Permit 4. CITY OF TIGARD' MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00033
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2008
PARCEL: 25111 BC - 03700
SITE ADDRESS: 10420 SW VIEW TERR ZONING: R - 3.5
SUBDIVISION: DOUGLAS HEIGHTS LOT: 004 JURISDICTION: TIG
PROJECT: FAIRLEY
Project Description: furnace replacement with (1) gas connector
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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 0
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
FAIRLEY, RONALD S + KAREN S Description Date Amount
10420 SW VIEW TERRACE
TIGARD, OR 97224 [MECH] Permit Fee 1/23/200E $72.50
[TAX] 12% State Surch 1/23/200E $8.70
Phone: 503 624 - 2704
Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 230397
TIGARDRD, , OR 8 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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: / / • - mittee Signature:
Call 5'639.4175 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.
`Mechanical Permit ,' t E s roll OFFIC . I F. ONI.ti '
City of Tigard Received
Datel3y: as • ; jt` I=1 /ice .:
IN 13125 SW Hall Blvd., Tigard, OR 992 2 2 200' 8 Plao Review
Phone: 503.639.4171 Fax: 503. 8a Date/By: Other Pettit
T I CARD Inspection Line; 503.639 . Iboe ReadylBy' ]uns WI See Page 2 for
Internet: www tigard-or l ovv i fA I i(J� St Notified/Mcthod: Supplemental Information
BT jg DIVISION .
COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
['New construction 11 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.
. CATEGORY OF CONSTRUCTION value. $
' ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT !SYSTEMS FEES*
For special information use checklist. '
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Coral
- , . . .. JOB SITE INFORMATION AND ATIO Meeting/cooling
Ja` ,1� S .4u conditioning or heat pump
lob site address: V GGGfff/// ���fff/ L to --/ (requires site plan showing placement) ,
City/State/ZIP: Furnace 100,000 BTU (duets/vents) 14 - 00
Suite/bldg.apt. no.: Project name: ri--1-.7)7 Furnace 100,000+ BTU (ducts/vents) 17.90
Gas t
Cross street/directions to job site: Duct work r p 14.00
Hydtonic hot water system 14.00
Residential boiler (radiator or
hydronic) 14 -00
Unit heaters (fuel -type, not dectric),
in -wall, in -duct, suspended, etc. 10.00
Flueivent for any of above 10.00
Subdivision: Lot no..
' Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 10.00
Gas fireplace 10.00
. /o c G_.- yet-0 �-r,.4/y.7 6 .-" r--1 ---- / Flue vent for water heater or gas
O / / fireplace 1000
Log lighter (gas) 10.00
7 O j 6fham, eA Wood/pellet stove 10.00
0 Wood fireplace/insert 1000
Chimney/liner /flue/vent 1000
pf.PROPERTY OWNER - ❑ TENANT Other. 10 00
Name: //a4 . / /A1 ,+ Environmental exhaust and ventilation
Address: r 1 Range hood/other kitchen
equipment 10.00
City / State/ZIP: Clothes dryer exhaust 10.00
�3 / 3 9 3 9 ,( Fax: t Single-duct compartments, exhaust (bathrooms,
Phonei
d ��, 4 ! ( ) toilet compmvttents, utility rooms) tS SO
❑ APPLICANT ❑ CONTACT PERSON Attickrawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name('. f- / 6 Y $5.40 for first four; $1.00 for each additional
Address: Furnace, etc I
Gas heal pump
City/ State/Z1P: Wall/suspended/unit heater I
Phone:03 )6 2, q - 2.-2,q I Fax : : )s -1 Q. 6--2() Water heater
Fireplace
E -mail: Range
n_ // CONTRACTOR Barbecue
•
Business name: l?l i p /C,.i /-1.2 i.. ec-it)//1 ! Clothes dryer (gas)
l� Other.
Address: q i3 o X .23 0 3 8 1 MECHANICAL PERMIT FEES*
City / State/ZIP:. G e 2 .4) D, q ,r p-'/ Subtotal
Minimum permit fee ($72.50) , gd
Phone: (Sri) toy -- -- - 7 1 0 41 Fax: (33 )r-5 -- D }-76 Plan review 25lo of
Gc.: Q-y ( permit fee)
CCB
/ 4, 3 S 9 ' Stale surcharge (12% of permit fee) g■ 70
TOTAL PERMIT FEE Qj/ . A0
Authorized signature: � � �� ' ,t I ,
This permit application expires if a permit is not obtained wi�ia 1 BU
`-� /`y J J days after it t has been been accepted as complete.
Prim frame' 4. At� /y/ I Date: /J4 / / 1 • Fee mythodology set by Tri- County Building Industry Service Board
I .ta,itdine Pcrniiu m
\MEC- PenAe, doc 04.06/D6 / 440-4617T r1 i / o1/CO'.N/wEBI
Z'd OLZO - 009 ONI.LV H VIERAInioa dL£: LO 80 LZ uer
CITY OF TIGARD ,�'
BUILDING DIVISION PERMIT #: MEC2008- 00033
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/7008
Phone: (503) 639 -4171 i A'
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I
INSPECTION WORKSHEET FOR DATE: 2/8/2008 TIME: 7 PAGE: 31
SITE ADDRESS: 10 SW VIEW TERR CLASS OF WORK:
SUBDIVISION: DOUGLAS HEIGHTS LOT #: 0( TYPE OF USE:
PROJECT NAME: FAIRLEY
DESCRIPTION: furnace replacement with (1) gas connector
OWNER: FAIRLEY, RONAL 0 S + KAREN S, PHONE #: 503 624 - 2704
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503
Inspection Request Scheduled For: Date: 2/0/20018 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G59 Mechanical final 0€'4721 -01 503 624 -27(}4 Y
Corrections /Comments /Instructions:
la -PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: �— S — o �, Phon #: (503) 718 -
p ( ) _A 4
CITY OF TIGARD
BUILbING DIVISION PERMIT #: MEC2008.00033
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/2312.008
Phone: (503) 639 -4171 •
Inspection Requests (24 Hrs.): (503) 639 -4175 „„ I P..
INSPECTION WORKSHEET FOR DATE: 2/4/200 TIME: 7:18AM PAGE: 26
SITE ADDRESS: 10420 SW VIBAI TERR CLASS OF WORK:
SUBDIVISION: DOUGLAS HEIGHTS LOT #: (j04 TYPE OF USE:
PROJECT NAME: FAIRLEY
DESCRIPTION: furnace sepiacem .nt with (1) gas connector
OWNER: FAIRLEY, RONALD S + KAREN 5, PHONE #: 503 - 624 -2704
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #:503 - 624 - 27(x)
Inspection Request Scheduled For: Date: 2/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 064392 -01 503 - 624 -2704 Y
Corrections/Comments/Instructions:
. (-4--) fir* /4 / 4/4c
.A 7 6- - _ I a , L am- — 7 GG�
Gi 2C.—
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: i' Phone #: (503) 718 - 2A-4,-\