Permit S .n
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 00243
' I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/16/2005
PARCEL: 2S 104CA -02500
SITE ADDRESS: 13599 SW LAUREN LN ZONING: R -7
SUBDIVISION: HILLSHIRE LOT: 025 JURISDICTION: TIG
Project Description: Installation of 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:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
RICO, DANIEL S + STELLA Description Date Amount
13599 SW LAUREN LN
TIGARD, OR 97223 [MECH] Permit Fee 5/16/200E $72.50
[TAX] 8% State Surcha 5/16/200; $5.80
Total $78.30
Phone: 503 -524 -0882
Contractor:
ANCTIL SHEET METAL CO.
4320 SE 162ND #10
PORTLAND, OR 97233 REQUIRED ITEMS AND REPORTS
Phone: 503- 281 -0752
Reg #: LIC 8897
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: - "= . 2_41 ��n �i Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da
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.
• t' echanical Perm A li _ ca ti01L FOR OFFICE USE ONLY "
0 r D:iiu"', 76 /P-a—... Permit No,: •
City of Tigard �, I y �()(7.ZOSoc�oZ
13125 5W 11311 Blvd., Tigard, 0' Plan Review Other Permit:
Phone: 503.634 -4171 Fax: 503,598.1960 lr� •tt� na(dky:
Ins ec`sion Lind, 503.639.4175 1 I- mate ItcadyyRy: lwis• 1 7 See Pace 2 for
p MAY 3' 2005 N otifzdim. hod: Sappternental Information
Internet: www,ci.ti.gard.ar,us t5�
CITY* 4F R - ' C O ......RCtai1::wFI * - USECHEcl(.uST.
d it ]�iittl�> e M Mechanical permit fes*'are based Oft the value Of the wor
❑ w construction BU performed- indicate the value (rounded to the'nearest dollar) o
New '
❑ Demolition ❑ Other: ' mechanical materials. equipment, labor. overhead. and profit • .
:. .. Value: $.. •
• CA EGORIC ,OF COi!ISTRUCTION ,� RESZDENT1AL';EQUiP1NIENT. % E AIS 'SYS
.. .. Iy.
J� -and 2-family dwelling ❑ Commercial/industrial 0 Accessory building - F'or sptu*il iriforrnulio use cheeklivi. •
P. Muiti- family ❑ Master builder ❑ Other: Description Qty E. • I Total
'.IOB SITE :INFORMATION AND LOC Heating/cooling . • .' `
• I Air eond$ioning or heat pump
Job site address: J -
City/State/ZIP: - rC�. Or) h- �[ - • Ire.uires'sitc 'Ian shuwinq lacemal+tl 14.00
` �� C '� z-�Z. Furnace 100.000.9TU (ducts/vents) ! 44,00 -,
t
� furnace IUU,000 + BTU (ducts /vents) l 7.)U
Suite /bldg. /apt- nil,: Project name: — Gas heat ',wilt-) 14.00
`• •gioss'strcWc*ectitinS :to job.site: , .. i4 00
'
H dronie hot water system
°�lR O0
Residential boiler (radiator, or '
• dronic� 14.00 . •
jL4 t� FIB V .. L'L _ Unfit heaters (fuel -type, not electric),
in - wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00 •
Subdivision: Lot no.: Other: IQ.RO
Tax map /parcel no.: J" Other fuel appliances
. DESCRIPTION OF WORK Water heater 10.00
10.00
M Gas fireplace
Flue for water heater or as
fire. (0.00
Log lighter (gas) 10.00 11111 •
Wood/.ellet stove 10.00 •
Wood fire.lace /insert 10.00
Chitn ey /liner /f)ue /vent NMI 10.00
%PROPERTY OWNER 0. TENANT Other: 10,00
Na 5 Environmental exhaust and ventilation
+� �� r� ' � Range hood/other kitchen
Address: equipment 10.00 III
City /State /ZIP: Clothes d er exhaust 10.00
_ G Single -duct exhaust (bathrooms.
Phone; (�) 1 G v O is . - Fax: ( ) toilet com.arrments, utility rooms) IIII 6 -80
0 APPLICANT ' ' ' CONTACT PERSON Attic /c rawls ace fans
10.00
Other: 1 10,00 ,..1 •
Business name: _ Fuel pipits w
Contact name' ac,, lC OL. y".T $5,40 for first four: $1-00 for each additional
Furnace, etc.
Address: r. _" C :as heat pump
(: ity /State/ZIP: . Wall /suspended/unit heater
Phone: ( )) Wate heater
e �..(1' - C) 1 rJ � Fax: (
. ) p
H- mail ) R _
CONTRACTOR l
_Cl dryer (gas -
Business name: k, �/ �C� 4, W v! , h
o t lt c:
Address: t i .' p , , /6:? and a n MECHANICAL PERMIT FEES*
l Subtotal ($72.50)
City /State /ZU': Z3 -
ivtinimwnt permit fee
Phone: ( ) £�1_61 Fax: ( ) a b 2 51.22 _ Plan review (25% of permit fee) r
CC R tic.:_ ic
7—
_ _ , State surcharge. (8`> of permit feel 1
T'OTA1, PERMIT FEE 7y, ,e)
Thls permit aindleation expir(�r if a permit i5 11Ut obtained w'tttlin 151)
�Ullx riycd r�tlal t �' dayz after it has been accelxed as COMP1Vte-
I ,... j... - ` hci l 11 by < y 1 n (rite nc.ustry, Se'n iec f3,iaid
5/73/s f 1 Q'' wt - I11Y li it( lm} :I '
' Print !Mille � ( Re �� (� �4� [)tug:
Id Wd6P:b0 SOOZ 21 FIN ZZZSZBZ LOS : '0N dNOHd 6ulloo6 'g 6uI•}E 1IlDNd : WOZId
CITY O,F TIGARD
BUILDING DIVISION A PERMIT #: MEC2005-00243
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1(3/2005
Phone: (503) 639 -4171 l '"'"n P ���q�lr��(�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/5/2005 TIME: 7:12AM PAGE: 68
SITE ADDRESS: 13599 SW LAUREN LW CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 025 TYPE OF USE:
PROJECT NAME: RICO
DESCRIPTION: Installation of furnace.
OWNER: RICO, DANIEL S + STELLA, PHONE #: 603 - 6240882
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503 -281 -0752
Inspection Request Scheduled For: Date: 7/5/2005 Pour Time:
• Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010662 -01 503- 5240882 N
Corrections/Comments/Instructions: �J
CL6Cr1e - IA" t r2 k f & 70 5 4-71g0 �7 % iC�'�/ C 1-ze
•
_ ASS _ _PARTIAL APPROVAL ❑_CANCEL _ _ __ _ __ ___ ❑_NO_ACCESS_ _
❑ FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: 7^�6 ` -79 6 --; Phone #: (503) 718-