Permit A A
- a CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00116
,� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/23/2006
PARCEL: 2S 104BA -01900
SITE ADDRESS: 13901 SW HINDON CT ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT: 100 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: 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DELORES MARTENSON Description Date Amount
13901 SW HINDON CT
TIGARD, OR 97223 [MECH] Permit Fee 2/23/200€ $72.50
[TAX] 8% State Surcha 2/23/200€ $5.80
Total $78.30
Phone: 503 -579 -5257
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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: `P 1\/0
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.
Feb 18 06 12:04p TriCounty Temp 5035570919 p.1
a •
,i 1
2 ; ,echanical Permit Application FOR OFFICE USE ONLY
City of Tigard �' Received p
1 �� / Dat Permit No l/6
13125 SW Hall Blvd., Tigard, OR 97223 eBy :� % t� ll LJ .1►a - ._ a
Phone: 503.639.4171 Fax: 503.598.1960 Plan Renew
Inspection Line: 503- 639.4175 FEB 2 2 20! �p +y4Il Datc/By: Other Permit: R. Date Read .B
www- ci.rigard.or.us Y y: funs: El See Page 2 for
Internet:
�' ,,__ ' 'y `J �Ionried/Meshod. Information
a
CITY OF TIGARD � r Supplemental �
C?AL;Tr?E *S,CHED.i7L >3SB *CHEC'KLIST•`
❑ New construction X Addition/alteration/replacement Mechanical permit fees` are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
_ mechanical materials, labor,
Other:
..� :. •Sa x t r.. , , CA TE R O� Ttf� to :
O RIr O[YS
R �'
''' -.j r. °;. °':l ,:... Value: 5
Y dwelling ❑ Commercial/industrial ❑ Accessory building
NI 1 - and 2 - famil dwellin RL'Sil3i6i . fil . EQt6IN'IEPli:)iSYST'EV1S.;FEES*
1 C] Multi ❑ Master builder 111 Other: For special information use checklist. ,_,: _.- .,.... Description Q ty. Ea. I Total
QB:;SIT.E INFOIt1YI N;t NI7
ATSO
_ A T.00ATI0IY � i : _. .• >,.. : >• _ eaten coolin '
lag Job site address: : 01 3y J nClO � �YJ� W rt Air conditioning or heat pump
e 11 VV 1 IJW I l (requires site plan showing placement) 14.00
City/State/ZIP: I f d c(2 ?2 Furnace 100,000 BTU (duets/vents) I ; 14.00
1 Suite/bldg. /apt. no.: �""• , 1 Project name: Furnace 100,000+ BTU (ductsrvents) 17.90
Gas heat pump 14 i
Cross streer / directions to job site: Duct work I 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: l Lot no.: Flue/vent for any of above 10.00
Other: I 10.00 ,
Tax map /parcel no.: , Other fuel appliances
_.n`, - ADESCRCPTTON._OF. :W ORK ^ :: - Water h
_ l�� , . _. ... .,, . • ,. ,.. -. .. . - 10.00
Gas fireplace eater 10.00
Flue vent for water heater or gas
' fireplace I 10.00
Log lighter (gas) 10.00
Wood/pellet stove � 10.00 .
Wood fireplace /insert I 10.00 j
EROP ' rr? :i' =- _; `*: > : ''f. ❑''xE`I 'i" : : :'' ".;' : :.. ;;'.' Chimney/liner/flue/vent 10.00
10.00
Name: CItirt6 httrterrilel
`rs"� Environmental exhaust and ventilation
.Address: G Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Ci y 1 ( j . 7, f Fax: ( ) toilet ingt co m p a rt e ments (uath
Phone: rooms) ("� (
_ ,t coprtnts, utility rooms) 6.80
,. , tD ,. ELZCANT : :: �: - Attic /crawls ace fans I
1 ACT,, "EERSON P 10.00
Business name: ��"� Cc U T� ' I f >.I '/y� 1 1 Fuel piping
.,... Other: 10.00 I
`� t t p (O ' ' ' "
Contact name: 1 S5.40 for first four; S1.00 for each additional
Address: 0 { W 6. C I a �kfj ; n liLl v .
j Rrr b r 7 I C Furnace, etc. j
l t�(U (IU J 1 v L 4 ~jJl I V Gas heat ourrn
City/State/ZIP: Cr 'l fl (j 0 . C( 7045 WalUsuspended/unit heater I
Phone: ( ,>l) S57..-- Z220 1 `f I Fax: : ( ) f .55 7 _/'l i �) Water heater I
E- mail: [ ! l 7 Fireplace
,, - •� :=' ,:. - � Range
r - t's' - ::CON ,<'.. 1, 'w: •' :. =
. .. , . - „. !r.;r> ,• 'L'iRe:`CTO & - - a �ii _ - Barbecue
Business name: I rI Cc " Terry Co Clothes dryer (gas)
l! I t�J ^ Other:
Address: / r t C ( � , .
(;)0 :`� . / r , U _1(a ' t � C - ^ t �/ • � � l Ili �� - "''; : r- � :-MECFI'tS i itr £>* ..-. •. -: • :
City/State/ZIP: OrtrO •'1 0 C c ( Subtotal
Phone: (50,15) 55-r 2 .2 rt Fax: ( F '+�� 7 6 i g Minimum permit fee (572.50)
Plan review (25% of permit fee)
CCB
he State surcharge (8% of permit fe nn
p TOTAL PERMIT FE /J
�
Authorized signature:
-71 --
G aO This permit application expires if a permit is not obtain vithin ISO
ti has been accepted as complete.
Print name: DLQ12Q 44 44 Date: 2L • Fee methodology days after i[ set by has
Building Industry Service Board
S',Bui!ding\PcrmitsIMEC- ?enraApp duc 12/03 440 - (t 1/n2/COM/' EBI
CITY OF TIGARD
BUILDING. DIVISION PERMIT #: M e..GD-00c-- do /((,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 a
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: j 390 f c CLASS OF WORK:
SUBDIVISION: ) LOT #: TYPE OF USE:
PROJECT DESCRIPTION: $Y�/ G
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3,3/-00 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions: 6 /
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ► Date: 3 — / / -- Phone #: (503) 718 - 4 - C —