Permit n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00616
• IGARD DATE ISSUED: 12/5/2006
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S133DC -09100
SITE ADDRESS: 13215 SW SHORE DR ZONING: R -7
SUBDIVISION: WINTER LAKE LOT: 020 JURISDICTION: TIG
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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
DALE ROBERTS Description Date Amount
13215 SW SHORE DR.
TIGARD, OR 97223 [MECH] Permit Fee 12151200E $72.50
[TAX] 8% State Surcha 12151200E $5.80
Total $78.30
Phone: 503 - 524 -1034
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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: r A, Permittee Signature: C ot 1- ..,..�
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.
Ilk :^ 12/04/2006 16:37 #566 P.001/002
City of Tigard RECEIVE �- 1a1 r1o�o gg PemdtNaM C —7C'
13125 SW Hall Blvd., Tigard OR 97223" Plan Review Outer Pert
Phone: 503.639A171 Fax 503.598.1960 °'*- t}t II t : I ` Del^
Inspection Line: 503 - 639.4175 DEC 0 4 2 I tj 1 f Date RentdBy. I See Loge 2 for
Internet: www.ci.tigard.or.us - - Notifiedlb(ethod: Su pplemental information
CITY OFF TIGARD ✓✓✓ ✓ ✓✓
. :.. 71 g411Wwadlblula COMMERCIAL. FEE' SCHEDULE - USE CHECKLIST
❑ New construction [jAddititm/alteretionkeplaCement Mechanical permit fees* ate based on the value of the «vii:
performed. Indicate the value (rounded to the nearest dollar) of al
❑ Demolition ❑ Other mechanical materials. equipment, labor, overhead, and profit.
'CATEGORY OF CONSTRUCI70N Value: S
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES'
1- and 2- family dwelling ❑ CormnerciaUtndustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other '
r Qty. i Ea. I Total
• JOB SITE INFORMATIdN AND ,LOCATION Beating/cooling
c, 1 y Air conditioning or heat pump -
Job site address: I3 1 S ♦ i e ( , pbn showing placement) 14.00
--11-9,,,,:k ('� Furnace 100,000 BTU (ducts/vents) I 14.00 /y
City/State/ZIP: T ��� Furnace 100,000+ BTU (ducarvemc) 17.90
Suite/bldg./apt. no.: I Project name. Gras )mot 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 (filet-type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no • Flue/vent for any of above / 10.00 /0
Other: - - 10.00
Tax map/parcel no.: Other fuel apps am - -
'':: DESCRIP'IYOIV.� O$ WORK : • . Water heater 10.00
,1 Gas fireplace 10.00
I i etv /Qie_ s 4 r Flue vent for water heater or gas
/ •
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet 10.00
Wood Gteplaeermsert 10.00
. Chimney/lirteditue/vent 10.00
; P R O " . C TENANT Other 10.00
mn
Nae: \VAIN ber`tS Eaviromnental exhaust and ventilation -
Q Ramge hood/other hitcher
Address: I A p. ► J S 0 ,c-1,,,e, r� I OOD
City/State/ZIP: 1 n - Clothes dryer exau
h st _ 10.00
^ �^%� toilet e omp smuts. utility l ty
Pho rooms) tt��� ). � /�34 , ) , [ / • to�rt<r�nta, tility rooms) 6.50 •
. _❑ . A> PLIC • '. 13 CO PERSON Anicksawlspaoe fans 10.00
Other. , _ 10.00
Business names: Fuel piping
Contact name: . &SAO for first four $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
I Fax:: ( ) Water beater
Phone: ( ) - Fireplace
E -mail: • Range -
. • . •; • . . • •iioMaii►crox ': ' • '' •- ' Barbecue
Rosiness name: A / »-2 f [�u� r
tidy Clothes dryer (gas)
J ou
Address: a eg / e f E p'1 fie p3l v(� . . MECHANICAL PERMIT FEESS•
G51y/State/ZIP: 17 / Q Me. 171521.1 Subtotal 2 y
J Minimum permit fee ($72.50) 72 „r)
Phone: (5213) ,;.2. (35 I Fax: ( SDI 2 � - 153 Plan review (25% of permit fee)
CCB lic.: Q� State surcharge (8% of permit fee) ,$",. ro
°"�' e' — TOTAL PERMIT FEE. 7gs e
Authorized signature:" J 7 his permit dayy, after It bee been accepted as scco obtained
within
t!
I Print name: _ �44 S j e 2 Z fi4• I Date: / ZJV A Co I • Fee meth dology set by TA -County Building Industry Service Board
• ....... - ..e- 16asm,- 0.......411.......... 11/111 / 44046171 (II /1 =COMIWEB)
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MEC200E; -00616
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5/2006
Phone: (503) 639 -4171 emu
Inspection Requests (24 Hrs.): (503) 639-4175 '4' I I ��
INSPECTION WORKSHEET FOR DATE: 1/18/2007 TIME: 7:06AM PAGE: 313
SITE ADDRESS: 13215 SW SHORE DR CLASS OF WORK:
SUBDIVISION: WINTER LAKE LOT #: 020 TYPE OF USE:
PROJECT NAME: ROBERTS
DESCRIPTION: Replace furnace.
OWNER: ROBERTS, DALE PHONE #: 503 -524 -1034
CONTRACTOR: AAA HEATING & COOLING PHONE #: 503204-2/73
Inspection Request Scheduled For: Date: 1/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 042151 -01 503 -284 -2173 N
Corrections/Comments/Instructions:
6 t kt, G4.4.4-0 5 /v 72-'
Fp _j am- - �ti'L•z6 i4.c�
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / -- / 8— 0 ? Phone #: (503) 718- 7--q-9 -J
n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00616
• IGARD DATE ISSUED: 12/5/2006
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S133DC -09100
SITE ADDRESS: 13215 SW SHORE DR ZONING: R -7
SUBDIVISION: WINTER LAKE LOT: 020 JURISDICTION: TIG
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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
DALE ROBERTS Description Date Amount
13215 SW SHORE DR.
TIGARD, OR 97223 [MECH] Permit Fee 12151200E $72.50
[TAX] 8% State Surcha 12151200E $5.80
Total $78.30
Phone: 503 - 524 -1034
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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: r A, Permittee Signature: C ot 1- ..,..�
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.