Permit �.
.
CITY OF TIG ®D MECHANICAL PERMIT
' 1( . .. " '
' ' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00495
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/9/2007
PARCEL: 2S104AA
SITE ADDRESS: 12685 SW KAREN ST ZONING: R -4.5
SUBDIVISION: BELLWOOD LOT: 041 JURISDICTION: TIG
PROJECT: DANG
Project Description: Install a furnace and 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
BENJAMIN DANG Description Date Amount
12685 SW KAREN ST.
TIGARD, OR 97223 [MECH] Permit Fee 8/9/2007 $72.50
[TAX] 8% State Surcha 8/9/2007 $5.80
Total $78.30
Phone: 503- 453 -9623
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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 B 0 (Ali � /� �� Permittee Signature: J �.
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
is 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.
Rug.n�9 07 09:09a Oregon Heating S. RIC 503 - 537 -2172 p.l
Mgchanical Permit Application FOR OFFICE USE ONLY -
CI Of Ti and EC I Y Received ♦ a0 S_a PermitNo.: 8rz/x � 00 5 • `,� g , [ �/ Date /B}:
rir
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.591.1960 AU G 9 2007 Date/By: Outer Perniit.
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Igni El See Page 2 for
. • - Internet: www.tigard- or.gov CITY OF EIGAFID Notified /Method: Supplemental Information
BUILDING DW1SMON
TYPE OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees` are based on die value of the work
❑ New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 111 Other: mechanical materials. equipment, labor. overhead, and profit.
Value: S
CATECORY OF CONSTRUCTION .
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
`, ' Air conditioning or heat pump
lob site address: IaE,85 5 11U Kor ,
or ' C G )► (requires site plan showing placement) t 14.00
City /State /ZIP: ` flr cj—d q -taD3 Furnace 100,000 BTU (ducts /vents) I. 14.00
L7 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. 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 -duct, suspended, etc. 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 . Water heater 10.00
• Gas fireplace 10.00
HVAC- vr-15 }n 11 i' rort. and F C Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 1 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00 ,
IN PROPERTY OWNER • ❑ TENANT Other: 10.00
Name: Flt ?ci\C \r\ pan Environmental exhaust and ventilation
Iac:A5 S ` � 4 Range hoohood/other kitchen
Address: VV e m equipment 10.00
City /State/ZIP: "T` n q--7 of 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
(M•5) Phone: ) 45 - q 6 cD3 Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT . - • ❑'CONTACT PERSON Attic /crawlspacefans 10.00
Other: 10.00
Business name: Oregon Heating & A/C Fuel tnn t
P
Contact name: RQS,..Pr,\e. $5.40 for first four; $1.00 for each additional
` Furnace, etc.
Address: PO BOX 297
Gas heat pump
City /State/ZIP: Dundee OR 97115 WalUsuspended/unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Oregon Heating & A/C Clothes dryer (gas)
Other:
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City / State/ZIP: Dundee OR 97115 Subtotal
Minimum pennit fee (S72.50)
Phone: (503) 538 -2953 Fax: (503) 537 -2172
Plan review (25% of permit fee)
CCB lic.: 172126 State surcharge (8% of permit fee)
TOTAL PERMIT FEE -- 78. 30
Authorized signature: This permit application expires if a permit h not obtained within 180
Bn d ays after it has been accepted as complete.
Service Board Fee methodology' set by Industry Print name: R�Shelle, � Date: �� Q ..-0-7 • hdl
6Y Y Tri- County Building Indust
t:• Building iPemits'•A¢C-PertnitApp.doc 04/06' 440-4617T (11 ?02'COM'WEB)
.0,9 07 09:10a Oregon Heating & A/C 503 - 537 -2172 p.2
i \k,L€C— 1 ()C AC( Level 1
5' +
1
5' + -10 5' +
—
Main Level Garage
SW Karen St
Job #: Oregon Heating & Air Conditionin... Scale: 1 : 128
Performed for: Page 1
Benjamin Dang PO Box 397 / 992 Hwy 99W Right -Suite Residential
12685 SW Karen St Dundee, OR 97115 6.0.101 RSR39325
Tigard, OR 97224 Phone: 503 - 538 - 2953 Fax: 503 - 537 - 2172 2007- Aug -07 08:41:22
Phone: 503 - 363 -8623 C:\My Documents \Wrightsoft HVA...
tarry@oregonheati ng.00m