Permit i s
Aril `. TY O F TI � CO MMUNITY DEVELOPMENT
MECHANICAL PERMIT
MENT PERMIT #: MEC2007-00482
0, DATE ISSUED: 8/6/2007
j ,,..�,,,,�. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110AA CC221
SITE ADDRESS: 10727 SW CANTERBURY LN 104 ZONING: R -12
SUBDIVISION: CANTERBURY CREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: CANTERBURY CREST
Project Description: Building 22, Unit #4. AC install.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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 DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
POLYGON NORTHWEST Description Date Amount
109 E. 13TH STREET
VANCOUVER, WA 98660 [MECH] Permit Fee 8/6/2007 $72.50
[TAX] 8% State Surcha 8/6/2007 $5.80
Total $78.30
Phone: 360- 695 -7700
Contractor:
ANDERSON HEATING, INC.
6463 DAWN AVE.
LAKE OSWEGO, OR 97035 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 841 -0742
FAX NA
Reg #: LIC 168214
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 4t44 Permittee Signature: 1 _ !" 1..c:r; 7Y1
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.
Mechanical Permit Application ,, I�. a 1 t,u y l :` , u� , r
• I ' �� � : '�r 1 3`.�a+�'".Jri..+�a�iis ros f,t 1 It
4 �'..��:- Is��erz�:�n: _t �s• :� :s,. a;�r�ch•
F ;: 6 l f Received O Parma No :
City of Tigard '1� r' Date�l,y. 3 0-7 a 6e�7 00 Ow
g s �� �a F
P `" Y n 13125 SW Hall Bl v d ., I 1 ga 6 /223: " t\? ` '
® t Plan Ravtew Other Permit
, # Phone: 503.639.4171 Fax °1`9 , i Date/By: Iftg lu rix „/ & f See Page 2 for
av'1w ?�" ii Inspection Line: 503.639.4175 1 Data Ready /13y: , l S , S e emental Information
M ari �< Internet: www.tigard- or.gov i 20� Nol.fied/Methoa:
1
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' COMMERCIAL FEE* SCHEDI lLE - USE CHECKLIST
TXpI �11 —
} tY t t ��(t D I M echanical permit fees' arc batiert n 1 th a value of the work
® New construction ❑ Addi t ration /replacemem performed. Indicate the value (round sd to the neatest dollar) of all
Demolition ❑ Other: - mechanical materials, equipment. lal7or, overhead. and profit. -
Value $
CATEGORY OF 'CONSTRUCTION - RESIDENTIAL EQUIPMEN r ( SYSTEMS FEES''
❑ 1 - and 2 - family dwelling [] Commercial /industrial ❑ Ac :essory building For .cpecial rnfon woo 1 use checkle.r.
Master builder ❑ Ot1 Cr • Description 1 Qty. I Ea. 1 Total
® Multi- family ❑ --
JOB SITE INFORMATION AND LOCATIC N - Heating/cooling
I , oning or heat pump
Air conditi le l Job site address: 10729 SW Canterbury Lane LtA4 - Air e rns iti plan showing placema 14,00 _
Fumacc 100,000 BTU (ductvvents) I4.00
City/Stale/7W: Tigard OR 97224 - Fur 100,000+ BTU (duos /vent •) 17.90
y Suite /bldg. /apt. no.: 22.4 J Project name: Canterbur l , -( r heat pump ,_ • : ` 00
Dat work I (L00
Cross street/directions to job site: 99W and Canterbury - I lydrottic hot water system 14 00
- Residential boiler (radiator ur u.00
hydrunic)
— Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, tits. _ 14.00
Flue /vent for any of above 6 80 _
Subdivision: Lot t / o.: 4 - Other: _ 1700
1 Other fuel appliances
Tax map /parcel no.: water heater _ 10 .00 -
DESCRIPTION OF, WORK W
Gas fireplace 1 00
Install A/C Units -^ Flue vent for water heater of gas I tl 00
fireplace
Unit 104 - Log lighter (gas) 1(1.00
r' - Wood /pellet stove 10,00
Wood fireplace/insert 1(1.00
L'himney /floc /vent � ('.00
Q ' 'T?NANT Other: I ('.00
❑ PROPERTY OWNER - -- --
Environmental exhaust and ventil: lion
Name: - Range hood/other kitchen
'-
Address: equi•ment _- 10.00
Clothes d er exhaust _ ,� l u,Op
City/State/ZIP: - Single -duct exhaust (bathrooms.
toilet eom.artntents. utiti rooms ,_ 6 80
Phone: ( ) Fax: ( ) -
❑ CONT %CT PERSON Attic /crawls • acc fans __ ___10.00
El APPLICANT - Othzr: 10.00
Business name: - Fuel .I.in• ----
$5.40 for first four: $1.00 Or each additiona
Contact name: - Furnace, etc.
-
Address: - G as heat pump
Wall /suspended/unit heater
City /State /Glf:
-
Water heater _
Phone: ( ) I Fax: ( ) - Fireplace _.-
E•mail: - Range _ --
CONTRACTOR - Barbecue —
Clothes dryer (gas) -
Business name: Anderson Heating Inc. - Other: - - '
MECHANICAL. PEI IMIT FEES"
Address: 6463 Dawn Ave. - Subtotal _
City /State / "LIP: Lake Oswego. OR 97035 -- Minimum penni fee ( - • 1
Phone: (503) 841 - 0742 J Fax: ( ) - Plan review (25 "0 if permit fcc) ..
State surcharge (8 )f permit izu) .
CCB lie.: - "!TOTAL PE RMIT FEE - . , 9
This permit application expires if n pe, mit Is not obtained within 180
dra ys after It has been a.c. pted as complete.
Authorized signature: Mi/frie
- �
• fee :ucthodology s<I by Tri County Ij� ildiup lndusuy Se•'�1ce Board
Print name Matt weatherdon Dat 8 -2 -07 _ .