Permit C ITY OF TIGARD MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00190
�rl �� DATE ISSUED: 5/9/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD -13400
SITE ADDRESS: 07770 SW CYPRESS LN ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 032 JURISDICTION: TIG
Project Description: Install a/c unit.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ROBIN BONANOMI Description Date Amount
7770 SW CYPRESS LANE [TAX] 8% State Surchar€ 5/9/2006 $5.80
TIGARD, OR 97224 [MECH] Permit Fee 5/9/2006 $72.50
Phone: 503 430 - 8399 Total $78.30
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265 REQUIRED ITEMS AND REPORTS
CANBY, OR 97013
Contact #: FAX 503- 266 -3478
PRI 503- 266 -1249
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 OUNC by calling 503 - 246 -6699
or 1- 800 -33 -
Issued By: P��`�/ P ermittee Sign ture: c,
Y
Call 503 - 6394175 by 7:00 a.m. for inspections that business day.
This permit cans 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.
05/08/2006 13:58 15032632513 ROTH MECHANICAL PAGE 02
tflechanical Permit A l VE FOR OFF ICE 1/SE ON1.1'
City of Tigard Rcoeivcd Permit Nn,:
131 Hall Blvd„ Tigard, OR 97223 Datc /B `) q /0 1/1X � ° 144' C7d / 96
P Man Review
Phone: 503,639,4171 Fax; 503.598.1960 MAY hV 0 J 2 U t 6s „ t l � ]) I ; Date/By: Other Permit:
Inspection Line: 503.639.4175 I°tH ,1 Date Ready /By; �Iuris: H See rage 2 for
Internet: www.ci. 'garl,nr,us �I Y Or iGA "i J Notined /Method• "/ / (}_ Supplemental Information
Vi
IT 2- . S 1 _ it ► n t ION —
. .. TYPE OF WORK .. ' ,.. • COMMER FEE S CHEDULE - USE CHECKLIST
`1 Mechanical pennil fees* are based on the value of the work
❑ New construction 0.ddi[ion /alteration /replac S ^` \ O a performed. Indicate the value (meded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials eci ipment, labor, overhead, and profit.
CATEGORY OF .CONSTRUCTION Value:5
:I - and 2 dwelling - RESIDENTIAL-EQUIPMENT / SYSTEMS FEES* .,
y g ❑ C ommercial /industrial ❑ Accessory building
For special information use checklist,
L{ Multi - family ❑ Master builder ❑ Other;
Description J Qty. Ea. I Total
• JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 7 S� 15.�"'t Air conditioning or heat pump
7 7 (requires site plan ahnwhig placement) 1 14.00 T•
City/State/ZIP: t, q CAL 97 9 ?1 f - Furnace 104,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTUJdueterventcl 17,90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14,00
Cross Street/directions to job site: Ductwork 14.00
"- Hydronic hot water system 14.00
Residential boiler (radiator or
hydroniel 14.00
Unit heaters (file) -type, not electric).
in-wall, in -duct, suspended, ctc. 10,00
Flue /vent for any of above 10.00
Subdivision; Lot no.: Other:, 10.00
Tax map /parcel no.: • Other fuel appliances
DESCRIPTION OF WORK .... r ,
Water ere
Gas fireplace 10,00
Flue vent for water heater or gas
fireplace 10,00
Q ` r���Q��j� Log lighter (gas) 10.00
`. t' rkk.._CrY1 Wood/pellet stove 10.00
Wood fireplace/insci 10.00
TY' OWNER : . j .. ' .::... . f TENANT • ..
10.00
Chimney/liner/Clue/vent r ------ 10 00
. .: `:. PROPER
Other 1
Name: Q _ Environmental exhaust and vcntitntion
Address: — Range hood/other kitchen
equipment 10.00
City /Statc /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) (--43b " g !j i t e l Fax: ( ) - toilet compartments, utility rooms) 6.80 • ......... . ....• . . APPLICANT... ...: . - • :. 0 - CONTACT PERSON' c . w sp ce fans
` � Attie/ rt l n
.,,.. (. ' Other, '---- ....,,.. 10 ,�,. _
Business name:
_,,, , Fuel piping �__ _
Contact name: . $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
_ ---- Gas heat pump _
City /State /ZIP: Wall /suspended /unit heater
-..
Phone: { ) �. ^ 1 Fax: : ( � ) Water heater
Fireplace
E -mail: large --
.:,E,, , ,:,;,,;:•:','
,•._:.::... ' s RACT Brbecue
�,:.''
: , : ' .:... >: •CON _
T OR ,....:.
Bu,- . Business name: A / 4 Othe Clothes dryer {gas)
.—. -^
,....
Address: &9 /-- 12 _&,,c; - .'. ; : r ..r1, , ;: : '::: l'AECHA�NICAL PEI MI 'I'.FICES'•...;;�...:..: .
j
City /State/ZIP: e 1 l ..,y L// \ 9 7C/, Subtotal
7 q Minimum permit fee ($72,50) 7
Phone: (5a5) Z.L, •--(2 L( I Fax: (5 ) 2 6,4, -. :3 � 71 f p Z,
(j 1 Plan review (25% oennil fee)
CCB lic.: 4 O f f State surcharge (8 %ofpermit fee) •
7 OrAI. PEt2M[T 1FEI;
!,
i This permit application expires if a permit is net ohlaieca within 1x11
Authorized Signtiture: t_- 1 days after It has been accepted as complete.
Print name; t . . .. D.tteyy _] • 1 ce nicthrxlelogy ect by Tri- Gamily Building industry Service Board
05/08/2006 13:58 15032632513 ROTH MECHANICAL PAGE 03
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