Permit •
p . CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/8/2008
PARCEL: 2S103CA - 03000
SITE ADDRESS: 11515 SW TERRACE TRAILS DR ZONING: R-4.5
SUBDIVISION: TERRACE TRAILS LOT: 002 JURISDICTION: TIG
PROJECT: THOMSEN
Project Description: Replace furnace, add AC.
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: 1 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
GEOFF THOMSEN Description Date Amount
11515 SW TERRACE TRAILS DR.
TIGARD, OR 97223 [MECH] Permit Fee 1/8/2008 $72.50
. [TAX] 12% State Surch 1/8/2008 $8.70
Total $81.20
Phone: 503 -577 -0715
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
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Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: Permittee Signature: 7 j (f 2 7. Z:L I A ..._ 4 de =2_ Y
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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a ' JAN -7 -2008 06:35P FROM: T0:5035981960 P.1
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Mechanical Per flit D FOR OFFICE USE ON
Received
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City O Tigard Zt Q% Date/By: r i 7 N PcrrniiNo.: ki _ _ is% {�
13125 SW Hall Blvd., Tigard, OR 972 O ? Plan Revie v
Phone: Inspection Line: 503.639.4175 503.639.4171 Fax: 503.598. j n ; . i ,. D C Omer Permit:
OJ:i: r _- I Date Reedy /Fly: rya. ® See Paee 2 /� ` P Notified/Method: Supplemental information
. ��.j�1�°• 11 � " n , �,, . .. : .7. W _ -', 't'�y_.. •r
.ri 601 :frr ITO', PI; li;; ■: ' , *thi • ; i ., . , O ,. ": ''l 4 ; '' d - ,, , i .. ' , g� � '', - ,; G ;CO t 11 � D , VL G1 . ``$ 1; E1 ', :S C REI$U L E - �SEiCHECKL 1ST
❑ New construction N igt 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 W f .. .p.vs �.kh «- rjl� p �e�{ r 1 e ,� �,.
..l,:e';' Value: 0'14 -V ::';; 1:• <�';,"'.''a4�i��r? .0..,, 6; 1 ; 1;0 ',e0,R4 17 �ON", r91�' ..' 9.r: ,:; :r4. `, ., , _ . Vue:
, al . , •
Au 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building $)Dl ly ;,13Q ion /SYSTEMS FEES*
multi-family or special information use checklist.
[3 y 0 Master builder ❑ Other: Description I Qty. I Ea. I Total
•�" ti ;� .,JisU'F�i�l�i .ka .,,_ ..x.4... ,iR!�`� e`-x�� i t7! k r„loy.,AT !' �jj�t.0 T�'.ro*';� �, , > '4`§' 4,1,4q ' :� +:
L''' v • . :, . Heating/cooling
+rt't'.t'il.
Job site address: 15 sYr& 4 / bri \/� Air conditioning or heat pump
w v v (requires site plan showing placement) 1 14.00
City/State/ZIP: ¶i Z Z Furnace 100,000 BTU (ducts/vents) I 14.00
Suite/bldg./apt. no.: I Project name: • Furnace 100,000+ BTU (duets/ vents) 17.90
Gas heat pump 17.90
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 Lot no.: Flue/vent for any of above , 1 10.00 _ -
Other: 10.00 ;
Tax map /parcel no.: Other fuel appliances
,., ;r :p•" i 4 , '�';,' .n. a4 ''t. ( :•�h.v ,.-m•, iir'
i }�r ;.))0.4,° a ,, it1u 1, `.)? •r 4 i' 0 4�• ti :1A xa; �;.: - ;„!i; f r ' Y„'u' : Water heater 10.00 '
�Y l . . � Y'Ir M�'c, rd�iy.lt' L. .. T i � I; �,;A
Gas fireplace 10.00
Flue vent for water heater or gas
k Q ti rrn I 1yt/1t f I IIr fireplace 10.00
`WIl9� (a t iQ t C17 V Log lighter (gas) 10.00
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Wood/pellet stove 10.00
,q 4 pa I�I�q Wood fireplace/insert 10.00
IL _,:a � :i a " e �'' t ` )� k tlg 4 +,: {.rr a - : •� r . . i . Chimney /liner /flue/vent 10.00
" A.
