Permit CITY OF TIGARD MECHANICAL PERMIT
s.. COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00526
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/24/2008
PARCEL: 2S114BB -14100
SITE ADDRESS: 10420 SW KENT ST ZONING: R -12
SUBDIVISION: SWANSONS GLEN NO.2 LOT: 082 JURISDICTION: TIG
PROJECT: ADEN
Project Description: Replace gas furnace.
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
JEFF ADEN Description Date Amount
10420 SW KENT ST
TIGARD, OR 97224 [MECH] Permit Fee 10/24/20( $72.50
[TAX] 12% State Surchai 10/24/20C $8.70
Total $81.20
Phone: 503 620 - 7255
Contractor:
BEN'S HEATING & AC
PO BOX 80607
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -1779
FAX 503- 651 -3345
Reg #: LIC 64597
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 503.2 . 1.800.332.2344.
Issued oilteLAAAieL.L Permittee Si natur : ' •
Call 503.639.4175 by 7:00 a.m. for inspections that b ess 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.
pi r 10/24/2008 08:00 FAX 503(1513345 BENS - HEATING &AIR VI 003
Mechanical Permit Application Q F0It 01� 11(F I �� I•: � tNLY n ,,., G �/
City of Tigard D e ive ��lI�� E05 II
pe;mitNo,; !(WOtWD",r✓
t "I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 pate/By Other Panne.
- - tti n u't) IltSpeclfott Line; 503,639,4175 Dale Ready /By: See Peat 2 for
Internet: www.tigard- or.gov Notified/Method: . Supplemental Information
''
TYPE" A Fv -a i4 ;. ? a «,',: „na§ s CS�RC1A1:.,NE &” SCHEbU1 E USE CHECKLIST
[7 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) or ell
❑ Demolition ❑ Other: mechanical materials, equipment, �_ labor, overhead and
, r^ ,.�, r Value: $ 3%D � ...
`. CAT045. I,Y i, QE!', .` *,$.42R [ tc 'LQIy a r' i` it.» °+� 'f ,4 k w"" S $I' ..' i / SYSTEMS FEES
1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building `
Per special ir)fonnaliort use checklist,
❑ Multi - family ❑ Master builder ❑ Other, Description I Qty. I La. ( Total
. JOD SITE, •INPQRMA '1UIY.FANO, 0d titig f,PPM ;'a,k Heating/coollnn
Job site address: A2/./ Air conditioning or heat pump
, j�' (requires site plan showing placement) 14.00
City/State /ZIP: �r • Ch'C ok t) K ! aft Cr7 sk it , Furnace 100,000 BTU (ductbrvente) / 14.00
Suite/bldg./apt, no.: Project name: Furnace 100,000+ BTU (ducts/vents) _ 17.90
Gas heat pump 1 4.00
Cross street/directions to job site: Duct work 14.00
I ironic 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: Lo t no.: Flue/vent for any of above l 10.00
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances . f „
t u `'' b' Water heater 10.W
�7 f ' Gas fireplace 10 ,Oil
If l_° 0 A-e,� 404-5 lF-i tt! tv/ cc - Flue vent for water heater or gas
fireplace 10.00
- - . Log lighter (6 ) 10.00 - _
Wood/pellet stove _ 10.00
Wood fireplace/insert 10.00 ,
►� pROPhR TY:,OWNER i : 9 ' y « Chimney /liner /flue /vent _ 10.00
:,'Q ENA1Yx, ?i. " , h., ,,., ;, Other: 10.00
Name: -i • A _ Environmental exhaust and ventilation
Address: o�� Range hood /other kitchen
�vy Q S / / �E'r S equipment _
City /State /ZIP: ' 'Yq ,4't'& 0. ' t1Z i f Clothes dryer exhaust 10,00
�l Single -duct exhaust (bathrooms,
('hone: (,,,S1,3) 6 a:.6' - '7 as-S'' Fax:( ) toilet compartments. utility rooms) 6.80
❑ APPLICANT .. ,F.: ^; ,,: ®,,: Q*.i"I'AC;'1'i ": „„- ,
J w, Atticfcrawlspace thus — 10.00
' ,.:.,._ Other: 10.00
1usiness name: Qa„1J •�,� « L r y� i. L L Fuel piping
Contact nand: Ci y tc Q 23 55.40 for first four; $1.00 for additional
Address: r ! Furnace, etc. _
Oats heat pump
City /State /ZIP: Wall /suspended/unit heater . ..
Phone: (5 3 f 3_ 3 g,, Fax: : u-y3) 6 r - 75 Y Water heater
E -mail: ` - Fireplace
Range
CONTRACTOR ` `' Barbecue
Clothes dryer (gas)
B ,�
Business name: r t 1 NP `,,, d i pr . r �x i L L C
Address: / _.
a i e , • U p :ti'' . , Other: 7 " :;::? <!,' ; MECHANICAL PERMIT FEES*:
City /Slate /ZIP: i r� -I moo 0 9 22e Subtotal rn
Minimum permit fee ($72.50) '9,2, ' ,t roue, (57)3) _ 3 3 — I 7 7 9 Fax: {spa IJ-/ —3 3 fir Plan review (25% of permit feel -®'--
1. - B tic.: ' L g A I State surcharge (12% of permit fee) g 10
'TOTAL PERMIT FEE
- Th i s perm appl expires If a permit Is not obtotnc within 80
Authorized signature: 6.Vi • days after it has been accepted as complete.
Print name: riyd 4 If * te a, e: Al a, 0 • Fee methodology net by Tri•County Building Industry' Service Board
I.l nuildint { ; \Mr OiJOa/Oo 440 -0617T (I I/9VCOM/WCa)
. . • • . - - ■ . - -- 7:
CITY OF TIGARD
BUILDING DIVISION : PERMIT #: tviEC2008,00526
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ..-4.,4 A !.
INSPECTION WORKSHEET FOR DATE: 11112/2008 TIME: 7:00AM PAGE: 48 .
SITE ADDRESS: 10420 SW KENT ST CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN NO.2 LOT #: 082 TYPE OF USE:
PROJECT NAME: ADEN
DESCRIPTION: Replace gas furnace
OWNER: ADEN, JEFF • PHONE #: 503-620-7255.
CONTRACTOR: BEN'S HEATING & AC PHONE #: 503-233-1779
M lil
Inspection Request Scheduled For: Date: 11112/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message nd ) 6 1° 0
699 Mechanical final 077915-01 503-233 Y
Corrections/Comments/Instructions: 6 Or ti
( 1.)-7)
_ Q PASS 0 PARTIAL APPROVAL 0 CANCEL NO ACCESS
n FAIL El CALL OR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: Date: — 1 12 ' Phone #: (503) 718-