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Permit a CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005 -00307 III DATE ISSUED: 6/7/2005 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S103CD -04800 SITE ADDRESS: 11685 SW TERRACE TRAILS DR ZONING: R -4.5 SUBDIVISION: TERRACE TRAILS LOT: 016 JURISDICTION: TIG Project Description: Installation of A/C & replacement of furnace. CLASS OF WORK: OTR 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: 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 BROWN, DAVID R + SANTINA Description Date Amount 11685 SW TERRACE TRAILS DR TIGARD, OR 97223 [MECH] Permit Fee 6/7/2005 $72.50 [TAX] 8% State Surcha 6/7/2005 $5.80 Total $78.30 Phone: Contractor: OWNER REQUIRED ITEMS AND REPORTS Phone: Reg #: 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: �,�.. Permittee Signature: -e 0 �p 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. 06/06/2005 10:24 FAX 503 797 4422 ADIDAS 1Zj002 i !s ,Mechanical Permit Application , FOIi OFFICE 1151: ONI.Y City Tigard I, / Received t /► J � i� Permit c / fp 13125 SW W Hall Blvd., Tigard, OR 9 2, V DatdBy - Plan Review Phone: 503_639.4171 Fax Other Porn& x 503.598.1960 i t•;it,, 1 t�, Date/By: Inspection Line: $03.639 -4175 JUN 0 2UU5 Internet: www.ci.tigard.or.us IV :I �` - = -W Notified/method: fill See Page 2 for Supplemental t o form a d o n CITY OF TIGARD - ;,:, _ .. it _ _ __ •n - - ra . rr - - - "i2 ) 3"l�?'_ _ I { :iil :6.9 , I I:;i rrr' ":I:::;�'W; � �I- -err, _I ^se::d ::•I. • - 7 1 . {. . al . . I � ^ t �': n r r ti . ^p I I • .t •Y•� I ��` � a, ° t, a�f . ;,o a h r r . L . 1 / J, I'1' - :•I• • �I •I :r' pl �n :i,: t, � !`tas1� •t l,_vc:l.lar.L • iii :Orr l : :.. ,. � {.', ., .�•. • � ; I, . ..'�. !;: I• z . _ �' , I � I. .211, , • 5 � r .f l Ili a•L - pll' G1 5 [h''a'L i- t ' Is • . : r .. l • I l I :. . r n �I;.. i; ll ' . `l l'. of . I'. ' ; � ' ;: ,,��,, • � la.�: t ..,,����.,�uii .. ���.. -1� �, -. I _..: ;�� -._ , •-'''- 1 - :-L q,ri;�it ❑ Ncw construction g Addition /alteratio 'eplacement . Mechanical permit fees' are based on the value oldie work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Aid mechanical materials, , overhead, profit Demol Other: / hani Is equipment, c o had and ro ' 11E1 I {i r � - ....• ci ' '+f"i 1.1 i i :. " pas "�rir•;ri;':u�ti;l;; a�l� � :- t:: - �':n�:. -- I, ,T -., r..,. ..' " "• .,..,Il : ,l ilii ��l 1 f I � I ;,I::- • �� I I, {sY�Alg 0, I11 ;t Alii(g I,o1,I I „ i 1, I r: .JIL IU,• -- Va1LLC: $ - l:da � ..!1., ,.JELL: '' � r tr•• I ili w n ..,'tl . �.- .`. :_a.'- - -....W � ,I I nw1 I . IL, i:y I I . _ I I I� ��i:�� d lu; i : r r'� ;W Ir l !111 14'tl.Jl l l 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master. builder El Other; _ Description I Qty. I Ea. Total �I i�!i !'{ :" : ,I;Il:II ;:, , r I; , 1.1111,.711,vi, °: ,17 7:7 1 i nt , ,1 , C ; r. d -4!•7 '''.1',;: -I;I 7t li il I•.: i:u,m,Ii! r © . ,H, ; .,,((U •1 1;Yi AK ) I _ 4 , 1»li;hl r `a r 1.21 .. I :P'.i. I�,IIlaill�„I .;L n ll�, r Ill I , . .. �, If f -11- .1 'il r.. ti 1.- r - -� , :-- I ,,., .. • , a, . • '' i_ ! • L...i l.' " i Heatinpfcooling . 