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Permit C ITY OF TIGARD MECHANICAL PERMIT A.00 alp DEVELOPMENT SERVICES PERMIT #: MEC2004 -00480 + -i— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/22/2004 PARCEL: 1S135DC-02101 SITE ADDRESS: 12045 SW LINCOLN AVE SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: R -4.5 BLOCK: LOT: 063 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: 1 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replace existing furnace & A/C units. Owner: FEES BACON, MELVIN Description Date Amount 12045 SW LINCOLN AVE [MECH] Permit Fee 7/22/200' $72.50 TIGARD, OR 97223 [TAX] 8% State Surchari 7/22/200 $5.80 Phone: 503- 639 -6677 Total $78.30 Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED INSPECTIONS Phone: 503- 453 -4822 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: _3_,0;4_, (` \ g Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day • Mechanical Permit i FOR. OFFICE USE OMEN' City of Tigard Received � 7 13125 SW Hall Blvd., Tigard, OR 97223 0 2004 Date/By 7 z 0 dy OCT..., Permit No.: 1,,,, r ODL/ o 0 v - Phone: 503.639.4171 Fax: 503.598.1960 JUL Plan Review � 46 � Inspection Line: 503.639.4175 t ax " F? } 1'�I' h Oate/By: Other Permit: Internet: Line: .tigar 39.4 s CITY OF TIGA _ Date Ready/By: Juris ®Soo page 2 for Notified/Method: Supplemental Information k .l1fi�Si�:: i:.0 � _,... in'r_:!i�wi.. ��' �:i::� _ - .,;J..,....,.y.c...;�115:� <�ll ^iiyuk_�GUr 'M4 ilipi:llCf `� LD NG 1 ❑ New construction .� t11S.�6CCI{IlISi 1.4G a di tion /alteration/replaa:ment ` a al permit a r e b o I ' ' o ` Mechanical permit fees* are based on the value of the work ❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all h mecan al materials, .... -.. n ,' ��;.;,;- r,41 =• �., I ;�;,.�:...�:._:_. _. �.....:,:. - .� .:......:.::. rc labor, overhead, and profit. ':°-i . It_.: W'''ilA i - 1 ,� ATE/ 4 ' . r equipment, or, a d ro 1 . � e � ........::.... ..::.: Value: $ J°LJ and 2- family dwelling ❑Commercial /industrial [] Accessory building - l,FSIDNT TE Acc ry ding 4..,:.- M��:.,_:S';.,,_11�FEE ?;`: -. ❑ Multi- family 0 Master builder [] Other: For special information use checklist. I ,;;n'! °;rL- „- •:•i',''t_, -..,. •:,: ,.. _ - - - - Description ©Rim b L.......... . � t:••: `_... � .: g? `' Qty. Ea. � Total . `k` N` : Y:f��CA'I'ION , Heating/cooling Job site address: ( J L/ (' •(� J I , ' (�� , r V .� Air conditioning or heat pump City/State/ZIP: l l� �( C� (requires site pinn showing placement) 1 14.00 1 9, 0 0 T30-AND‘ ! ® ' 1 ' 1 ?7'3 Furnace 100,000 BTU (ducts/vents) i 14.00 ILA ,00 Suite /bidgJapt. no.: L Project name: , Furnace 100,000+ BTU (ducts/vents) 17 Cross stre.et/direction_s to job site: Gas heat pump 14.00 Duct work 14.00 6 66-- .--- � 3 Hydronic hot water system 14.00 G �- 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.: 4:: ... = .r:,. :,: rr u:, Other fuel ;� ,.. ^n' i:' tie appliances :::...,,. K Water heater j ':. . 