Permit 1\
CITY TIGARD MECHANICAL PERMIT
a l DEVELOPMENT SERVICES PERMIT #: MEC2005 -00574
" X11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2005
PARCEL: 2S102DB -06900
SITE ADDRESS: 09169 SW HILL ST ZONING: R -4.5
SUBDIVISION: CHELSEA HILL NO.2 LOT: 046 JURISDICTION: TIG
Project Description: Furnace replacement.
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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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
NELSON, DOUGLAS S /JEANNE M Description Date Amount
9169 SW HILL ST [MECH] Permit Fee 9/14/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/14/200E $5.80
Phone: 503 639 - 9368 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 - 538 - 2953
. Reg #: LIC 125815
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: A�/ Permittee Signature: p Cfr €2
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.
Sep : 1.;. 05 1O:51a Oregon Heating and Air 503- 537 -2172 p.2
"'! FOR OFFICE USE ONLY
Mechanica Per mit E® Received / Permit USE O .Qv57
City of Tigard �� ® Date /By. • � I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.19tEP 13 2005 Vii, i t Date/By:
Date Read /B 0 l 0 Sec Page 2 for
Inspection Line: 503.639.4175 Ready /By: 1 ( � Suppleai enrol Information
° L'''" �`� Notified/MMhod:
Internet: www.ci.rigard.or.us CITY OF TIGARD ., . • - - FEE' :SCI Dv..4. -1:r. : CH E . g4 . 4ST
IP1 D' : ` : ........ ;.C OMMF�KCXAI: : : .` • -• , : .,, '.
:: ;.: < .:: • ' Mechanical permit fees* are based on the Value of the work
New constr- uction Addition /alteration/replacement •
performed. Indicate the value (rounded to the ncalcst dollar) of all
mechanical materials, equipment, labor, o
❑ O ther: rerhead, and .rofit.
❑ Demolition . : •
'..• :: ::: x.r .::' Y' OF• C . ONSTRUCI O
TN:' '''..;:' : _ ._,.. - : _ : : _ •: c .::: . r.,.: . . ' . ;.. ;;. . _:..:.::,.- .,'E`-U S'STF.MYIS:F' , -;:'-'. • , -. ' -Q _TPMENT'/ � 1
131/and 2- family dwelling ❑ Commercial/industrial El Accessory special information use Accessory building —� checklist.
fotal
❑ Multi- family ❑ Master builder ❑ Other. Description I `<
_.......: •. .. " Heating cooling
'•::::::::•:.::'-':'::;::;;W..::r.:, ;:: °.;..
:: JOB: S . ITE. INk' ORMA" I` tON:.' AhID :`LOC ° :'::i; : _ >:;-si'�:
,.,:.: .... -.. - - Air conditioning or heat pump 14 00
L( j \� . (requires site plan showing placement) ill
Job site address: + �, 1 J � 7 14.00 Ball
100,000 BTU (ducts/venls)
City/State /ZIP: f J Furnace 100,000+ BTU (ducts /vents) 17.90
J 1 Project name: Cras heat pump 14.00 W
Suite/bldg. /apt. no.:
Duct work 14.00
Cross street/directions to job site: Hydronic hot water system 14.00 Residential boiler (radiator or 14.00
h Unit Unit heaters (fuel -type, not electric), 10.00
in -wall, in -duct, suspended, etc.
Flue/vent for any of above 10.00
Subdivision:
Lot no.: • Other. 10.00
-
Other fuel appliances
Tax map /parcel no.: 10.00
y �� y yr.,.'a,;' Water h
a: : :•`4::% r'. _ x.,: c`DE5C ..., ..... .:.... ..........= fl,______ r lace
10
_; :?: . s ±',. __. , ., G as eP
� Flue vent for water heater or gas 10.00
10.00
firenla -
Lo li h ter (gas)
l. () (.plc G�V1 10.00
Wood/pellet stove
:::.::....
Wood firep ac tnse
-
Chimney/liner/flue/vent l 0 00 10.00
:?t;i. .,ki �:;4ar r' %� Othe 10.00
_ - - . �s� ,1:, � ?� "�:'- ; =�'QTENAN _._.... >...- _ -.:�. r.
_ �PR OPERT =7tc ��^ z�;;.,_.:?i :i ?, �;1.'� ;4 .....
Name: I:.:. Environmental exhaust and ventilation
Name: ` U p t _ Range hood/other kitchen 10.00
Address: t 1 .. equipment
A �J 0 ?+ Clothes dryer exhaust 10.00
City/State /ZIP: C� //' (/ '�`� Single -duct exhaust (bathrooms, 6 80
Phone/ �) .4 U310 D toilet
craw p ce fans o )
Fax: )
. ..:._,...._ CF'i'P 0 00
_ toil compartments, rooms)
ONTt1 .::)✓1250N <�s`�;'�`-` Attic/ is 1
a
1 _
._
...:: : .::. ..:::. - APPL );CANT;,;'`'s....::: ::r"sa -• ,. _ .. :..... -:- . Other.
Business name(�lr'� �- bit,..);/ 6I 1 -, Fuel piping
� $5.40 for first four; $1.00 fir each additional
Contact name: }� O 1 l� Furnace, etc.
/1 �1 v�4 r) Fur heat pump
Address: ( X J c/
City /State/ZIP:
/ l v ,�() 01 n 1 1 I S Wall/suspended/unit beater
Water heater
Phone. - ) • 1. _ Fax:: _ ) f// --1 Fireplace _ Range .
E -mail: e
a e,,. , - ..','.:: i n .
:• :. :..... .......> . '.: ::::... . _..... � Clothes dryer (gas)
�;.iC RACTO
,ii, /] / t _ A Clo
Business name: , / ! /�"' . �Y �Q Other.
iv[1;CIANICAI .PE .
Address: r +) /� ! / Subtotal yr City /State /ZIP: &Cf.
: 4i1 / t v i I I L� Minimum perm:: fee ($72.50) r/ itlil
Phone:aC S3 r 1 /�t b oti i Fax / 3 t 6 !/ r! i Plan review (25% tf permit fee) _
/ t fee) ��
State surcharge (8% of permi ) /
CCB lie. �� TOTAL PERMIT FEE rf.�
11 I � h This permit application expires if a permit Cs not obtained within 180
Authorized S v ature: • ` ) I J . / . " I ' days after it has been act :pled as complete.
/r C1 • Fee methodology set by Tri- County t.uilding Industry Service Board
Print name:
440 -4617T (11 /O2)COM/WEa)
is�Buildla ¢\PamirsVvlEC- PamiV+ou.doc 12/03
1
CITY OAF - TIGARD --
BUIL DIVISION PERMIT #: MEC2005 -00674
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1412005
Phone: (503) 639 -4171 iii -Igini I` -
I Requests (24 Hrs.): (503) 639 -4175 ' W l l
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM • PAGE: 109
SITE ADDRESS: 09169 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO.2 LOT #: 046 TYPE OF USE:
PROJECT NAME: NELSON
DESCRIPTION: Furnace replacement.
OWNER: NELSON, DOUGLAS S/JEANNE M, PHONE #: 5034638-9368
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503-538-2953
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 01876301 503.538 -2963 Y
Corrections /Comments /Instructions:
/ .% c5 • '1 4 0444.l0,4L: - S 6 0 '. 4--2 & rz L (iz/LC'4J, ,
.L.L e `Z. - r v /_S . _ _ -
_ ,,,,_,
•
...
lz/ PASS PARTIAL APPROVAL El CANCEL .
N O ACCESS
I I FAIL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:42 - 2C 3----- c) h ne #: (503) 718