Permit r
',s
ACITY OF TIGARD MECHANICAL PERMIT
Ai_ i I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00185
ei� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/21/2005
PARCEL: 2S110DD -10200
SITE ADDRESS: 15715 SW HIGHLAND CT ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.6 LOT: 318 JURISDICTION: TIG
Project Description: Replace furnace.
CLASS OF WORK: OTR 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BT U 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BERTRAND, RALPH R Description Date Amount
EILEEN L
15715 SW HIGHLAND CT [MECH] Permit Fee 4/21/200E $72.50
TIGARD, OR 97224 [TAX] 8% State Surcha 4/21/200E $5.80
Phone: Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
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: Permittee Signature: ...i.e 0 V Q
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.
Apr
t X 20 05 11:16a 503 - 537 -2172 p.2
14 Mechanical Permit A • plication FOR OFFICE USE O
City of Tigard I � �� �y Date /By: Received t /" / ,5.- Permit No.: GL . OD 9)/ "S
13125 SW Hall Blvd., Tigard, OR 972 V Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' Dater Sy: Other Permit:
Inspection Line: 503.639.4175
APR
' I
! j (} ^ OO � � Date Ready/By: El E l See Page 2 for
Internet: www.ci.tigard.or.us l► ( Notified�'Method Supplemental Information
.. ... ... . : . - - - .. . , - • s I f 'a fiVAD COMMERCIAL IEEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition t i os 7t'e hi acement Mechanical permit fees* arc 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.
. CATEGORY OF CONSTRUCTION. Value:
LJ 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Commercial/industrial ❑ Acce ssory building
El Multi-family ❑ Master builder For special information use checklist.
❑ Other:
Description p Qty. Ea. I Total
- • • JOB SITE INFORMA ION AND LOCATION . • Heatingfcooling - p.La.,,,.:4 Job site address: 5 +, j� ' i (requires site plan g shou showing cement) 14.00 � (� ,./---- City/State /ZIP: Q V1.� Furnace 100,000 BTU (duels /vents) 14.00 ) L t.
Furnace 100,000+ BTU (duets /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hyiironic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit beaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' C. .... . • . DESCRIPTION OF WORK .. Water heater 10.00
) i r Z � / L ill Gas firepla 10.00
,(,(, � f Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
_,_,� ,�� Chimney/liner/flue/vent flue/vent • . L )J/PROPE • O W ' .. : .. • .Q TENANT • • • • '
Wood 10 00
Gh i 10 00
Other. 10.00
Name: ),,i iv If it /f Environmental exhaust and ventilation
Address: !! f ' ' 1 _ Range hood/other kitchen
[ , I 4 -0 g ` equipment 10.00
City/State/ oa s ZI P: 't `� V • / a Clothes dryer exhaust (0.00
` ,...‘4,,s -
/L� J Fax: Single -duct exhaust (bathrooms,
Phone.'
?, ( ) toilet compartments, utility rooms) 6.80
PLI ` ' ' . ` • [ CONTACT PERSON. Attic /crawlspace fans 10.00
I� n� eArt Oth er. 10.00
Business name: 7' I l \\ 1��1 �. ` F uel piping
Contact name: j1; r n _ IY� UUU $5.40 for first four; $1.00 for each additional
Address:
},� � Furnace, etc.
'� / ) /
�t / Gas heat pump
City/State /ZIP: 'It // jK Q �` V ! ` y/ 01-1 ((> Wall /suspended /unit heater
Phone' \4 , Fax: ; 1 Z , Water heater
Fireplace
E -mail:
Range
• ONTRACTO[t Barbecue
Business name, �� Clothes dryer (gas)
Other
Address: ,K_ nr, .
MECHANICAL PERMIT FEES *' .
City/State /ZIP: l 41 I,h L / (S �g 1 1 1 1 , Subtotal ) i.4
�] /( 3 M inimum permit fee (S72.50)
Phone:
3) 3 !J'1 Fax : 5) J 7 74 - ' Z
Plan review (25% of permit lee) �
CCB tic.: l • State surcharge (8% of permit fee) C./. Vl "
ti ` \ TOTAL PERMIT FEE 76)
Authorized signature: L (- ( p / / t This permit application expires if a permit is not obtained within 180
t t I` O tt days after i t has been accepted as complete.
P name: r I �`�.�+ Len n eon Date: i• c
0,,r, Sll r Fee methodology set by Tri- County Building Industry Service Board
Print
- �
aao- 4eiyrtu:o::con.+;wre1
i: Building \Pamils•MEC- Y. 12103
CITY OR TIGARD
BUILDING DIVISION PERMIT #: MEC2005 00165
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/21/2005
Phone: (503) 639 -4171 ��i/i /Jpti�i�i
Inspection Requests (24 Hrs.): (503) 639 -4175 ,�.:.
INSPECTION WORKSHEET FOR DATE: 50/20055 TIME: 7:10AM PAGE: 79
SITE ADDRESS: 15715 SW HIGHLAND CT CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.6 LOT #: 318 TYPE OF USE:
PROJECT NAME: BERTRAND
DESCRIPTION: Replace furnace.
OWNER: BERTRAND, RALPH R, PHONE #:
CONTRACTOR: OREGON HEATING + A/C INC PHONE #: 503 - 538 -2953
Inspection Request Scheduled For: Date: 5/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 005737 -01 503.538 -2953 Y
Corrections /Comments /Instructions:
0 c'Lr,- ,7:4/L �- ;„,? -L rit f p) 4,9
ASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: =2. - Phone #: (503) 718-