Permit ° CITY OF TIGARD
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00491
AV I V
DATE ISSUED: 10/13/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S1 11 CC 16200
SITE ADDRESS: 10040 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 213 JURISDICTION: TIG
Project Description: Replace gas furnace & install new flue, reconnect new furnace to existing gas line.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: 1 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:
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
LARRY & CA MCCULLOUGH Description Date Amount
10040 SW HIGHLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 10/13/20( $72.50
[TAX] 8% State Surcha 10/13/20( $5.80
Total $78.30
Phone: 503- 684 -6984
Contractor:
SUPREME COMFORT HEATING
9425 SW COMMERCE CIRCLE #16
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 682 -1985
FAX 503- 682 -1018
Reg #: LIC 21892
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.
Is ed By: 0 Permittee Signature:?( `
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.
Mecilanyal Permit Application FOR OFFICE USE ONLY
IL ,' Cl of Tigard Date / Received l P ermit No.:W 0 . 41 VF
131 SW Hall Blvd., Tigard, OR 97223 y
Jrip
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Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date /By: Other Permit
Inspection Line: 503.639.4175 Date Read /B Juris: See Pa e 2 for
T1 Internet: www.tigard -or. ov y o B
b g Notified /Method: c „.., Supplementallnformation
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T XrE OF; W ORK .'4, ,GOMNIERGPAG „ ,,,,, - S HED . USE CF ` ?1
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❑ 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
; ,..,,,,.- ..�,,',,,,. �,�Y�� <.:�- :,:..:�,:,: �,r" , s ,,,.,.' m M's�; Value: $
,$ ' Cr1TEGO,,, ; OF: CQNS . ON ; 3 ,,.,r,
,vNRESIDENTl f E Q` UIPME NF hSYST EM S':FFrES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description p Qty. Ea. Total
.; _, :,,, a�k,�= 415,- 3,,,,, ,a =�:.' �;�.r.,:; ,,�.a-
,42'f',:'- s' • 76), gtiizrINFORMATIO lY AND,,
�_ �_ Heating /cooling
Job site address: 10040 SW Highland Dr. Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97224 -4602 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 1 17.90 17.90
Suite /bldg. /apt. no.: Project name: McCullough - Gas heat pump 14.00
Cross street/directions to job site: Duct work 1 14.00 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.: Flue /vent for any of above 1 10.00 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
;�_, : %' = ';.,> >r r. ' ` "` Water heater 10.00
r ` 1) . : s TI;ON _WORK' „-*. ".:. .' ,.: ; i `
,� R '<, f g , �;., = . , �- Q . �� � � E:: : -, F' x,1. -_": �`,.:�J`,'b�,� i,� ..,. ._ " >i ,.., q , x..: .. = .: =�. �3.i��i. - ' : \ `C ,..:v :.a :
Gas fireplace 10.00
Replace gas furnace & install new Clue. Dedicate existing B -vent to existing
Flue vent for r water heater or gas
Dedicate existing B -vent to existing water heater fireplace 1 10.00 10.00
Log lighter (gas) 10.00
Reconnect new furnace to existing gas line Wood /pellet stove - 10.00
Wood fireplace /insert 10.00
, , ,;, -, ,;,, �.>: �._.:_.- >;. ; , .,,, a u y iner /flue /vent 10.00
.,� t� ��. , w ; ;'$��` t F� � °,�v��.`. ._� Chm to
`"" ' ►� PROPERTY OV1 NER
°= �.�;.t:st�an.._. °i ��•< �,: .,,u�� _�: _.�_- ...,,� , . : � Othe 1000
O
Name: Carol & Larry McCullough Environmental exhaust and ventilation
Address: 10040 SW Highland Dr. Range hood /other kitchen
equipment 10.00
City /State /ZIP: Tigard, OR 97224 -4602 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503- )684 -6984 Fax: ( ) toilet compartments, utility rooms) 6.80
" =' f- ,, kJ ,� 7 �,,.h•,,:
�� -: "� ` .� -F;' Attic / crawls ace tans 10.00
'' %AF'PLICANTA 7:. CONTAC'1 % r p
Other: 10.00
Business name: Supreme Comfort Inc.
Fuel piping
Contact name: David Kropf $5.40 for first four; $1.00 for each additional
Address: 9425 SWv Commerce Circle #16 Furnace, etc.
Gas heat pump
City /State /ZIP: Wilsonville OR 97070 Wall /suspended /unit heater
Phone: (503) 682 -1985 Fax: : (503) 682 -1018 Water heater
Fireplace
E -mail: dkropffeasystreet.com Range
b
3'. T4' smv;'":,""'•Fn. :: y,. cam:: >�'y,, .'�'"
..> ,. `;Fi> xl „: Barbecue
Business name: Supreme Comfort Inc. Clothes dryer (gas)
Other:
Address: 9425 SW Commerce Circle #16 - "'` I' .. #M1F
�. �,' 4:. MECHr�N7C;Ali;P•ERMIT'.EEES„� ^.. ".,A
City /State /ZIP: Wilsonville OR 97070 Subtotal
Phone: (503) 682 -1985 Fax: (503) 682 -1018 Minimum permit fee ($72.50) 72.50
Plan review (25% of permit fee)
CCB lie.: 21892 State surcharge (8% of permit fee) . c c50
TOTAL PERMIT FEE 7 g-. '30
Authorized Si nature: This permit application expires if a permit is not obtained within 180
g 1 days after it has been accepted as complete.
Print name: David Kropf Date: 10 -13 -06 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits \MEC- PennitApp. doe 04/06/06 440 -4617T (I I /02 /COM/WEB)
CITY OF TIGARD
BUILDING. DIVISION PERMIT #: MEC200&00491
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2006
Phone: (503) 639-4171
6274mbi#
Inspection Requests (24 Hrs.): (503) 639-4175 4 4J!.
INSPECTION WORKSHEET FOR DATE: '10/2512006 TIME: 7:03AM PAGE: 49
SITE ADDRESS: 10040 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD N0,4 LOT #: 213 TYPE OF USE:
PROJECT NAME: MCCULLOUGH
DESCRIPTION: Replace gas furnace & install new flue, reconnect new furnace to existing gas line.
OWNER: MCCULLOUGH, LARRY & CAROL PHONE #: 503-684-6984
CONTRACTOR: SUPREME COMFORT HEATING PHONE #: 503-682-1985
Inspection Request Scheduled For: Date: 10/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 038786-01 503-682-1986
Corrections/Comments/Instructions:
•
I PASS
fl PARTIAL APPROVAL fl CANCEL fl NO ACCESS
I I FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
ifAt Inspector: Date: 6 Phone #: (503) 718- Z.."4-4