Permit ill CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00736
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2007
PARCEL: 1 S 133RD -06300
SITE ADDRESS: 10925 SW SUMMER LAKE DR ZONING: R -7
SUBDIVISION: AMART SUMMERLAKE LOT: 107 JURISDICTION: TIG
PROJECT: DRAPER
Project Description: Furnace replacement
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JOYCE DRAPER Description Date Amount
10925 SW SUMMERLAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 12/18/20( $72.50
[TAX] 8% State Surcha 12/18/20C $5.80
Phone:
Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
7 ��t_ Permittee Signature: (?'y] ] ..,,
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
c.-15'a20E17 09:42A FROM: TO : 5035981960 P.1
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Mechanical Permi 4i' lei . �"y,}'' % ii FOR OFFICE USE ONLY
City of Tigard n e t e/By / I . • Permit No et __ 7
13125 SW Hall Blvd., Tigard, OR 972M- y t7 �
Phone: 503.639.4191 Fax: 503.598.89g C 1 t G ," .� , t �� ; -� Plan Review Date/By:
Other Permit:
Inspection Line: 503,639.4175 / � , : � II
J
Internet: www.ci.ti rd.or.us CIT i �6 ® i- f IGAFID • -� _ Date Ready/By: : J BI See Page 2 for
Notified/Method: r Supplemental Information
BUILDINCDIVISION
Ri,3, ;�,.•+ ,, �,, �_,..�.. ,..;,•, ;.�., ; - „c FIE
10,� iJ .ilk• :!ii .Ii _ '�' 1 � ,� *. "'. ': � _I- ,, % _
F�, ,,•,;t�; ,.,Ir,.�:�f,r';a'�:nn';.. T•,�,;:...� �q�, ;t,'.•: }.:.' ;gip! ;spy. i �.CCjVr� , 7LR�.y�r - NEE!+: =$CHEDi>'LE' r�SEeC GKLTS T
❑ New construction X! 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.
' �';' - ;I °),lil ay ,. Fl : :• ; • m Value. S
.,o ?,l ..i :ntxr_v.,,!°_•lti:.1 . . ,.4i'. r .- E- O ,..., ., .I [JCC[ON . u ,. � ',1 -. .,..�, :,. , :' ._ --
1- and 2 family dwelling El Commercial /industrial ❑ Accessory building S DEjyTS'' ':, >JIl'MICNT / SYTEMS - FEES+
S
fi. , 0 Q.
For special information use checklist.
Multi-family Multi-family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
iw;- ? Yr , ' , 1 1i 4 _', It . 11.g 8 l 1 TR L , . '! 0 ' Uc A,. ,C ti: , �:; : , , ' ,'. .. Heating/cooling
Job site address: I Dg25 1/491‘) a 11.U( ' J Air conditioning or heat pump
(requires siteplan showing placement) 14.00
City/State/ZIP: ilaCIr' OJ Furnace 100,000 BTU (ducts/vents) 1 14.00
Suite/bldg /apt no.: 11 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, suspended, etc. 10.00 -
Subdivision: I Lot no.: Flue /vent for any of above I 10.00 '
Other: 10.00 ;
Tax map/parcel no.: Other fuel appliances
, `a { , ! `'h r J et r ' N Ja �, ♦ 1 .: ;:F:a
'�'t ^ d ir. (t I� �O • 61/ kdt I , t , M . iA r v , . : - rIN Water heater 10.00
i r.e ,; '" ! ► ` ; -g4- . �` : . -._ .....ryr..l ', up;_ :ii:',,,4, .e.".0,� 1 1,1 .
Gas fireplace 10.00
Flue vent for water heater or gas
(� �� /t_, �^�,�p Log fireplace 10.0 _
�Q�( `� / ((�1�J�1 Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00 .
fi; e a . o : L1, ! , 1; `ot• ' L xni .,. ;, .,,Y, ;:,I' },,;. • „ • tq # L.
r R c a ' + Chimney/liner /flue/vent 10. 0
..1l', w. -
' a4t„ Other: _
Name: 0r Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/ZTP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms.
Phone: (UR)) 5 7q q Fax: ( ) toilet compartments, utility rooms) 6.80 _
1i1A r a�,,s,Y1ie . 4 J . e y J is
P ('�p.,}i ; ' F " 1 Fi � , �� 'Nx;: =4: , ii' � r li - i61 - : " Auic/crawlspace fans 10.00
illl ' lt4� .;:sq., fts ;. � • { ?:!.. , i ' axa{: 4 .•VV• 41: tux;, }� ".. ) ;vy�`! 'N,1.0 ,,... r. -,-L, . .,f:i. ', -
Business name: In CC .0 1 i Y Temp p (C I I o' 1 Other: 10 00
I Fuel piping
Contact name: ,( +� ] /�/�' D' yc� 6 $5.40 for first four; $1.00 for each additional
Address: (•"J I aC) l c lac k ai 1 C ) IV l UC.t Gas heat pump
City/State/ZIP: (reyO)1 CI '� C" i' <t 7C)11 -Ci Wall/suspended/unit heater
Phone: (50..6) S 7. - ,22() ` Fax:: (0%)) 557-0 l (1 Water heater
Fireplace ,
E - mail: Range
y" !ln •.;, r i 1 r.•'�r, J ",� + ,wcs , v °M' h" '* ,•�,�,�/ I `r , 4,,...,,.. ' Barbecue
3 f, 't s' l� l' �t�Yi:�/i p n ay W.11♦ ,lf , h .1 1 1T 1;.V
_,.� �1� _j;..'��?i����:�;nr� .;n.;,M ,t . ,.!�,:,, (('' � r r{� .�!: tF ��i.%'�� t,. �;��'t , ` 1 ''' -.. � �.
.f � .7><:'�'.�' •rI'��:YI 1r; _.T .a•1' �k "ri.
Business name: Tr! C(t Teel ([!I -'('I- j Clothes dryer (gas)
L Other
Address: V i ("J( r) .( ! r la`5 � � �. ri 1' Ls t ` %:, ti ;IK EEt ER1V[I�1. FEES "
Ci ry /State/ZIP: I { \ Subtotal
Phone: C 6 7 - �n G c5 • -7 n i• Minimum permit fee ($72.50)
(� ) .�✓ ' LLB C I Fax: (•�Q) 'J� / _ 1 I Plan review (25% of permit fee)
•
CCB lie.: '72:11) 2,s State surcharge (8% of permit fee) g/) /�/'�
� �r TOTAL PERMIT FEE ' (
Authorized signature: y1 C.12 r Z ` t of-; ?au �L This permit application r accepted as complete.
is obtained within 180
days
Print name: njQj Li Ilvt,a6(1 {) Date: 12.1401 Fee methodology set by Tri County Building Industry Service Board
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: MEC2007 -00736
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/10/2007
Phone: (503) 639- 4171P.�i�l
Inspection Requests (24 Hrs.): (503) 639 -4175 .- P_-
INSPECTION WORKSHEET FOR DATE: 12/28/2007 TIME: 7 PAGE: 44
SITE ADDRESS: 10925 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #: 1Q7 TYPE OF USE:
PROJECT NAME: DRAPER
DESCRIPTION: Furnace replacement
OWNER: PHONE #:
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 -557 -2220
Inspection Request Scheduled For: Date: 12/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
689 Mechanical final 062266 -01 503557 -2220 Y
Corrections /Comments /Instructions:
6LeG r L v�co -A- 1,4iA,5 C. 4L4 s - / s S 3 q _ d t ,z- , r– / - w
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:/ Phone #: (503) 718 - L -J--------