a � , r; � � 8 .- `F�... I •i,6.._ • 1 Other: 10.00
Name: 4 1 , E; I A ryy201 Environmental exhaust and ventilation
Address:�/� Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single - duct exhaust (bathrooms,
Phone: ) V J 01,0 Fax: ( ) toilet compartments, utility rooms) 6.80
ri ye. „� 44 +1 ywu,e i .- SY r a ,r ,wn. .n r - ,.. Anlc/crawace fans 10.00 lS
q�' i G.Si• 1 ,.{ ��,, � 7 (, ' d �; l YE ; � a: 'p
; �.11k':�. '4,.at.�.' s P ?tr.1's _ifFF ,I't � it i !'t' '. k WID' YO ° 1 '.1a10'! 6W,";�, : 7 �
T ri (: T'r np COQ rim 1 Other: 10.00
Business name: Fuel plpint;
Contact name: $5.40 for first four; $1.00 for each additional
Address: 0 (G) ( C'')')[ Ri �"C�,r �C' Furnace, etc, ,
Gas heat pump
City/State/ZIP: Crrg Ci 1 ( ' ( IQ ({ 7015 Wall/suspended/unit heater
Phone: (tG. '5) S,f • I- 2120 I Fax:: ( 5c5 7-CX f I q Water heater
Fireplace _
E-mail: , ,
.,�,.,���., , r. � r:;�le+ k�cr ,tnt�tw ww, �� +.�o r' r i ' . •�,��. .�. karbecue r
a N ;}� o- ;', t4 a )� .' 1 w ;;
it' i t ` t N �(� y ( a g ut " . ,;�. 1C; ,
Yr,' F- �' h. �+ l !'' ".�7HiJj1�'��o�i�iftFaL'u''a i�'�' +J-,3'1i:�1�A:�! RSA. �' �r��, d'. t�• �Fi�,' a���rla '..�.a�w:'!.�1,rt.''cwl.Ilfi; - T.il�
Business name: TI'l Ct ' Te I l) Co Tit c1 1 Clothes dryer (gas)
` Other:
+ ,,! �c � .7 ,.. q ', + ' I:�..r. 1: {r , 1. •
Address: 1 i G . Ctc kttind 3 / R,i Vll�r.t) r 4 )- . )`t;: "i ; •"'' , EC AN1-0; L PEUM1T ?, EES ''' 1
City /State/ZIP: k..II�e( 17 C CS_ c Subtotal . 72. ,
Phone: (F3Y3) - 5 7 G/�I r ') Minimum permit fee ($72.50)
)� - Z�-� I Fax; CJ • 1 I ( O Plan review (25% of permit f ee) C2
CCB lie.: '701.0 Z f 3_ State surcharge (fif -Mf permit fee) ` :
TOTAL PERMIT FEE
y
Authorized signature: -r ;I J )/2 tJ T hle permit application expires if a permit Is not obtained within 180
!Tn days after It has been accepted an complete.
Print name: /Vat / Ll' ,1j , jQl6) I Date: 1 1 (V A • Fee methodology set by Tri- County Building Industry Service Board 7
JAN -7 -2008 06:35P FROM: TO:5035981960 P.2
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® 002/002
d ay - COADry
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INSTALLATION ADDIUSS:
'. . %5 5 i .4 Ac , .skfs Oa .
Q
PfOrFliRY LINE .
1
ZS FT 61 QCi I
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Fr:
P� mr :.
14�
FRONT
� FT:
PROPUZITY LINE
QUIaluaN _-r S. REE
CITY OF TIGARD
+ BUILDING DIVISION PERMIT #: MEC2009-00009
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/0/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F 'II�
INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7:01AM PAGE: 54
SITE ADDRESS: 11515 SW TERRACE TRAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 002 TYPE OF USE:
PROJECT NAME: THOMSEN
DESCRIPTION: Replace furnace, add AC.
OWNER: THOMSEN, GEOFF PHONE #: 503-577 -0715
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 -657 -2220
Inspection Request Scheduled For: Date: 1/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 063031 -01 503-557-2220 Y
Corrections/Comments/Instructions:
ASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /-- // vA Phone #: (503) 718-