Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00080
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/7/2006
PARCEL: 2S108DA -02801
SITE ADDRESS: 14895 SW HAWK RIDGE RD ZONING: R -4.5
SUBDIVISION: GRAYHAWK LOT: 003 JURISDICTION: URB
Project Description: Gas furnace install.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
CHISM, MARK E + HEATHER J Description Date Amount
14895 SW HAWKRIDGE RD [UMECH] Permit Fee 2/7/2006 $72.50
TIGARD, OR 97223 [UTAX] 8% State Surcha 2/7/2006 $5.80
Phone: 503 -590 -0621 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact #: PRI 503- 640 -3607
FAX 503- 681 -0793
Reg #: LIC 66578
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: Permittee Signature: /� ��n ,
/// 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.
02/07/2006 09 : 14 FAX a 0 0 2 / 0 0 2
f.1
Menalikal Per r. t .1.ibirill FOR OFFICE USE ONLY
5 ,-' 7 _ ::•!"
City of Tigar Received A
Due/BylA 1 Cq, lip 6 Ferrnit No.; C7-( - 'b' — (
13125 SW d Hall Blvd., Tigard, OR 97223
Plan Revie
Phone: 503.639.4in Fax; 503.4791B6o0 7 2006 A Other Pensiir
&int:NI/if, Daceiny;
Inspection Line: S03,639,4175 "
Bete Ready/By n See Page 2 for
Internet: wv"v.ci.tigard.or.us
Wont-led/Method; =
CITY OF TIGARD Supplemental Information
, ''. ,'.::. ,.; .:',', - .),....;iiii;',.:;•:`. .. -,.,' ' ... , R - 1.7 ' ';'.y ..i'' „'comiaxt.ciAt FEE* ;SCIJEDULE - USE'CRECICAST
New construction El Addition/alteration/replacement Mechanical permit fees are based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) at' all
O Demolition El Other: mechanical materials, equipment, labor, overhead, and profit
::; CATEdO'P1( b# . CoSig.p* I ii , lo. Value: S
.: , • .
1- and 2-family dwelling D Commercial/industrial RESIpOITTA:L EQUIPMENT/ SYSTEMS FEES
mercial/industrial 0 Accessory building
or in
Ef Multi-family 0 Master builder 0 Other: Fvecial nformatio use cheekily,
Descnption Qty. I Ea. Total
1;:'.76ii.,prii LOCA±ION .,,:,. ,,,. , - Heating/cooling
Job site address: Air conditioning or heat pump
Hi c" C
cl,........) -1,- e-"... (e_ ‘2, ' ct g ., t2 4 ,. (requinin site plan ghowing placement) . ... , 14,00
Cty/State/ZIP: Te '5 , c) ,....,,L Ch-2-2-1 Furnace 100,000 BTU (ducts/vents) _ [4.00
Furnace 100,000+ BTU cductsiyorits) 17.90
Suite/bldg./apt. no.: Project name;
Gas heat pump 1,1.00 I
Cross street/directions to job site: Duct work 14.00 ; I
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14 00
- -- Unit heaters (fuel-type, not electric),
in in suspended, etc. 10.00
]
Subdivision Lot : Flue/vent for any of above 10,00
: no. - -
Other: 10,00 I
Tax map/parcel no.: Other NCI Appliance.%
1
,' - ':.: • '.;'. ' : dikkkjp:tiaM:07;,*uc .. : , , ,.,; ,.. : 1 ;1,11.. . . ,. .:.,,, 1 water heater 10.00
-
_
,. , „„
Gas fireplace I 10.00
Flu vent for water heater or gas
cg--•(-6--z fireplace 10,00
Low lighte_igas) .
S ( .
10,00
- . ,
Wood/pellet stove 10 00
Wood fireplace/insert 10.00
.„ chimncoinermucivcrii 10.00 ! .
P4 , L' ,.. !r. , ‘.:' -.:' Er:M . :i.i : . :., other: 10,00 I
Name: 1/1(,:t...,...t.,L_ CL-. Environmental exhaust and ventilation
Address: Range hood/other kitchen
,
I
equipment 10,00
City/State/ZIP: Clothes dryer exhaust 10.00 1
- - sin exhaust (bathrooms,
phore: (SV 3 ) s C) (.1, 2 i Fax: ( ) toilet compartments, utility rooms) 6.10
I I ' ' ' 0" """,',•',' l CONTA;CE.PERSblY, .i ''' ',
, 'd : . '. . ... Actic/crawlspace fans 1 10.00
Other; J 10,00
Business name: S ,•-r k; r ‘ I-- c c -1 ( 1.--,( Fuel piping
1 • J
Contact name: _± t f.- v E Cs.- (--' I Y 'Th- ; $5.40 for First four; 51.00 for each additional
- Pt ( 2_ L: Furnace, etc-
, Addrcss: .-. S' 6 c E L ,..„' - rC C' L. C C .. '-•v r_.> Gas heat pump _
C
Ciry/State/ZIP: 7 t - er a ‘. ct , C Ji 1 )-. 2_2_ 3 Wall/syspended/unit heater
-
-)
Phone: ( cb ) 1 L( ca - (..,., 6 _.?. Pax: ' ( : ) 1,, -( - -,..c. 4 - 1 ? Water heater
Fireplace t .
E-mail:
Range
::- ,....,•A-a,g41, .,: • '.; T-;:e* •'R, 4b** . :,, : . .,..*:, ,.,:. , , . , - .: Barbecue
Clothes dryer (us) I
Bu.siness name: L'...-L+-1 _
Address: :Hr : E ES'
City/S tate/ZIT: _ Su btotal
- ' Minimum permit fee ($72,50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
1
CCB tic,: (.7 (0 - ' State surcharge (8% of peivnit fee)
,
TOTAL PERMIT FEE
la permit application expirea I/ a permit la not obtained within ISO
Authorized signature; Th
C ‘--t - \(..5- - .-- C - k-- , ■--..._:. days after it ha, been accepted as complete.
Print name: 1....1 0,‘,(1,..-c. (.; 1 s (2-6.-\ Date; - - /1-- ( 0 t „,, - Fes methodology eCI by Tri•County Building industry SarViCe Eiclbrd
0 33uild(tlehlIniMNIEC-PCfrili1A,pp,doc 11/01 440-1617T ( I 1/01/COMME,B)
CITY OF TIGARD
BUILDING DIVISION
A PERMIT #: MEC20060G080
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 217/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,..,41- .11 •
INSPECTION WORKSHEET FOR DATE: 2/16/2006 TIME: 7 PAGE: 73
SITE ADDRESS: 14096 SW HAM RIDGE RD CLASS OF WORK:
SUBDIVISION: GR LOT #: Q03 TYPE OF USE:
PROJECT NAME: cHisi
/
DESCRIPTION: Gas furnace install.
OWNER: CHISM, MARK E + HEATHER J. PHONE #: 603_590
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 50.640_3607
Inspection Request Scheduled For: Date: 2/16/2006 Pour Time:
.
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 026979-01 603-620-5643 N
Corrections/Comments/InstructiOns:
4 J-el 4 5-
4 I'ASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I FAIL I I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspect° '
c?-114 Date: ,46 .6 Phone #: (503) 718- 706