Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -10005
�' I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/28/2006
PARCEL: 2 S 103 B B -09100
SITE ADDRESS: 12265 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: LAKE TERRACE LOT: 018 JURISDICTION: TIG
Project Description: Replace gas 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: 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
RON WHITCHER Description Date Amount
12265 SW WALNUT ST
TIGARD, OR 97223 [MECH] Permit Fee 3/31/200€ $72.50
[TAX] 8% State Surcha 3/31/200E $5.80
Total $78.30
Phone:
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503- 692 -1565
Reg #: LIC 5193
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:
Call 503 -639 -4175 by 7:00 a.m. for inspections that business da
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 Application' FOR OFFICE USE ONLY
City of Tigard 1 �1 ` Permit N.
13125 SW Hall Blvd., Tigard, OR 9 22 c1 i ' (!6' E -� Received Yi l' 0 �_ • /� 6_4,6,20,
Phone: 503.639.4171 Fa,c 503.598.1960 Pin1Og1
Inspection Line: 503.639.4175 !�. r I Date./By: other Permit:
www.citigard.or.us FEB 28 2001---- • ► � : �i I r ffi
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❑ New construction i it I I . , I t Ir i .,; ' Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the neared dollar) of all
❑ Demolition ❑
mechanical materials, equipment, labor, overhead, and profit
z `Y'i � � h•� _ '`` Value $
cree {t Ria
J3 �YPF'�Y s Lr
1- and 2- family dwelling ❑ Commercial mdust ial ❑ Accessory building < it Y L'a b l i Y 1 "
A Multi-family ❑ Master builder ❑ Other For special information use checklist.
; , z n t 1� t O _ Description I Qty. I Ea. _I Total
`-'1, c .._...;i,_r'i aC' f ! Cl , iiil. t`s..tilJ tli ty h. ∎Z E:='•∎ ` fi'" ' Heating/cooling
Job site address: Z Z( S Z k �l/r Air conditioning or heat pump
(requires site plan showing placement) 14.00
City / State/ZIP: �l / rTA R.0. pg ( 177,Z_, 3 Furnace 100,000 BTU (ducts/vents) / 14.00
Suite/bldgJapt. no.: I 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 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
s 3s' cw� s ,. ,x v: m .t
!? - ' 9 - c", y 7 . t ;f: _ef',.4: tl f c i, gis!) .4I; Water heater 10.00
Gas fireplace
i Ld f�t}L - : f ? ?m,Ov/ &I d) r /!1/(.7 6,4c �//,h A.iAe �" Flue vent for water heater or gas 10.00
reg. W J /..../1..,1 C'A S AU12/�. Aa. as L l gh 10.00
/ Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplacetmsert 10.00
k7 ° s Chinmey/liner / flue/vent 10.00
- °``'�" other: 10.00
Name: 0 AI hipi f TGHErz, Environmental exhaust and ventilation
Range hood/other kitchen
Address: / 2 2 (.S' 5 U.314 LP,1L..r
equipment 10.00
City /State/ZIP: ! to-A R A bn Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( )
toilet compartments, utility rooms) 6.80
T. � �� - �_, t � � �% �
.' .t- &' c; �e I p' 0 4` .. °` h Attic/ctawlspace fans 10 00
Businessn ..e: f� y Other: 10.00
�tC�Al�L / 4.,1) /c. is Fuel piping
Contact name: 18. 1. g, ,. 44/, $5.40 for first four, $1.00 for each additional
Address: /2j 3 ?O' S(n) 11:44-1-11-r/ Aj !> Gas heat etc.
v � . Gas heat t PAP
City/ State/ZIP: 7 6 LAT" j OA /7 62/0 y . Wall/suspended/unit heater
Phone: ( ) e, / L --/s--6,5- I Fax: : ( / 9/ - Water heater
E-mail: � Fireplace
, ,f' s � �{,,.: - "_"` �°' �yl q � � v. M ��Ss�; �°r`-.c h" : 4 -1:1W �
F 2 5 °'.,, '' -; Range
NFa s..o6. c... _ :f':13 > :. T 1 3 _ - . k 1?rt:..i -, ∎ n .,..;t L.: l _ I � ,3�� -,r d ? C A . x.. Barbecue
Business name: 4 ,i Clothes dryer (gas)
Other
Address: ^ K- zf .t i u rn S s u u ry ` 41- ...- � . 7 City/State/ZIP: S 44 - • . Subtotal
Phone: ( ) Fax: ( ) I - I Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 'J State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE
Authorized signature: � ' a Y - 6 rhb permit application , .tier N accepted a: c
0 omplete.
es If peIs rmit obtained within 180
I �_....... _. _. I -•- I • Rr...rlv..L.L....r ..t Mr Tri_I'n...., ri..il.li.... Tr..hw*n. C.nrir.. An...l
r
CITY OF TIGARD ,, /V
BUILDING DIVISION PERMIT #: �.od6 — �XOS�
13125 •SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A i Inspection Requests (24 Hrs.): (503) 639 -4175 ... `'I I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: . / 2 2_4;S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - CO - 0 ` Pouf—Time:— . 44,
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL : ; ALL FOR INSPECTION ❑ ADDIT ON FEES ASSESSED
Inspector: Date: ` 6 j Phone #: (503) 718-