Permit li �� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00441
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/28/2008
PARCEL: 2S 103D B - 02500
SITE ADDRESS: 13490 SW GENESIS LP ZONING: R -4.5
SUBDIVISION: GENESIS LOT: 001 JURISDICTION: TIG
PROJECT: LOWRY
Project Description: Replacing A/C.
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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
DAVID LOWRY Description Date Amount
13490 SW GENESIS LP
TIGARD, OR 97223 [MECH] Permit Fee 8/28/200E $72.50
[TAX] 12% State Surch 8/28/200E $8 70
Phone: Total $81.20
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: i / mittee Signature:
Call 50 .• A175 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.
AUG -28 -2008 11:12A FROM: T0:5035981960 P.1
„,,, • Mechanical Permit Application FOR OFFICE: I.ltil. -ONt'V
,Tro City of Tigard R e ce ived
IN � Date/By
.v 13125 SW Hall Blvd., Tigard, OR 9722 jJ Plan Review , �r
. `Phone. 503 639.4171 Fax 503 598 1960 p 1 0% Dat y, Other Permit TI'9 A'KI `' Inspection Line' 503 639 4175 pGG 2 D Date Ready/By Iune H See Page 2 for
Internet: www tigard -or gov
Notified/MethodT" Supplemental Information
FT
C1' OSi0`
TYPE OF WOt1CYl�x1N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Othet. mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
6
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi - family ❑Master builder For special information use checklist.
❑ Other: RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Description
Qty Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address. 1 6 g 727 _ { �' to V v l � `� / /� r��� Air conditioning or heat pump c; ,
� �� L SJttY/ (requires site plan showing placement) 1 14 OD /4 W
City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 14 00
1 �� � Furnace 100,000+ BTU (ducts /vents) 17 90
Suite/bldg. /apt. no.: Project name: L7 A./ y Gas heat pump 14.00
Cross street/directions to job site. r7 Duct work 10.00
Hydronie hot water system 14.00
Residential boiler (radiator or
hydronic) 14 00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 14 00
Subdivision: Lot no.: Flue /vent for any of above 6 80
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water healer 10.00
(�j�
�„ `^ cor -hOtn Gas fireplace 1000
Y l r t l l 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
PROPS OWNER ❑ TENANT
1 (- //���
Other 1000
Name: ( (UIl Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10,00
City /State /ZIP: Clothes dryer exhaust to 00
Phone: ( ) Fax: Single duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6 80
A APPLICANT ❑ CONTACT PERSON Attic /crawlspnce fans 1000
Other
Business name:
10,00
Fuel piping
Contact name: iW ►L_'Y .00/1 f
._1J $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc,
Gas heat pump
City /Slate /ZIP: Wall /suspended/unit heater
Phone. ( ) F x:: ( ) Water heater
Fireplace i
E-mail. Range 1
CONTRACTOR Barbecue
Fax: (
Business nante•-a) Q [� ,� h Clothes dryer (gas)
13 LS® V r a 1 11O. 5 D' M tl/Yl Ot
Address: y i \i �/y MECHANICAL PERMIT FEES*
City/State /ZIP: ® V' ®� C dT ®R e -7 Subtotal /�/_tlu
�p�q
Phone: (=7 6`l ` - � t ' rt -i� 7 Qq � A �i Minimum permit fee ($7250) 7a,6
.
Plan review (25% of permit fee)
CCR iie • ` 24 State surcharge (12% of permit fee) `
• TOTAL PERMIT FEE �� an
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it bat been accepted as complete.
i
[Print name: Date: f r . t ! • •, j Fee methodology set by Tri•County Building Industry Service Board
i
1 lrwldineermiu\MEC•PcrmitApp sac DI/19/07 440- 4617T(II /Ca/COM/WEB)
AUG -28 - 2008 11:12A FROM: T0: 5035981960 P.2
�,.
04/22/2004 07 00 FAX 002/002
iiti INSTALLATION ADDRESS
--�_ PROPEitl'Y LINE
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PROPERTY LINE
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CITY OF OF TIGARD I \
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BUILDING DIVISION - PERMIT #: IvIEC2008-00441
13125 SW Hall Blvd., Tigard, OR 97223
. DATE ISSUED: 8/20/2000
Phone: (503) 639-4171 t
:N
Inspection Requests (24 Hrs.): (503) 639-4175 ,, - - - - -W `---'
INSPECTION WORKSHEET FOR DATE: 9/4120013 TIME: 7:02AM PAGE: 11
SITE ADDRESS: 13490 SW GENESIS LP CLASS OF WORK:
' 1 1
SUBDIVISION: GENESIS LOT #: 001 TYPE OF USE:
PROJECT NAME: LOWRY
DESCRIPTION: Replacing NC.
OWNER: LOWRY, DAVID PHONE #:
CONTRACTOR: 17,1 COUNTY TEMP CONTROL PHONE #: 603-557-2220
Inspection Request Scheduled For: Date: 9/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 075076-01 503557-2220 Y
Corrections/Comments/Instructions:
0 -:E'Le - c-rmtr-tat.-- I.A.A-L-1-1.A.A.,- h 4t;. s- / 46.6 z., IZII e1iet7---
% / AAr
---
ASS 0 PARTIAL APPROVAL 0 CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED
Inspector: Date: 9 4__C R Phone #: (503) 718- 7 „