Permit C ITY OF TIGARD MECHANICAL PERMIT
a ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00188
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/15/2008
• PARCEL: 2S111CC -10200
SITE ADDRESS: 15800 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 129 JURISDICTION: TIG
PROJECT: PEACOCK
Project Description: Replacing gas furnace and installing 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
WILLIS & ROBERTA PEACOCK Description Date Amount
15800 SW GREENS WAY
TIGARD, OR 97223 [MECH] Permit Fee 4/15/200E $72.50
[TAX] 12% State Surch 41151200E $8.70
Total $81.20
Phone: 503- 624 -2704
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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.
r
Issued By: —_,-,-e ��. — Permittee Signature: 1Q G� ,
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.
Application i :- t�tt
Mechanical Permit A � � °c;•rr� lc t: t' st UNI;I
a.. ; City of Tigard a�� p $ y�i n
/ ' L�l -�
13125 SW Hall Blvd,, Tigard, OR 97223 �` �D p Review Q
1 Phone: 503.439.4171 Fax; 503.598. Other Permit:
ZIGA K11+ Inspection Line 503.639.4175
tY p r1 M Date Ready/13y: tuna: 6J See Paac 2 for
Internet: www.tigard- or.gov o9 ‘. 1• mined/Method; Supplemental Information tit, P 4 P-
.... TYPE OF WORK . _: ai._0.... cA lk ij . . • • CO FE E' SCHEDULE USE CHECKLIST ❑ New construction ,Additionlalteratiol / i �f� 'J Mechanical permit fees' are based on the value of the work
❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead. and profit
• CATEGORY OF • CONSTRUCTION . ' • Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
-and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For specsl rnformaron use checklist.
❑ Multi- family ❑ Master builder 0 Other: Des uon
P Qty. I Ea Total
. , . 40E1 SITE INFORMATION • AND LOCATION - . : Heating/tooling
Job site address: ) S7 ' ' . W G w; 1 �� Air conditioning or heat pump
/� t _ /v (u 4
(requires site plan showing placement) 14.00 r i l• U
City/State/ZIP: • Furnace 100,000 BTU (ducts/vents) / 14.00 (ti , (A)
Furnace 100,000-13TU (ducts/vents) 17.90 ;
Suite/bldg. /apt. no.: Project name: /2,e_Q f (_)Cl.( ..- G heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronie) 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: n o.t 5'
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . .. • ' Water heater 10.00
` Gas fireplace 10.00
e - / e/ e rj r 4 lea. Y) a c„ , Flue vent for water heater or gas
fire
-p1S *� 1/ . !, Log place 10.00
Log lighter (gas) 1 10.00
Wood/pellet stove 10.00
Wood fireplace/insert • 10,00
A - PROPERTY OWNER i • •ti • EN Chimney/liner /flue/vent 10.00
// ,, 11 Other: 10.09 _
Name: Pi e Ce. c__.-- G Pte. CA)) t /! S 3' led,.[ Environmental exhaust and ventilation
Address: ' i - Range hood /other kitchen
equipment 10.00
City /State/ZIP: Clothes d exhaust 10.00
��� p
Single-duct exhaust (bathrooms,
Phone 3 6ff !r ' 7 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT: ❑ CONTACT PERSON • .. , Attic/crawlspace fans • 10.00
Business name:
I Other: 10.00
/ '7)/1. / 1 Fuel piping
Contact name.
7 , I b V $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. ;
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: )63. LI - 2,-)Q f `LI Fax:: ( 9`3 )s G G - v x'26) Water heater
E -mail: ._ I Q Fireplace
Range
CONTRACTOR ' ' Barbecue
•
Business name: l(.yr2 b/ fk i 1 i.. Clothes dryer (gas)
Other:
Address: ge, N o x .2 0 3 9 -7 MECHANICAL PERMIT
City /State/ZIP: .---77 (y /R.. ..„ u 2 q -7 2-4'1 2-4'1 Subtotal
Phone: (52r) l j! 2- - -U # I Fax: (563 ) - q(p `. v-) i
Plan review (25% of permit fee)
CCB tic.: 7 di 3 9 r State surcharge (12% of permit fee) g r 7U
��f TOTAL PERMIT FEE u(, A)
Authorized signature: ,942- %I' This permit application expires if a permit is not obtained within 180
s� days after it hay been accepted as complete.
Print name: ,4 /h y Da te: ;p/ , Fee methodology set by Tri- County Building Industry Service Board
4 Y/
L' �& ild ;nglPennits6l�.C•Pern:irApp.aa 04/06/0O e .4 t�t'r t um!rnt.rwFn,
Z'd OLZ0 969 ONUNDH VI8Wf1100 0 69 1 01 90 171, Jdy
ar ezn a it
HEATING & COOLING, INC.
R.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN
ADDRESS: /2--e4.1--ro jeLki
d OLZO DNLLV3H d18Wl1OD e00: L L 90 1 adV
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008..00108
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/15/2000
Phone: (503) 639 -4171 J
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 517/2003 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 15800 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.2' LOT #: 129 TYPE OF USE:
PROJECT NAME: PEACOCK
DESCRIPTION: Replacing gas furnace and installing A/C.
OWNER: PEACOCK, WILLIS & ROBERTA PHONE #: 503-624-2704
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624 -2704
Inspection Request Scheduled For: Date: 5/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 069501 -01 503 -624 -2704 N
Corrections /Comments /Instructions:
a4--z_ ova_.. L : ' — /(d . ?r/ �-•(ze
•
� f
ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: i1�"a Date: :.> =7 —� Phone #: (503)
p � ) 718 -