Permit I
C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00115
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/5/2008
PARCEL: 2S 111 DC -12700
SITE ADDRESS: 15960 SW OAK MEADOW LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.11 LOT: 623 JURISDICTION: TIG
PROJECT: STONEKING
Project Description: Replacing 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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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:
Owner: FEES
RAYMOND & GERALDINE STONEKING Description Date Amount
1040 CEDAR ST
LAKE OSWEGO, OR 97034 [MECH] Permit Fee 3/5/2008 $72.50
[TAX] 12% State Surch 3/5/2008 $8.70
Phone: 503- 636 -6611
Total $81.20
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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: ` • - d ittee Signature: -75/1/
Call 503.63* 5 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.
F . r 111-sr 05 08 10:48a p.2
1... -
Mechanical Permit Application . • ' FOR OFFICE USE ONLY
City of Tigard , Received a �Or
13125 SW Hall Blvd., Ti Bard, OR 972 BECEIV E 1 Da Re / ��� Petmir No. j ,iytT�- �S� �c O �`!
Plan Review ( (/
Phone: 503.639.4171 Fax: 503.598.1 6 Other Permit:
Ins ection Line: 503.639.4175 Date/By: T I G r\ R D p _ Date Ready iurir. See Page 2 for
Internet: www.tigard ot.gov 1 t r^' r vg.._ yFj 08 N
-{ �'C J� Supplemental Information
TYPE OF WOgTY U IGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction �j �lddition /altetBU l : '
` �1tr �1 VC� Mechanical permit fees* are based on the value of the work
❑ Demolition ❑ Other: _ -Dill performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead. and profit
CATEGORY OF CONSTRUCTION Value: $
cial- and 2- family dwelling ❑ Commercial /industrial p Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi- family • ❑ Master builder ❑ Other. For special information use checklist. E
Description 1 Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Hearing/cooling
Job site address: ( 1 CCJ Su) (9 O S� ... v y ` o-,Air „ q; �\.• -. , Air conditioning or heat pump
p � n (requires site plan showing placement) 14.00
City /State/ZIP: ''''t. t - f 0 1 - 1 2_2J -.( Furnace 100,000 BTU (dacrslvents) - 1 14.00
Suite/bldg./apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
W Gas heat pump 14.00
Cross street/directions to job site: Duct work 1000
Hydronic hot water system 14.00
9 Residential q `` �� , • \ t \ _ hydorii) boiler (radiator or
/� W l �=. hydtonic) Z 14.00
` 1 � heaters (fuel -type, not electric),
a�J,�
\--- f ��'� 5 in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above _ 6.80
_ Other. 10.00 J t
Tax map/parcel no.: Other fuel appliances
IPTION OF WORK _Water heater l 10.00
Gas fireplace I 10.00
la Flue vent for water heater or gas •
- J a_ 'J� • 0 Pr 'Rf�'Q!` fireplace 10.00
Log lighter (gas) 10.00
(...-M SLC3 -‘. • _ Woodipellet stove 10.00
Wood fireplace/insert 10.00
E-^P PERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other. 10.00
0.00
Name: Environmental exhaust and ventilation
Address: I O0 C - Range hood/other kitchen
���� 1 equipment 10.00
City /State/ZIP: 1 tz,,A.Cs),_ 4. 1 .- 76 (_ Clothes dryer exhaust 10.00
Phone: (5 ) i l `
F ax ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80 _
APPLICANT ❑ CONTACT PERSON Atticicrawlspace fans 10.00
Business name: r 10.00
Contact name:
Fuel piping
55.40 for first four; $1.00 for each additional
Address: r, etc i
y /StatelZIP: Gas heal pump
Cit
Wa lllsuspe heater
Phone: ( ) Fax :: ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: 14)14\-t-60,+.1 � C mt ] ,� Clothes dryer (gas) I
Address: t) bV'�' 1r)--,S '� Other:
MECHANICAL PERMIT FEES`
_City, C Ac , `? O� Q Subtotal
Phone: (q: ) 2-L010. C �!
�1 q 1 f F rl> 4 Minimum permit fee ($72.50) . (
CCB lie.: �C p I mo' k ")� Plan review (25% of permit fee)
- 7 t
� O t State surcharge (12 %ofpermit fee) g .'t
je) I `�! •-- 1 TOTAL PERMI FEE '(r 2�1
Authorized signature: f / l�' This permit apprte due expires if a permitis not obtained wi thin 180
name: / days after it has been accepted as complete.
Print l J� Al IN I Date: 3 -- -1) I • Fee methodology set by Tri- County Building Industry Service Board
1 . 1 BulldingVermitslMEC •PermitApp.doc 01/19/07 440-4617T (I I/O7/COM/WEa)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200R -00116
13125 SW hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/5/2008
Phone: (503) 639 -4171 Jsvt!
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/6/2008 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 15960 SW OAK MEADOW LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.11 LOT #: 623 TYPE OF USE:
PROJECT NAME: STONEKING
DESCRIPTION: Replacing gas furnace.
OWNER: STONEKING, RAYMOND & GERALDINE PHONE #: 503636.6611
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503.2661249
Inspection Request Scheduled For: Date: 3/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 066207 -01 503 - 2661249 Y
• Corrections /Comments /Instructions:
& f' EA -t Azo A.- G,!L4) c-L. ` / 4 6 . e
C,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • Date: 3- G -o 8 Phone #: (503) 718- 2-0