10.00 VI 1, _11 1 -, j � ' C � Gas fireplace 10.00 ` L e Flue vent for water heater or gas /-© A. .A :N N Q ‘4. t l2 • I �i '1/1 I . ' S fireplace 10.00 / `�- �-� 'Log lighter (gas) 10.00 "17••' wows iJ► ' � .� ,.1 Wood/l3elletstove 10.00 :::.ti,pal,e;'t t° , . _ - :.1: 10.00 �.::...... „ 0 1 ep nscrt r ;';fi:w; � � ;:t:_ .::?;;::- :;'::., ..._,, Chimney/I' � [luc/vent .. . ,..,,_.::_ > : +: =r -. �....... ... ❑ _ . : �::. . Name: , j r t I t Other: 101000 .00 V V Environmental exhaust and ventilation Address: `as() •'1 y • 'J /...._:, , c I _ Range hood /other kitchen City /State/ZIP: T. 1 � � r� equipment 10.00 ` - , ck. v 3 a` m-3 Clothes dryer exhaust 10.00 Phone: (t),31 3 ,. / j „ -� 7 Fax: ( ) Single -duct exhaust (bathrooms, e: ( '.:l g1.::, C^ '- !..:,: . .., :. `� l toilet nm utility rooms) ._. -. t comp __:: �, �::�.;- :I�a..,:!,_- :� 'a?�`C�'Al�l - - - - room 6.80 - - ,_, :..:.:.::::� .::. ........ ........... a cot of i V'1'ACT PE N ::. Attic %yawls ace fans ... .. ,. p 10.00 Business name: ` t � /l 19 ( _ Other: 10.00 Contact name: ` tp \ , Fuel piping L � � S5.40 for first four; $L00 for each additional Address 5040 - j Lk) ' Y Furnace, etc. City/State/ZiP: j �C��� l 0-p,„____1-730,4 Gas heat pump Phone: (5a3) _ ��/ '' Wall /suspended /unit heater : f3 - y g) a l Fax:: (5b3) e Water heater E- mail: Fireplace Range Barbecue Business name: Clothes dryer (gas) Address: 4 LJJ vi-c--N_ Other: City /State/ZIP: - ME'GHANlfwil l (.1')CRMCT.'FEES o N - k �, �� 9 i'a.94-1 Phone: (wy�) Subtotal oZ� .00 �' � Fax: (5P ) a� L� i f Minimum permit fee ($72.50 - � o Z� ) * sp CCB lie.: a Plan review (25% of permit fee) State surcharge (8% of permit fee) 5, Authorized signature: A O / '/ ' 1 // /J/� TOTAL PEItMITFEE�7$. PL t� This permit application expires if a permit is not obtained within 180 180 Print name: R�i days after it has been accepted as complete. ■ e., �lPr l,, Date: •7 gyrall • Fee methodology set by Tri- Comity Building Industry Service Board ist B uildinsTermitAMEC- PermitApp 12/03 440.461 rr (1 IN2/coM/wEB) 1 ' cl trzZG 896 cos io�'uoo a�ewiio dGZ�EO b0 02 Inc Jul 20 04 03:28p climate control 503 968 7224 p.2 ?4 V . W / 2 1 7 7 � Z+ �0 _ - ..___- _( Ir L. //4 CITY OF TIGARD � BUILDING DIVISION PERMIT #: MEC2004 -00460 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/22/2p04 Phone: (503) 639 -4171 �� , Inspection Requests (24 Hrs.): (503) 639 -4175 `. I.. INSPECTION WORKSHEET FOR DATE: 3/2912005 TIME: 7:11 OF PAGE: 53 SITE ADDRESS: 12045 SW LINCOLN AVE CLASS OF WORK: SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. LOT #: 063 TYPE OF USE: PROJECT NAME: BACON DESCRIPTION: Replace existing furnace & NC units. OWNER: BACON, MELVIN, PHONE #: 503.639.6677 CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503.453.4B22 Inspection Request Scheduled For: Date: 3/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 003093 -01 503 - 453.4822 Y Corrections /Comments /Instructions: • \ .v PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FE ASSESSED 3 (2-q Inspector: Date: Phone #: (503) 718-