Permit
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT MEC2007-00172
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/29/2007
PARCEL: 1 S133CA-04600
SITE ADDRESS: 11463 SW REBECCA TERR ZONING: R-25
SUBDIVISION: GABRIEL WOODS LOT: 025 JURISDICTION: TIG
PROJECT: GABRIEL WOODS
Project Description: Install a/c unit.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SFA 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:
ELE 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO FURN < 100K BTU: AIR HANDLING UNITS DRYERS:
OTHER UNITS:
FURN >=100K BTU: 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
INTEX CONSTRUCTION Description Date Amount
7235 SW BON ITA RD
TIGARD, OR 97224 [MECH] Permit Fee 3/29/2007 $72.50
[TAX] 8% State Surcharc 3/29/2007 $5.80
Phone: 503-860-6001 Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact # PRI 503-266-1249
FAX 503-266-3478
Reg LIC 14008
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued Permittee Signa e:
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.
1202/ C V
Mee fanicai Permit ,Application
7
City DfTigard Ri?s ates/lgued ~8 D PermltNo.'
Y;
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.508.1960 Date/By: Other Permit;
lthsppction Line: 503.639.4175 Date Ready/By: Sun ' 0 See Page 2 for
Intcmet: www.cl.tigard,orals Notificd/MeUtod: t Supplementallnforaaruen
!.T' -PE :Ok' :WORK. COMMERCIAL 'IfEL..:5CI3EDULI : ,Li5C>CIIECKL]S?
Mechanical permit'fee5* are based on the value of the work
❑ New construction Addition/altcratjon/rerlacement perfornied. ludicate die value (rounded to die nearest dollar) oFall
El Dolnolidon 0 Othcr; mechanical materials, C ui lmcnt labor, overhead, and profit.
Value: 5
,cAT>rc#olif: o~colv~T ttr a
1- and 24amily dwelling d Comtnercial/industrial ❑ Accessory building SOU NI1/kL,? QU<i'1 I NT:/:SY67l~1VIS') IC S* j:!; :is°
For special information use checklisr,
Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Tatnl
T i.; i : SITE INi QRMATIOIV AND LOCATlO.I r
1]catin r coolie
Air conditioning or hcat pump
l06 site address: r Y (m quires site plan shoving laccment) 1 14A0 ! t/- bV
city/start:/7.1P: Furnace 100,000 BTU (ductovLntn) 14,0(}
Furnace 100,000-1- BTU (ducra/vents) 1 17.90 , 7- 10
Suite/bldg./,apt. no.: Project name;
Gas heat gum 14.00
Cross strecddirections la ,job site: Duct work 14.00
H drunie hot water system 14.0(1
Residential boiler (radiator or
h drottic 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Subdivision: Lot no,: Fluelvent for any of above 10.00
Other. 10,00
Tax map/parcel no.: Other fuel a (lances
"ii;' 'I: .II.: p1;5Gtt n 1?~C~N.I QF WOR[C': Water healer 10.00 k-U Q Gas fire laCC 10.00
Y A (j& ~1 v1 Flue vent for water treater or gas
fireplace 10,00
Lo lighter (gas) 10.00
Wood/ cllet stove 10.00
Wood fire Iacc/insert i0.oo
ChinincyAiner/fluelvent 10.00
IPROYbRTY OWNETt. p`;7CJr{nNz
Other. 10.00
Name: vx+?-x b y~ST , Y, c Environmental exhaust and vcntllalion
Address: 35 11 Z 2_, Range hood/odher idiehen
equipment 10,00
City/State/ZIP: Y Clothes dryer exhaust 10,00
Singlc-duct exhaust (bathrooms,
Phonc: (903)(ap - (o00 I Fax: { ) toilet com ariments utility rooms 6,80
isi?'`'ii "I' "APPLICANT:!' 'i. I:d CbN`1"r,C1:'pLtl~bUN;` Attic/crawls ace fans 10.00
Other:
name: 10.00
Fuel piping
Contact name: $5.40 for first tour- $1.00 for each additional
Address: Furnacc, ctc,
Gas heat pump
City/State/ZIP: Wall/sus ended/unit treater
Phone: ( ) Pax: ; ( ) Water boater
Fireplace
E-mail:
Ran&c
~ :d•; :f :L, ~,.',_7i ,;,;:lh,a" ;:jj;2:,yJ: slit?."; Barbecue
~la,aa . rj~l„ ;`It .r1;,r.,i; rtC•' ii ii :i : ,,,L.I .pa TI?i1CJT0!R''
~r.. i.i.I• ,.".l , •'i I ,i. , I it a t• r~
Clothes dryer •us)
Business name:
other,
AddrC55' JG 1..:...
CIIAN7
;~IAI~+,tlt,,..,.::;,~,1~~;:. S eALPL RNIIT:is* •
Subtotal 3~,~p
City/State/ZIP: C.~A ` 9 /Q13
Phone: ( ) Fax: j) 2.6Gj Minimum permit fcc (;672,50) Q
Plan review (25% of prom! fee)
W3 tic,: ~Q State surcharge (8% of permit fee) S , a
TOTAL PERMIT FEE i1
Tide lrerrnlt tttlprlcntltrn expires If +l trermlt Is not obGdned within 180
Authorized signature;
_ d+tyrr sifter it has been accepted as complete.
Print flame; (U L. Date: Fee tncUiudology set by Tri-County Building htdutttry Scrvlee 13usrd
I:\llulld'ing\Her'rtdhntvll'CC-PernsitApp.du~ IJtl1 d•rlA•IG l9'l'(l l/(1?/CCltvl/WLLt>
V0 'd BLVEHU05 'ON XVA ONIIVIH HiM WV 66:60 GM LOH-K-bVW
CITY OF TIGARD
BUILDING DIVISION PERMIT MEC2007-0017:1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312912007
Phone: (503) 639-4171 „t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 413/2007 TIME: 7:00AM PAGE: 78
SITE ADDRESS: 11463 SW REBECCA TERR CLASS OF WORK:
SUBDIVISION: GABRIEL WOODS LOT 025 TYPE OF USE:
PROJECT NAME: GABRIEL WOODS
DESCRIPTION: Install a1c unit.
OWNER: INTER CONSTRUCTION, PHONE 503-8Cat}-6001
CONTRACTOR: ROTH HEATING & COOLING" PHONE 503.266-1249
Inspection Request Scheduled For: Date: 41312007. Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 045861-01 503-849-8595 N
Corrections/Comments/Instructions:
/11C71 0 OS
42 MA A PI-JA A A,,l
s
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
444 Date: /Inspector: Phone (503) 718-
. vtd..al 3 -3o -o
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8Lb£99Z£05 '0N )(VA
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