Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00571
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/1/2007
PARCEL: 25111 DC -12300
SITE ADDRESS: 15920 SW OAK MEADOW LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.11 LOT: 619 JURISDICTION: TIG
PROJECT: SCHAEFER
Project Description: Replace 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: W L DSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SCHAEFER, MAX L + AMY J Description Date Amount
15920 SW OAK MEADOW LN
TIGARD, OR 97224 [MECH] Permit Fee 10/1/2007 $72.50
[TAX] 8% State Surcha 10/1/2007 $5.80
Phone: Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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 - ,// ///7" / / Permittee Signature: QL /p
t
C j _ c
Call 03.639.4175 by 7:00 a.m. for inspections that business y.
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.
SEP- 28-2007 02:55P FROM: T0:5035981960 P.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received ;il I ' , Permi[No _00 - Ow 1
13125 SW Hall Blvd., Tigard, OR 972233ECEf VEm Pi Plan Review
Phone: 503.639.4171 Fax: 503.598.19 /,,, v ,\ no way Other Permit:
Inspection Line: 503.639.4175 SEP 2 8 200,_. E l l
Internet: www.ci.ti onus s .1 DateReady/By: See Page
l Notified/Method: ' Supplemental mentnt al / Information
CITYO'ETIGARD
t ! . 4671 hr :�. �.,`r.CY): I ti ': `' 1 r: r •. '� 'P . . . r :,f•.. •• . -- . ip�.: .1...� a �CS y i, {L'
� ,` ,f ���� � � ' yr, t` ,`� n 1': r .
`' 'mac ��
.; , v1' , '` 4 W.4 ,. .. : f_ , ;:..,,r , ... � ,, , ..S: . , . .. / r - ,,,, �':- :, " '
. . ' A ; 1 y :. ... . `!Fl LY'Sa.�++'Y. '� . i` . . • V.5E' C IC i1ST
❑ New construction Addition /alteration/replacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
1i �pa.t' I �p i�SyAa ills 6, w,Y a.r i k ,. I . : ' , ,'. Value: $
.�l y: Ur`1 4,! Y't Y ( y ,,• --. Il t' E • i r, :`,` '�,'''' L ' ... .'y: p
�F [ R . :,�1 I��{ i�ll� �• i ?� rTrSl�'. �,��� _�0 w .' � : � � . #.." 7, . �� �F= • _ J .. r v. ....- • r. h v • '.; , 4 ; { : }d j i E 11411ge.Nr_
F SYSTEMS FEES`'
X 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building '�` "` 14
For special information use checklist.
❑ Multi - family y s �aY ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
r 'v `` °�, •,; . r Heatina/rnotlnQ
Job site address: Air conditioning or heat pump
5 1 Q �11 V r� UV (requires site plan showing placement) 14.00
City/ State/ZIP: R3 I i U Furnace 100,000 BTU (ducts/vents) I 14.00 l' . PO
Suite/bldgJapt. no.: I Project name: • Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work _ 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00 ,
Unit heaters (fuel -type, not electric),
in -wall, in -duct, supended, etc. 10.00
•
Subdivision I Lot Flue/vent for any of above 10.00
Other: _ 10.00 ,
Tax map /parcel no.: Other fuel appliances
1,,..
:
� 1 rN . qr r u c uti it : ' " ': 10.00
yy�� +r ,. m t lute} +e 9 0 ,. r} ..,., Water heater
y - .1 Lk'i7Li!' 2 r ,S• nt�], '9� Cf - ie k i R, _ . ,:. !i
Gas fireplace 10.00
Flue vent for water heater or gas
�onl / J s yam/) a p t fireplace 10.00
�, �,1 rltiC�J Log lighter (gas) 10.00
Wood/pellet stove 10.00 •
Wood fireplace/insert 10.00
�
Chimney/liner/flue/vent 10.00
F
F j f`y ►5'p \r�4i 4f �l�l Ku�r32 s� "d 1 3 sC `� -''' Other• 10
Name: Ira r "Ili; - Environmental exhaust and ventilation
•(.�C) Range hood /other kitchen
Address:
VV�u�� �r � „`�•'' equipment 10.00
City/ State/Z1P: Clothes dryer exhaust 10.00 ,
l ��"I Single -duct exhaust (bathrooms.
Phone: ( ,fa ) 1 1 1 • • � 1
i ' Fax: ( ) toilet compartments, utility rooms) , 6.80
n sm ! r � e �D ,1 , qy , ' m 1 r � 1 '' • . • • . k . . -
1 r) COW Te COI 1 1 o 1
Other: 10.00
Business name. Fuel piping
Contact name: S n ' n JP-VC V �C $5.40 for first four; $1.00 for each additional
Address: I� � I 'JV (3 C,.. /� `aCk (Ji N ' JI I vor , Furnace, etc.
Gas heat pump
City/State/ZIP: Ci'iel 1 Walls uspended/ unit he ater
GI f� �` � t 7G _� ,
Phone: (o) Sb 7 I Pax: : (603) 55 -01 1 q Water heater
Fireplace
E -mail: Range
nN257 [E�; ,�, .r . y�T rp 1. r'r' M1 T
: r•c �.� '' ; • . _ . ,' ., '1vr :` r",�kdd Hal il 11511g4 Barbecue .
Business name: To CP.A. ' 1 ?n p C a !' Clothes dryer (gas)
Address: 17)1 r) . QC t�ltt a5 § /C JI r It � � [ 's R! ''r„ 4�,'tM :"Y',t - f iii y:n' t ' , '. .
City / State/ZIP: Cu 1 (..,� ( \k `17t4S " Subtotaal 14•.00
�) � ' Minimum permit fee ($72.50) T7- • 50 Phone: (5_:± Js I Fax: (� , 1 -01,1 Plan review (25% of permit fee)
CCB lic.: -7.21:02,s State surcharge (8% of permit permit fee( • V
- TOTAL PERMIT FEET 1 VW
/ / 1�,t7�C11 Th is it application expires if a permit is not obtained within 180
Authorized signature: ` r mi days after It has been accepted as complete.
I Print name: bi an( A jQI I) I Date: 412, O1 1 • Fee methodology set by Tri- County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: MEC2007 -00571
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/2007
Phone: (503) 639 -4171 4 Me °' r1! \
Inspection Requests (24 Hrs.): (503) 639 -4175 ._'!�L'��
INSPECTION WORKSHEET FOR DATE: 10/5/2007 TIME: 7 :01AM PAGE: 46
SITE ADDRESS: 15920 SW OAK MEADOW LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.11 LOT #: 619 TYPE OF USE:
PROJECT NAME: SCHAEFER
DESCRIPTION: Replace furnace.
OWNER: SCIIAEFER, MAX L + AMY J, PHONE #:
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503557 -2220
Inspection Request Scheduled For: Date: 1;/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 057023 -01 503 557 -2220 0---
Corrections /Comments /Instructions:
•
4 PAS rA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL i f CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED Z67
Inspector: Date: Phone #: (503) 718-