Permit 1.
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00014
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/11/2006
PARCEL: 2S 112BC -05600
SITE ADDRESS: 08380 SW LA MANCHA CT ZONING: R -4.5
SUBDIVISION: LA MANCHA ESTATES LOT: 009 JURISDICTION: TIG
Project Description: Gas 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
NORA EDER Description Date Amount
13194 SW YAARROW WAY [MECH] Permit Fee 1/11/200€ $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 1/11/200€ $5.80
Phone: 503 - 521 - 0950 Total $78.30
Contractor:
BEN'S HEATING & AC
PO BOX 80607 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97280
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 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: _
4 , Permittee Signature: 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.
JAN -11 -2006 09:05; BENS HEATING 503 651 3345 P.02 EI Pp,
V.,,,,,
Iva _. ! Permit A atwu
1.012 0141('F USE ()N1
City. of Tigard Received
13125 SW Hall 131vd., Tigard, OR 97223 /JAN 1 ?006 Date/By; T - _ o � i Permit No V _ . 0 • / 000/V Phone: 503,639.4171 Fax: 503.598,1960 Plan Review
p � r , y , "/'∎1 p '"' { / 4 ' Date/Sy:
Ins
Other Permit;
Inspection Line: 503.639,4175 CI Ty (/�� [
1 -• 4 ernet: Www:ci.tigard,or.u8 .8 V1L ? 1 ` � �-a See Page 2for
�J� DT� g � rg Supplemental Information
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❑ New construction Addition/alteration/replacement Mechanical permit fees" are based on the value of the work
u � performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other:
mechanical materials, e•ui• ment, labor overhead and .roflt,
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For special lriforrytrCton use checklist.
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Job site address: 4e .4 go _ski h`,4. niter/ e- / , Air conditioning or heat pump
G.� .uims site aan showih: • tacement w 14.00
City/State/ZIP: (7 et7 3 Furnace 100,000 BTU ducts /vents 14.00
` Furnace 100 000+ BTU ducts /vents 17.90
Suite/bldg./apt. no.: Project nettle: Gas heat .0 . 14,00
Cross street/directions to job site: Duct work 11111 14.00
H dronic hot waters stem 14.00 NMI
Residential boiler (radiator or
h dronic 14.00
Unit heaters (fuel -type, not electric), ,
in -wall, in -duct, sus *ended, etc.. 10.00
Flue/vent for an of above 10,00
Subdivision: Lot no.: Other: 10,00
Tax map /parcel net!
Other fuel a. ]fences
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Gas ft ' •lace 10,00
�r • (lJ W C— Flue vent for water heater or gas
fire. lace 10,00
- .. Lo:li:hter 'as 10 -00 Milli
Wood /.ellet stove 1111111 10.00
Wood fire lace/insert 10,00
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arvr' r, ^ :.,r : . ; ; a 7'. ;v r , nc: ': usd},;r : "; 7y.ir• „ e : nr' Chirrule /liner /flue /veal
10,00
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Name: 'e /' A .2 - CAI Environmental exhaust and ventilation
Address: i I434 lii tr o IA) y Range hood /other kitchen
e. ui.ment 10.00
City/State/ZIP: . • Clothes • er exhaust _ 10.00
Single-duct exhaust (bathrooms,
Phone: �
Phon . � Fax: (.1 1 F ( ) toilet com.artrncnts,utili rooms b,8
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Business name: Oth er: 10.
Contact name: g tA � /� __ ' $5.40 for first four. $1.00 for each additional
Address: _ ... MO
IMEMMIIINIMIll City/State/ZIP: Wall /su • ended /unit heater _�_—
Phone: (g)3) .3 (3 ■ 3 9&' F ax:: ( ) Water heater
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E-mail:
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Other: � UM
Address: , I� t o ti p 7 ( 7 TIE1� � l II 1 1 1 lu l t r t},nl !3h _ �' , L , J 11 , s If j y1 ; : , , .1%. 1„ f
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City /State/ZEN i t I • 0 a_SZ 0 Subtotal
one: (V3) -y Fax: ) r 3 �S Minimum permit fee ($72.50)
S P�3�' / Plan review (25% of permit fee)
‘ rtC131ic.: — _ _ L!� / *c9.7 -i'l 1 $ oC State surcharge (8% of permit fee)
/,,� — y / .��
TOTAL PERMIT FEE
Authorized signature: �I/� V This permit days ftertt bat accepted i es complete. ed within lea
• Pee methodology se b Tin County Building Industry Service board
Print name: a JO Date: / Le , s v
ialuitdinggper 61161 HC- PernttApp4oc 12/03 440-46171' (11/02/COMJWBB)
- -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/11/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) .14-.10■ 1 .1.
INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7: OGAIvi PAGE: 62
SITE ADDRESS: 08380 SW LA MANCHA CT CLASS OF WORK:
SUBDIVISION: LA MANCHA ESTATES LOT #: 009 TYPE OF USE:
PROJECT NAME: EDER
DESCRIPTION: Gas furnace replacement. 8/24/06: THIS PERMIT IS REINSTATED FOR PURPOSE OF FINAL
INSPECTION FOR A PERIOD OF THIRTY DAYS.
OWNER: EDER, NORA PHONE #: 503-521-0950
CONTRACTOR: BENS HEATING & AC PHONE #: 503-233-1779
Inspection Request Scheduled For: Date: 8/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 035560-01 503-233-1779
Corrections/Comments/Instructions:
00 a I t afa (fit,-pr) /14.
14/( PARTIAL APPROVAL PI CANCEL I I NO ACCESS
I FAIL I CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector: 17 Date: Phone #: (503) 718-
_ .