Permit •
• -'''..,
CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00542
TIGA1 ^ D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/14/2007
PARCEL: 2S109AD -14100
SITE ADDRESS: 12896 SW WAHKEENA CT ZONING: R -7
SUBDIVISION: ARBOR SUMMIT NO. 2 LOT: 037 JURISDICTION: TIG
PROJECT: MILLER
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:
REPAIR
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ERIC MILLER Description Date Amount
12869 SW WAHKEENA CT
TIGARD, OR 97224 [MECH] Permit Fee 9/14/2007 $72.50
[TAX] 8% State Surcha 9/14/2007 $5.80
Total $78.30
Phone: 503 -598 -7085
Contractor:
REX HEATING & AC
14015 SE STARK
PORTLAND, OR 97233 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 255 -7233
FAX 503- 257 -6317
Reg #: LIC 66418
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. , /
Issue = J z Permiftee Signature:, �i )4j')
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Call 503.639.4 75 by 7:00 a.m. for inspections that business hay.
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.
09/13/2007 08:56 FAX 5032576317 REX HEATING AND AIR COND Z003/003
�, 4d s :Apr 7.t`G'f .v.; e v;1• Y ,, , M w r-
Mec hanical Pelrm A pp lic a ti on , M A i tilt t r 1 !c l.'uSl c)NI Ir .4 t 4 <,
City of Tigard ECE V E .1 P e B Dre/ay: 95 N [mi[ No.. E L 131S W Hall Blvd., Ti and OR 9722i'
Phone: 503.639.4171 Fax; 503598, I .0 t D nL e/ y: Other Permit:
inspection Line: 503.639.4175 h�u'�l y
1 a •:, Date Read /B
Interne[: www.ci.tigard,or,us S E P g " -'' Notified/Method; ®See Page 2 for
IF F f (GIkaD Supplemental Information
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tee• Mechanical mit fees' are based on the value of the work
❑ New construction . r ddiuon/alierlati /re er
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❑ Demolition V Other:
performed. Indicate the value (rounded to the nearest dollar) of all
;
pNS� ' t s u.,, 5 , + � t,� (+ s ; r 1 II �
,J 4 r ;�,lp Y , xttan'�, aJ , ,, ,�„ �� g , mechanical materials, equipment, ! p
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1 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building iy,t.a 4.•uM� "i =' = / �c Y ;� } °4 ° .r r �4 ` , t ?t l °f � , /4 , % # , { U ;, „!
El Multi [] Master builder ❑ Other: For special information use checklist.
Description I Ea. Total
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Yd (,,,' f Y I li t 714 r `il r+ G t + t o y , 4 f ro , I r ` - Q1Y�
l fdl�.1P I Ji ':i , l :I' °fl}J t lit:r rrt4 irll lk ✓q �rt ++�e j,ll :'ir,-+ : :(
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: Iri,. � _c nf.,J .r'r�..l : ,. .Ltll t..D ?tt_s;b�,.l :d,� - ritead»g/LOO11nR
Job site address: i Air conditioning or heat pump
s1 ' air? r'1 4 'e 1 . • (requires she plan showing placement.) I 14.00 140
City/State /ZIP: r 7 , Olt • - 7 Furnace 100,000 BTU (duets/vents) 14.00
Suite/bldg. /apt no,: Project name: _1'tlmaco 100,000 +HT (ductthents) 17.9 .
