Permit CIT O TIGARD MECHANICAL PERMIT
� �► DEVELOPMENT SERVICES PERMIT #: MEC2006 -00475
I`': DATE ISSUED: 10/5/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S103CD - 08100
SITE ADDRESS: 13755 SW 118TH CT ZONING: R - 4.5
SUBDIVISION: CREEKSIDE PARK LOT: 011 JURISDICTION: TIG
Project Description: Replace furnace and water heater.
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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
HAROLD OFFIELD Description Date Amount
13755 SW 118TH CT.
TIGARD, KO 97223 [MECH] Permit Fee 10/5/200E $72.50
[TAX] 8% State Surcha 10/5/200E $5.80
Total $78.30
Phone: 503- 684 -5316
Contractor:
OREGON HEATING & AC(125185)
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815
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 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 10:OOa MS Rentals, Inc. 503- 537 -2172 p.l
Mechanic itJ a mit Application FOR OFFICE USE ONLY
City of Tigard DDateiBy: /:' �j O v Permit Na.:M �2 ] .x01/474
13125 S W Hall Blvd., Tigard, OR 97223 plan Review vvv ✓
Phone: 503.639.4171 Fax: 503.598.1960.12:C1 . » nfIn --- v4i . a Date/By: Other Permit
Inspection Line: 503.639.4175 i.. U lI , I l i (Pate Ready /By: mss: FIZI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
• Z YI'Es OF, WORK " �� COMMERCIAL FEE* 'SCHEDULE USE CHECKLIST
❑ New construction ® 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: S
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE: INFORMATION AND LOCATION Heating/cooling
^-� Air conditioning or heat pump
Job site address:
3 ig5 3L0 1 i8 - C,} (requires site plan showing placement) 14.00
City/State /ZIP: T YT A OR t D.a. 3 Fumace 100,000 BTU (ducts /vents) ` 14.00 (tt AO
Furnace 100.000+ BTU (duets/vents) 17.90
Suite/bldgJapt. no.: 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 -ducr, suspended, etc. 10.00
Subdivision Lot Flue/vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
. .- ;DESCRIPTION OF WORK.
Water heater k 10.00
Gas fireplace 10.00
H VAC Flue vent for water heater or gas
P9lt1Ce • t 1rL11C1.( (�L1f ld WQ,i -C `(1e0.� ev"
fireplace 10.00
- (' l.1 a Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. Chimney
iner /flue/vent 10.00
. N . PROPERTY OWNER ' t TENANT
Other.
Name: lAnlrola C ctQkrk Environmental exhaust and ventilation
Range hood/other kitchen
Address: 1 5 t..4.) ' igi+., of equipment 10.00
City/ State/ZIP: `TI r % Op_ q� a� Clothes dryer exhaust 10.00
0 t Single -duct exhaust (bathrooms,
Phone: ( ', 50 3) .. 531C, Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT . {] CONTACT PERSON : Attickmwispace fans 1
Other. 10.00
Business name: Oregon Heating and Air Conditioning
Fuel piping
Contact name: Rc he.i e $5.40 for first four; $1.00 for each additional
Address: PO Box 397 ! Furnace, etc.
Gas heat pump
City/State /ZIP: Dundee OR 97115 Wall /suspended /unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2712 Water heater
Fireplace
E -mail: rashclle a)orcgonheating.com
CONTRACTOR Barbecue
Business name: Oregon Heating and Air Conditioning
Clothes dryer (gas)
Other.
Address: PO Box 397 MECHANICAL PERMIT FEES*
City/State/ZIP: Dundee OR 97115 Subtotal ay,00
Minimum permit fee ($72.50)
Phone: (503) 538 -2953 Fax: (503) 537 -2712 Plan review (25% of permit fee)
CCB lic.: 125185 State surcharge (8% of permit fee) 5,8.0
� ^ TOTAL PERMIT FEE 30
Authorized signature: ,I\ / \J
This permit application expires if permit is not obtaine within ita hin 180
days after it has been accepted as complete.
1
Print name: F?o.shel1e. M er ,Y_ Date: /0_ O'1 ' Fee methodology set by Tri -County Building Industry Service Board
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