Permit r ,J j t•
CITY I MF TIGARD MECHANICAL PERMIT
u I DEVELO SERVICES PERMIT #: MEC2004 -00606
F �' ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/10/2004
PARCEL: 2S 112CB -09400
SITE ADDRESS: 15232 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7
BLOCK: LOT: 108 JURISDICTION: TIG
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: 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:
Remarks: Replace furnace
Owner: FEES
GROFF, MELISSA A + Description Date Amount
MORRISON H III [MECH] Permit Fee 9/10/200 $72.50
15232 SW KENTON DR [TAX] 8% State Surcharl 9/10/200 $5.80
TIGARD, OR 97224
Phone: Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 62196
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. —
Issued By: Permittee Signature: spy �
1 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bids ness day
9.
I
Mech r ica^>rl Permit Ai i 1jciatioh l OR. ()FFl(�l� l.sr•_ (I\1_X
City W I a 1 t and Blvd., Tigard, � ` D Date/By: y i ! PermitNo.. ".- ' r. \ 41 13125 SW l'dTigard, OR 9 , � � - a d L � � � �
9 Arm Ph Other Permit:
D atefB view
Phone: 503.639.4171 Fax: 503.5
el l ` " Date/By:
Inspection Line: 503.639.4175 9 '1 L , . Date Ready/By: See Page 2 for
Internet www.ci.tigard.or.us O ` • '"
SEP u !►f�D
Notified/Method:
Snpple
qm r ,...: i[it . lJ i i L s, , s i . r )a, t. r . ---- ^: 5„nmp_ -Y.._.__. a
- r_ . [5 Y _ g1: j q,r 1� .v .1111irt1 1 .S�
__ .. , m v�iTin ,11,*;&ti„., -e., .� - � `r r tiyt s "-• ---atifa7imit '--- -- $ flit Rir- °i mi iF3. -•••" �' ..•.c ) , m n in 1.„141 n r.. _ for_ <Ire +• '
❑New construction ,� • do Qi, i ' ttahon/replacement Mechanic permit fees* are based on the value o the work
.� " performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition • Other: mechanical materials, equipment, labor, overhead, and profit,
�� � ___. • -- -_- = =��� Value
,,:.,;:,:�, . .-
0 builder -- l llt- - s a,� v,i( I H r Faq oaillvro : :a ts$ffi ,r1 x ti t 5 7 1H - �14 o ItJ71t tl ` 1IrStl j 1 `. ❑ _=-
L - and 2-family dwellin h 9 .,. t , ... _4 :� .._
y g ❑ Comme re ia Uindustrial El building For special information use checklist.
Multi- family ❑ Other:
=== �atu, {�ti, Description 1 Qty. I Ea. + Total
'5!>7!tit IU 0 ; !t3, St." ' _ i _ , irea 9 f sl+li. ,". u7E ,ritiiii ? a gt: Heating /cooling
Job site address: \T3 a l `Dv- Air conditioning or beat pump
(requires site plan showing placement) 14.00
City/State /ZIP: y 1 � Q � 1 Furnace 100,000 BTU (ductsivents) l 14.00 1 q r
t 1 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgJapt. no.: V Proj '' 7 - -) " t ect name: Gas heat pump 14.00
Cross street/directions to job site: • Duct work 14.00
�� Hydronic hot water system 14.00
t.f�2�= 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 10.00
Other: 10.00
Tax
• map /parcel no.: Other fuel appliances
iii V - _.::;,.�. I ` h`l:l i = °' _ = - . _ __ Water heater 10.00
u1t,Ilil.zr7tt - . a.
