Permit 1 C D TY O F T D O rte' D MECHANICAL PERMIT
'` COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00365
rT A, RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/20/2007
�"""! PARCEL: 2S103BB -09800
SITE ADDRESS: 12020 SW 122ND CT ZONING: R -4.5
SUBDIVISION: YE OLDE WINDMILL LOT: 019 JURISDICTION: TIG
PROJECT: WELLS
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JONATHON WELLS Description Date Amount
12020 SW 122ND CT
TIGARD, OR 97223 [MECH] Permit Fee 6/20/2001 $72.50
[TAX] 8% State Surcha 6/20/200i $5.80
Total $78.30
Phone: 503 - 481 -7366
Contractor:
ALL FAMILY HEATING & COOLING INC
3606 CHERRY AVE #A
KEIZER, OR 97303 REQUIRED ITEMS AND REPORTS
Contact #: PRI 1 -503- 341 -5010
FAX 1 -503- 304 -7118
Reg #: LIC 171431
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 i /v w A./ / Permittee Signature: it
" ) Q �'�J 1 ti aV
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.
Jun 19 07 02:50p ALL FAMILY HEATING 503-304-7118 p.2
41002 • - -
Nilechanical Permit Avolication_ . FOR (.31..J.ICE I:
LSE ON,
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City of Tigard tCEIV Et) t i 30 0 00 1=NMAM
iN. TigardOR 13125 SW Hail Blvd., ,
Plan Review
1 ' Phone: M3.619.4171 Fax: 503.598.1M 1 9 'MO Date/By: Other Pennie
1.1 ::, .., ,;, f rnsPection Line: 501_639.4175
DateRce Mil Z SeePar
Internet www.tigard-orgov CITY Gi: NGAAD , blotifortddolsod:
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' .:.:• t 1 5 . (..-..:'-.:Tirre bx -- ','.'. 1 ' . . .:":.:.:.,.: ."..: ' .-:- ..'. -•.--.: ..:.! :- :'OgilOtigc . P',.s.00F+01* , ...;.P1.0*tttfti. •
Mechanical permit fees' am based on the value of the work
0 New construction AdditiOrdeiterationfreplacemeed
performed. Indicate the value (rounded Epee nearest dam.) dal'
0 Eemolition 0 Other mechanical materials.. equirmient. labor overhand profit
''' t ' - '. '''' • ":' ' ' ',.";:''.' "Y : ' ..*-"tivriookii ..:..: .': - :•:.• ..- --,—, .- value s
A .
5f5- 2-family dwelling 0 Comtruxcialfindustrial 0 Accessory buRding
For special inform:Jen use checklist.
0 Multi-family 0 Master builder 0 Other
Description 1 Qty. I Ea, 1 Total
:401-snt *4D OcAtioN:,:::.. , .;:i.., 7 :. 7 :2 , B
Air conditioning or heat pump
,,,., fri eg
Yob si address: I ao Qo sci.) la IN c i Ck !requires site Ow showinAptatenienu , / 1 vv 17
city/state/zip; &-(4. Otz PL-I3a..__ rum= 309000 ETU (ductarveatif 14.00 ..
Furnace 100,000+ BTU (docurveau) , 17.90
Suite/bldg./apt. no-: . Project i oa tr 1 e :
• Gas heat pail 14.00
Cross stmeticlirectioris to job site: Duct work ' 10,00
Hydronic hotwater system 14.00 _
Ftesiderstial boiler (radiator or
. hydronie) 14.00
• Unit heaters (fuel-type, not electric),
in-wall in-duct, suspended. etc 14,00
, Flue/vent forany of above _ i 6.80
SubdiviSiOn: 1 Lot no.:
Othcr: I 10.00
.
Tax map/pateel no.:
Other fuel appliances
' .: ' : ' '. • ". '''' — '''.if• -' ' •••,' ' rirscurrfolv..olivima: -• .:- • •-• ;.- . : .. ..:,:- : , Water heater 10.00
Gas fircPIRee 10.00
1 11 tt 4- ( C- Flue vent for water hearer or gas
fireplace • . 10.00
Log lighter (as) , .10.00
Wood/pellet sieve 10.00
Wood $repluedinsert 10,00
- • -......-... tea c fro vri i R .; .....(:. , ..... I.. • .7 ... .. • ,.._, - . 1 ..k AN . r. ...; . • • :, -.. : • : Chimney/litterlfitteiveat 1.0.00
10.00
Nasw it)Ntaiito C41 .e( S Enviroomeand exhaust and vendlidon
Range hood/other idtehen
Addis= lac _. .."..... m A c _4, T.
e 10.00
cityistuterap.::_ /.....liiae■c)a,c-i7_aaz__ s c i. lo gi ezerffm . exilust ins. . 10.00
Phone ( 56 3 4S1. - 7 3 ca 4, Fax ( } toilet compartments, utility moms) 6.30
:".. ....cl.Orir,aarlrOsoN:' : '.. ' • : Mk/ fans 10.00
- Other 10.00
Business name: ....0
,„. AccFme G
_HEATIN & Foe' trizimt
Contact naineros povt.1.121 c,now4G, INC. , . HAD for first court .51.00 for each additional
-
Ave suuL - ' Furrusee, etc. r ■
Address: 3606 CHERRY , 1
KLI2t.t1, OR 37201 Gas heat pump
City/State/ZEP
Wall/suspendediunit heater
Ph°ae: ( Sb5 ) 3c I i3 I Fax: ' ( . c ti ) 304=1 kl a Wales heater
, .
Fireplace
E-mail:
Range
....'...':-.... - . 7. .....; ; •:• : POill*AtTP,!tz . .. , ' ' ;.;,.., ..- -...::: : ....-...• :: :;:, Barbecue -.
Clothes dryer (as)
Business name: _____,,
ALL FAMILY HEKTINGA_ Other:
Address:
001 r CAIr INC. : ::::,..- ‘. . :'.... —1100tO .:-
City/State/V. P: 3606 :,"::::.-... Subtotal ' / 7 ""
Phone: ( ) iryg.i.-‘, VII i i■ .r..-
Minimum ogsmit 1= (ST2.50) ")...<5 0
Plan review (25% of peunit fee) „....------,
CC.13 lie.: I LIS/ state surcharge (8% of pennit fec) Si)
th /___4111111111■ o r ,_ TOTAL PION= FEE - 7i; . an
Auorized signature: 40•41,441174 1 Oe 7 .. . ...t., Mao permit application mina if a penult is not obtai;nd within Ott
days after it bas been aeolpteet ea complete.
Print nam - e: 117 - / i I Iir --I.. Dote: 6 -. /. _,...- • Fee meth eclolety sec by Tri Beildins lociatery Service Hoard
tAbeatamprnniceoaeceTerovtAmooe 01 440.49171' (i 1t07,tCOM1w5it)
Jun 19 07 02:51p ALL FAMILY HEATING 503 - 304 -7118 p.3
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