Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00832
°11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/20/2005
PARCEL: 2S 114BA -07800
SITE ADDRESS: 16260 SW WOODCREST AVE ZONING: R -4.5
SUBDIVISION: COPPER CREEK STAGE 2 LOT: 018 JURISDICTION: TIG
Project Description: Replace 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:
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
MARC SPITZ Description Date Amount
16260 SW WOODCREST AVE
TIGARD, OR 97224 [MECH] Permit Fee 12/20/20( $72.50
[TAX] 8% State Surcha 12/20/20C $5.80
Total $78.30
Phone: 503- 639 -7680
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: i Permittee Signature: p , p
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business dal)?
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.
Dec 20 05 10:54a Tri County Temp 5035570919 p.1
Mechahleal Permit Applicatdo FOR OFFICE USE ONLY
City of Tigard �� \i V V [received _ / _
13125 SW Hall Blvd., Tigard, OR 9 DatrJBy: / / . Permit No.L C ,, `) , ,
Phone: 503.639.4171 Fax: 503.59 it .----J
0 Pla y Review
0. n5 A r r ig Date/By: Other Permit
Inspection Line: 503.639.4175 0
Internet: www.ci.dgard.or.us r• r, �' � r:� DatedYBY: turn: / q► See Page 2 for
1 '' � ('G °; + 1J Notified/Method: ... Supplemental Information -:-. rr 1' �_r�S.a.w� �:1 ' y + • } Y• a., �.. W L T 1 y r � j " J
.1. ti P ::Cni�.1:7* QiCL�:. 3+Yr e. 1tikt:r... al-i',,." . d .,
�• � _•, .,. .. ..tl� �:r.,_ . .r:' ;... - ;t':CUIVIIVILrRG' ':�E"P;:S "•= DSElCHECKI;iST
❑ New construction XAddition/alteration/replacement Mechanical permit fees* are based on the value of the work
❑ Detnolidon ❑ Other performed. indicate the value (rounded to the nearest dollar) of all
�:. ;may: on _ - , �� mechanical materials, equipment, labor, overhead, and profit.
-. • .:.., :, -' " :`,CATEGO1EtIr'Ufi C1 4.TRTJGTIOIY•"` m-�ZaF' ' d ii`• i ; Value• $
1 - and 2-family dwelling ❑ Commercial/industrial ❑ Accessory buildin
al a. �'._ ~ 1_g 1 �_ , I r ? S ? TF5p.: 4 I:�NIENT'[ SYSTEMS,FEES•
❑ Multi -family ❑ Master builder ❑ Other: For speciel information use checklist.
- 3Fx:=` 4 r- "SOB °STTEeIL`OH�TATXON ��tLVD. "' : �; Descnption I Qty. I Es. I Total
1 .� 1JO , ,, f; ,. Heating/cooling
Job site address: IW Z4O SW ' a kosf Avenue Air conditioning or heat pump
r �11�.rf �tlV (requues site plan showing placement) 14.00
City/State/ZIP: 4 22. Furnace Fuace 100,000 BTU (ducts/vents) j 14.00 '
Suite/bldg./apt. no.: e Furnace 100,000+ BTU (ducts/vents) 17.90
Project name:
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: Lot no.: Flue/vent for any of above L I
10.00
Other: l 10.00 ,
Tax map /parcel no.: Other fuel appliances
. "e ,.'.' i•.. `' ? ; . ` • .. • . P • .. .. N . i _: Olr•'� . . • • - . 0 , ''? > ' 4 W ater heater 1 10.00 ; • �Pf1� Gas fireplace ' 10.00
�1J� Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00 I
Wood fireplace/insert 10.00
...:-.2-:` . . BF.I .. UPERTY:;,OWI!1ER:,y..... . •. '..47-''.-1.• ti:° rj• ' i+ - •i:.''•..: ; Chimney /liner /flue/vent 10.00
. .. ;:r - . .+ t . ,i,. 0 - T,E AMT- ' Other: 10.00 j
Name: . ,. .. - Environmental exhaust and ventilation
M611(...4617111 . ... . ,
Address: atiftej Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Phone: ) 1_lifitt) F ax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
i, ®eip.I;ICASIT, ,. • "+ '. r, CbNTA A ttic/crawlspace tans 10.00
Business name: Tr, CCU l I / T rap Control Other: 10.00
r Fuel piping
Contact name: S5.40 for first four; $1.00 for each additional
Address: !MD J C[a(kaJY Q ti !y��--,'Nt/'11 f Furnace, etc.
t1 0 "hi C f ( CI 7045 5 l..` � l V \ Gas heat pump
CitylState/ZIP: c fin' Wall/suspended/unit heater _
I Phone: (013) 557- 979f) I Fax: : () 557- -( l q • Water heater
E-mail: I Fireplace
4:•c�'. , i . -` ".- '+ : ,-- �,i..;. e .• { t �'-w Range
3 : `::',air•'.. :s "i . .}. yy : Q + l brr' i . r '�`', lt.-• ••
'.`��> .:"h= �:r, • %, x,14. 3Y A( :;,' � i .. t >_ti
_ � ..< :ti r %4.7., � :_ t'�'. -�r"• d:-:�. �'�: 1 ' .�. Barbecue I
Business name: I I l_EJu "�Pyn Control Clothes dryer (gas)
p �j� c imp �' Other: i
Address:
�� 50 `J 111 a ck MOS RI ' jri M ' '� -- °. * , ' ' ^ .ME6te,olic}i i*RiiITr •EEES�
l t ' I3 fl / I
City/ StateZIP: /J C r Subtotal
�r C• Uf t C I L Jg_ `
Phone: (C _3) 55-r-17 ��() I Fax: e j a � 65 7 ,-1n 1 g Minimum permit fee permit fee ,
0)
���" ICJ J ( C 1 Plan review (25% of permit fe
CCB lic.: 7 2
I State surcharge (8% of permit f e
���pp f /� TOTAL PERMIT F E ??y&)
Authorized signature: S`-4�� ° -- 774 `4----. This permit application expires if a permte is not o rained within Igo
n t d ays a i t h as b een accep as c
Print name: .bGQ12e /UI 0) j'I I Date: 4 • Fee methodology set by Tri- County Building Industry Service Board
i^ Building , PcmuatMEC- P:rnutApp.doc 12/03 440 -461 (I 1 /07/COWw!B)
�•,,-
CITY OF TIGARD . _.
BUILDING DIVISION PERMIT #: MEC2005 -00632
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/200005
Phone: (503) 639 -4171 4
Inspection Requests (24 Hrs.): (503) 639 -4175 ill ..
INSPECTION WORKSHEET FOR DATE: 12/30/2005 TIME: 6 :59AM PAGE: 4B
SITE ADDRESS: 16260 SW W000CREST AVE CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 018 TYPE OF USE:
PROJECT NAME: SPITZ
DESCRIPTION: Replar:e furnace.
OWNER: SPITZ, MARC PHONE #: 503-639-M90
CONTRACTOR: 1R! COUNTY TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: /2/300005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 024212 - 01 503 Y
Corrections /Comments /Instructions: cA RQMo 9 4111
�
1 Co \ tr-, S — ,co 3)1-6)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `'�^ "` Date: j () /5 — Phone #: (503) 718 - 2 1 V