Gas heat pump 14
Cross streeddirections to job site: Duct work ..r. 14,00
_Hydronic hot water system 14
Residential boiler (radiator or
- hydronicZ 14.00
Unit heaters (fuel - type, not electric),
in -wall, in -duct. suspended. etc. 10.00
Subdivision: Lot no.: Pluetvent for any of above 10.00
J
Other: 10,00
Tax map /parcel no.: Other fuel appliances
r,. 7 ,i I l,t Yi .; Water heater � l
:'a!u•.�t LIiF ,,f, r rPilf I ) F. ! h! ( ) i 11 i 1 .. u ' � - i ' ,;
....r..... af. I `
t . w... t, r G tr�� r rl � ., , � ,t � ,
+ Gas fireplace 10.00
�` , 0 Flue vent for water heater or as
fireplace 10.00
Loin lighter (gas) _ 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
t'F1 :f( :I ,, �a1t i. ; �.;a :C;e,l,-;,;; ?c�+xfryf. , . e • c > wJ , c :- *, -t. .ut! " .,_, : :• , . L ',.:,,..Vi., - ,
d . ; , ' .. „ � .- ;'r�Y. v ; r .,,� .m „1 .`. c.li, , •+177.,r-:•I - Chimney/liner/flue/vent /liner /fl
1 . �a:.7):, t. r � 12 1 :a`d,i...1' d x"'4 't ,',. ,.' ?rl. :.. . .. ;;;�r.. ; - :, ll: -rl Y udvant 10.0
.:' �lr 1 ^ P .. . y t! ..L .1 4 `';: t ,;:!'. 1 !''' : ,1 r t r , l i I � u h, ! , 10.00
„ I + rl t:,,•, Other: _ 10,00
Enviaonmen exhaust and ventilation
Address: • Range hood/other kitchen
. • r n / @ W 1, equipment
City/State/ZIP; A 017 , Clothes dryer exhaust 10.00 10.00 _
Phone: i t ) - D Fax:
pro „c;-'�" :.. :, � -.... ,,. -...: ..
8s
,.,. , .. �, .....,,.,
( ) to uc exhaust (bathrooms,
toilet compertmcnts, utility rooms) 6 -80
'1d�,m.e : :rn. a : :v ,. . is ',.... , J i , ;. ; (( + •; t;.4' ., yl. F'G82' <:,: � ':,dii pr .�, .+ �
! i �Ja' J i i �i 1 i 4 j + CI /f l � �, ,,, � L I ! l � l' 1 + I{ d °, r Y,6 P!r 11 l '1 � � : I ll i , l Attic /crawls ace f ans
,:, P 10.00 , .1.11.x•.... . ....a..,.,..,.. d ,L ._....:, .... .... . ...:....:.:..... .::M . : :.._ : +,.. " .:.,...... 1
i Other: 10.00
T Fuel piping
Contact name: -�
u� _ $5.40 for first four; $1,00 for each addltionat
Address: O s C Furnace, etc.
Gas heat pump
City / State/ZIP: ' br r Wail/suspended/unit heater _
Phone: . ) 3.S - Fax: : 03) aS7 -6, ) 7 Water heater r
E -mail: y� ia, • L, C Fireplace
1 (0 -41 .. 0. s t "� Range
jl =71 : ::!; I;•; : :I :'tr! :yt i ;W: irli .:1' 'I ° : '.: _�, ot4 : ;∎p:; ..v:
rAI :, itl . r ,, .1'. . fll h Y i l y l r,J, Y'+r t I ;i 11 t}, , {d !, i 1 jU I` ph t!'1rr �yl ,11 ( rn (r
r..,..., .d�.,a :.dl - , .. ,..4 � I it L�. d ! t ,, .I,tL,, i • ..rl � h, .0 %.j Barbecue
Clothes dryer (gas)
Address: Other
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City/State/ZIP: i0 A..14 11) - • Subtotal . �.......
Phone: ) _
Minimum permit fee ($72,50) 1 041
Plan review (25 %of permit fee)
CCB lie.: i.2 8 I / t o 001 State surcharge (a% of permit fee) EI , 60
(....\ . TOTAL PERMIT FE 4 $ , 1
Authorized signature: \/ This permit application expires if a permit y not obtaibed witbfn in 180
/ ' days after i has been accepted as complete.
Print name: 1 I 1 V15 two ✓ €/ I Date: 13 7 - Fee methodology set by Tri -County Building Indueey Service Hoard
1 1 BwldingTermlis \MEC- PermitApp.doc 12/03 { 64a (11/02/COM/l4'EH)
09/13/2007 08:56 FAX 5032576317 REX HEATING AND AIR COND Z001/003
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