrections /Comments /Instructions:
•
a PASS O APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A - aura - Date: / 4- 9°1 Phone #: (503) 718- Z‘gr
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