1nt1, ( eh 'LII � ^. d - �/� ' : .i II: ': n: -� Job site address: � a A LE 0,,i tits I /� (requites alto pla showing p lacement 14.00 ,�0 City/State/ZIP: r/Cittp 61 ' P 7 Z 2- Furnace 100,000 BTU(ducts/vents) / 14.00 ILL OD Furnace 100,000+ 13TU (duets/vents) 17.90 Suitc/bldg. /apt no.: Project name: Gas heat pump I4.00 Cross scree. directions to job site: / 4t4 r u•...... Duct work 14.00 Hydronic hot water system 14.00 ' - Residential boiler (radiator or hydronic) 14.0 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue/vent for any of above 10.00 • Other_ 10.00 Tax map /parcel no.: Other fuel appliances 1 i;l< 1 ''' ,,� .,.� .•.:� ^1 GLI 1 I t .I' L o�y ' 1 ''° 'rte : l T l `'T t I'1 I 1 ji ;I'i'1' „�, !, ,. ! :hI17�Qy,fA, ,' GI �I 4rp {. i II 1 I I II' ! f {�.I li:;' LLj 'II::F.% '!ml!,�sl...il,,_.;; _,;, L,L.iI IIm ..tji fi01 ?Gil�llaill�l 1'� I I� illy 1�III „•fiia ;•i1::',f. " Water heater 10.00 , Gas fireplace 10.00 L1 Li %! - �s:4... ....!..% _ - ...:!L,4...a4h , , , iL... Flue vent for water heater or gas / : • / / fireplace 10.00 i /L��'. S / L L .. i t - .„/ i .iLi Cr 1llght (gai) lt).t)O wood/pellet stove 10.00 Wood fireplace/insert 10.00 1'!i li!i ,il i ; ' °: 4 "C � - - ;= - 7• �ti'r A iI , If:?,.,I:; � I T 1 I !' i c }W'l� it l`^ :, -- '- ,r,-„ -1 ;, .- Chimney /liner /flue/vent 10.04 17 I i 7',illlIlrMfl - { 1`.1- • ll ! I [GEli , ( 11 It7g FiI" I . , � v nit I Ill ' I )i lLll;.h.. ; 11II i.4111It III -� ---i' : Other. 10.00 Name: i v/ D . 0 1 Environmental exhaust and ventilation Range hood/other kitchen Address: , _.. , ,1.., /.. equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 Single - duct exhaust (bathrooms, Phone: (.5203) g' 3 g toilet compartments, utility rooms) 6.80 .tl,rr a� l :� C {I:1�d:1W ti =•i�:, i ..iliihnl :III IIII� Jl�i,':I;".h-l. II - ''1'� - - 1, L+?I� . I, ,,, i; ^t Irl'1 ll .�n' _ i I - ?l• t 1 I ' Attic /crawlspacefan f.'i t�� { X1 � -'" .l r l .i I I :•. .:,• 10.00 III,, "� ^' . Ir U.li.. , i•n v �ulu • � i � ,l 1J. 1 ' iil�ilil{ liil llil i llittil�l; i l .ii.�; • • -•' . h;' tL ^�';lILS'1'::ilfi? I Business name: Other 10.00 Fuel piping Contact name: $5.40 far first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall/suspended/unitheater Phone: ( ) Fax: : ( ) Water heater Fireplace E- mail:. - • j��' .- ?I iS: ,,., ;11::?-:. "1 1 �..i �G. :G ( m 01177 . ,,,ir„ r;. •I I 1 7:117, 1 " 1 1in'IV!"1 Ili: 7.7- Range 6�lllRI �dJ { I 1 : i 1 1 ,,,. , ■ 1 1}I" i •l [I j y ' 9 I2 r,4 "`,`,, I LS �1 � l gl i 1 . 11 illt:1i1 :? 1 '1Illi„Ii r..: " ! 1 . t . 1 1 Barbecue I . Business name: r Clothes dryer (gas) / Other Ad cos: -^ -,-m;r *. ` r,jc :5 :1t.tih 1 77 :7 7- :.;;; =i: ■ City /State/ZIP: - Subtotar v - '2.5,€7' Minimum permfc -fee ($72.50) j 4 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) Oa) lie.: State surcharge (8% of permit fee) S, t TOTAL P rmit i :[T FEE Authorized signature: �_ This perm a ppticntion explrca It a prmlt la not obained whin 155 das afte It Asa been accepted as complete. I - Print name: () , 0 4, gz y I Date: ,S /3/ /Qr ] - Pao methodology set by Tri-County Building Industry Service Board Ri3u;IdinOemily \MsC PPm,lwrip.dec 17J03 440.4617r tilio2/com/wES) • , //695 5W n- -er 7t //tcs a. g 7/6 id1 aI -y we, 3 t. a taz r 4 4 e 417 0 's e Filk.N.Oc e e /WS TA e n � 0 1 4)31 A rg f 3f /r 6 38 ,�usc': � 3 p Csi i 6R� GC S� 0 N O .