• y- Gas fireplace 10.00
0 a.•� C u.� In C1t_C_ C__, Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/inseri 10.00
•
� apt F s+n ( { ; nix ( Chimney/liner /flue /vent 10.00
'- ii• it A ........,i ttk7ltllm.c . I( (- - : -..`ue 1.i. • - .-•• Other: 10.00
Name: 1 \ c f t Sev1 4.) / ke.,V 15 5 ,G--1- Environmental exhaust and ventilation
Address: 1 IS , 3 a 5 LA) �i .0� lie" D
Range hood/other kitchen
equipment ment 10.00
City/State /ZIP: I 1 t -. -& 4:-)'1------. t3\ 7 Ra L. I Clothes dryer exhaust 10.00
1 + Single -dud exhaust (bathrooms,
Phone: (51)3 ) 5 to Fax: ( ) toilet compartments, utility rooms) 6,80
...
1 t . t.';` s t l
. - I t !MI MI, 4•,i'• :-as _ „ -. 4 t t a i Attic/crawlspace fans 10.00
: �- .,,_ ,, - f w� k . ,........ L , ,w aizia� _tU ._ • Other: 10.00
Business name: C \ UMa* ..
.. -; () V Tr.0
Fuel piping
Contact name: KA'i�' ., v lo-Vl/\ $5.40 for first four; $1.00 for each additional
(s 5-0 C. 5 d■ 74,<\.)e....__
Furnace, etc.
Address: 1
Gas heat pump
City /State/ZIP: T 4-1 c1/4 A,�e..) ( 9 �g.L) Wall/suspended/unit heater
Phone: ( -D3 ) ti 3 3 ...._ti g 9_- I Fax:': ( 3 ) q 6 8 - 7,-(...1--it Water heater
Fireplace
E -mail:
Range
I ,... ni.. _. .; 1 __w:aii Barbecue
( tip : °13 W: _.::, ` 4 t ulit I<l
Clothes dryer (gas)
Business name: C I i yi- t 4-- _ �H°:-Y`� Other
Address: (1.0500 S 7"0 - `A- �I j • -- I`'i';3N�1,'..r --
City/state/ZIP: •9 t••E -\ a,k r'� .9 t 2 0 l - 7 a ., Subtotal H . -
( 93) ` ' J33 - 9 A 2' - I ( ) 416 ` �� -L Minimum permit fee (S72.50) • �Q
Phone: 7 Fax:
Plan review (25% of permit feee)
CCB lie.: (o ? I " (_ (p - _ : State surcharge (8% of permit fee) .5. $a .
- i TOTAL PERMIT FEE 7 , 3
f >
• This permit application expire! If a permit Is not obtained within 180
Authorized signature
days after it has been accepted as complete.
Print name: 2__ i- i t Date: /c / () * Fee methodology set by IYi- County Building Industry Service Board
iNituilding\Pernits /MSC- PennitApp.dac 12/03 440 -4617T(11/02/COMiWEB)
i ' d zZL896EOS DWI 10M1140D 31UW I13 WUED = T i ibDOZ 60 daS
CITY OF TIGARD - r
BUILDING DIVISION � PERMIT #: MEC2004 -00606
13125 SW Hall Blvd., Tigard, OR 7223 DATE ISSUED: 9/10/2004
Phone: (503) 639 -4171 : °��4Vyp�liyl�f�l`�
Inspection Requests (24 Hrs.): (503) 639 -4175 _,�
INSPECTION WORKSHEET FOR DATE: 3/21/2005 TIME: 7:10AM PAGE: 74
SITE ADDRESS: 15232 SW KENTON DR CLASS OF WORK:
- SUBDIVISION: ASHFORD OAKS NO. 2 LOT #: 108 TYPE OF USE:
PROJECT NAME: GROFF
DESCRIPTION: Replace furnace
OWNER: GROFF, MELISSA A +, PHONE #:
CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 - 453 -4822
Inspection Request Scheduled For: Date: 3/21/2005 Pour Time:
Code # Inspection Description • Confirm # Contact # Message
699 Mechanical final 002271 -01 503 -453 -4822 N
Corrections /Comments /Instructions:
_ #.) . g 71 L L,�<- , / S -- PV / 1 ,q -7 4 z 'c r
;b. - ' = ART -IAL- APPROVAL ❑- CANCEL ❑_NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date 2/ ---0. s--- Phone #: (503) 718-