Permit 1 "r
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00147
RAJ I " DATE ISSUED: 4/13/2006
^ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 114AB -09100
SITE ADDRESS: 16282 SW 93RD AVE ZONING: R -4.5
SUBDIVISION: KNEELAND ESTATES NO.2 LOT: 093 JURISDICTION: TIG
Project Description: Replace furnace & A/C.
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: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BEN ROLEY Description Date Amount
16282 SW 93RD AVE
TIGARD, OR 97224 [MECH] Permit Fee 4/13/200€ $72.50
[TAX] 8% State Surcha 4113/200€ $5.80
Total $78.30
Phone: 503- 624 -5842
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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: S„..c.; 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.
xecetveo ' Perm"
City of Tigard t r Da t e/By:4i - /� C1 � Nov, C,2GU K col 5'
13125 SW Hall Blvd., Tigard, OR 9 \� Plan Rev
Phone: 503.639.4171 Fax: 503.59 i Other Permit:
11 !!" �/��ie� ft� Date/By; t
Inspection Line: 503.639.4175 �!� Date Ready /By: Jura: 0 See Page 2 for
Internet: www.ci.tigard.or.us 2 06 Notified/Method: /�/ f' Supplemental Information
E OF WOlt3Ii6FAO ) COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
1 11 Mechanical permit fees* are based on the value of the work
❑ New construction T pit ���� performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition [btlf @rP F mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
IlA 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
rd Air conditioning or heat pump
Job site address: (�, 2_2 2. S,„) C1 3 mss/ E (requires site plan showing placement) I 14.00 P
City/State/ZIP: -` ` r ), 0iz. eli Zy Fumace 100,000 BTU (ducts/vents) i 14.00 1
Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I 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 1
Flue /vent 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 1
Gas fireplace 10.00
I4.5 . Ps..v . c. - ,■.. t L. /P,,i t A(C .P...-Sl,/ lPw « Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
J PROPERTY OWNER 0 TENANT Other: 10.00
Name: 3 c/,..\ „..vl Environmental exhaust and ventilation
Range hood /other kitchen
1
Address: 1\0$1 S to ` - ) Q-4 t: equipment 10.00
City/State/ZIP: T: d 6 q Z 21 Clothes dryer exhaust 10.00
c �-c Single -duct exhaust (bathrooms,
Phone: (5 ) 64 sr4 s '4 Z Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT
CONTACT PERSON Attic /crawlspace fans 10.00 Other: 1 0.00
Business name: Fuel piping
Contact name: TokNt■l 5c.c.1,1. pc - $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 2i 1 S e M . p<. S-(t 31 J .t Gas heat pump
City/State/ZIP: /".., 5, r W di,Z 972 2 Y Wall /suspended/unit heater
Water heater
Phone: ( ) Fax: : ( )
Fireplace _
E -mail: Range
CONTRACTOR Barbecue
A _' , I / Clothes dryer (gas)
Business name: 944 �LJl flq f oa [ ) Other:
Address: 0 24 1 y7,E " 011 `( e 6I�� J MECHANICAL PERMIT FEES*
City/ State/ZIP: , Q'� q712.12 Subtotal Z$
Minimum permit fee ($72.50) 72 -
Phone: ( 2 . 2 i Fax: ( ,5 ) Zall.- i � Plan review (25% of permit fee) �------
CCB lic.: State surcharge (8% of permit fee) S
TOTAL PERMIT FEE 79
` This permit application expires if a permit is not obtained within 180
Authorized signature days after it has been accepted as complete.
Date: eI ' Fee methodology set by Tri- County Building Industry Service Board
Print name: Sot,N SPtZ21� 1 '�����
7 rt.a4;..e1D.m.itc1MFr_DmmltAnndnc 1 12/03 440- -4617T (11/02 /COM/WEB)
•
1 • CONTRACTOR NC -HEAT PUMP ---; UNIT SITE PLAN
(0b1::,
. - i'k,..i .
21( N C "'L.14_ 3 i3f d—D pivec.+;C) n
'Pock >_..._.
A. ,.. o , t 7 2 (14/1 I Z
is
a
E •� i .
Y i a�..
4, .
. f 4 4 1
i d
.
1
i
T O STREET .
S t,.7 ° 13 ` a A-4 C .
•
i • • CUSTOMER fNFORMVMATION .
_ "NAME lea 2a .... . •
•
ADDRESS •
ItotgL • Sw `1S 0 •
7 4 d O ix, g 1 22 il
PLEASE REPAX APPLICATION WITH SITE PLAN.
i 9 •
.` . . _ _ ........ .,. -
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MI: C :2006-00)M7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2O0z
Phone: (503) 639 -4171 r ^II
Inspection Requests (24 Hrs.): (503) 639 -4175 -� "'I_�
INSPECTION WORKSHEET FOR DATE: 4/7/2003 TIME: 7 :01AM PAGE: 39
SITE ADDRESS: 16282 SW 93Rt) AVE CLASS OF WORK:
SUBDIVISION: KNEELAND Et: ;TA ES N(:).2 LOT #: 093 TYPE OF USE:
PROJECT NAME: ROLEX
DESCRIPTION: f' :;?hce furnace fi< NC. -
OWNER: ROLE Y, BEN PHONE #: 603
CONTRACTOR: MA HEATING & COOLING PHONE #: 503.284 - 2173
Inspection Request Scheduled For: Date: 4/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mochanic:at final 067783 -01 503 -284 -2171 N
Corrections/Comments/Instructions:
c Le c i i /'4'L [tit. ki.1.0•/ ' 4 4 L G�.e� ty� 5—
G t S -7/ 392
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL ❑ CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: . / Date 7 - � Phone #: (503) 718 - z-4- N ---
p � )