--I in O O N to r O to - O -s,- s MS- . CITY OF TIGARD • BUILDING DIVISION PERMIT #: MEC2005 -00307 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7/2005 Phone: (503) 639 -4171 4 ..11 °+ 1 Inspection Requests (24 Hrs.): (503) 639 -4175 , „_..J f .. INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7:07AM PAGE: 97 SITE ADDRESS: 11685 SW TERRACE TRAILS DR CLASS OF WORK: SUBDIVISION: TERRACE TRAILS LOT #: 016 TYPE OF USE: PROJECT NAME: BROWN DESCRIPTION: Installation of NC & replacement of furnace. OWNER: BROWN, DAVID R + SANTINA, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 010974 -01 503- 968 -6318 V Corrections /Comments /Instructions: ( ---- c i \PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date Phone #: (503) 718- 06/15/2005 11:34 FAX 503 797 4422 ADIDAS 11005 CITY OF TIGARD :._. ; BUILDING DIVISION c ' ' �J PERMIT #: I`�} "C�sGO'iy- OS f 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: eiti • Phone: (503) 639 -4171 !:.a • Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6,14{210 TIME: 7' t')AM • PAGE: (iii • r, I is SITE ADDRESS: 1161:1 : :. :; .I ACE 'MAILS DR CLASS OF WORK: SUBDIVISION: TERRACE: TRAILS LOT*: 016 TYPE OF USE: PROJECT NAME: BROWN. • DESCRIPTION: .' r15 on /VC ii: rtiapiac :�s`.''f1.e1n. of Furnace. . • OWNER: +1 ROWN, DA ,.10 rF + ; AI'd PHONE #: . CONTRACTOR: OWNER PHONE #: . Inspection Request Scheduled For: Date: 6f14/2006 Pour Time: ' . Code # Inspection Description Confirm # '' Contact #. Message $99 Mechanical finsI 009185 -01 503- 96B -63i8 • I.i • Corrections /Comments /Instructions: M/No 2 4- A F L 4 J./ ,' __ - . - .- • -- . . 1t >' 2w i! .k C ,4> 41 . 4 _. Ick AV Ali ` - -� 1) r _ - . -, t . AA .."-- — O . ‘. ' ..:: . c .1 • _. t' :.' ....' ' C r' 0 %' f 1 rri s - &,..... ` — ti 0 •%oice_ A. fr vAi /7-- . • 2 -) ' Pg..° y it'' ir ir9 r' Fa 4 7_:7 ,4c 4._/ . -t ,2 r. , •-■ -F u lc hl c C ❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL 'EA)L FOR INSPECTION ❑ ADDITIONAL FEES ASSESS Inspector: 1 /( `-- .,!~ � ' Date: ' T - � ' //�� Phone #: (503) 718- • 06415/2005 11:34 FAX 503 797 4422 ADIDAS 0001 • • a I FACSIMILE TRANSMITTAL SHEET TO: FROM: Bui1ding Division — City of Tigard Dave Brown Fax #971234A422 COMPANY: DATE: City of Tigard 6/15/05 FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: 503.598.1960 5 PHONE NUMBER RE: Electrical Permit App. & Payment Auth. URGENT FOR REVIEW ❑ PLEASE COMMENT PLEASE REPLY ❑ PLEASE RECYCLE w. NOTES /COMMENTS: Attached is an electrical permit application and payment authorization form for replacement of my existing furnace and installation of a new air conditioner. Chip Barnett did the mechanical inspection yesterday for Permit # MEC2005 -00307 and instructed me to apply for the attached electrical permit Barbara helped me this morning in completing the application. Pm also attaching a copy of Chip's inspection worksheet for reference Once the application is approved, please fax it back to my attention at 971.234.4422. Also, please call me at 971.234.4653 when you fax it so I can pull it off the fax machine. Thanks, Dave Brown Phone: 971.234.4653 e`maiL browndavid@adidasus.com