Permit C ITY OF TIGARD MECHANICAL PERMIT
p i? DEVELOPMENT SERVICES PERMIT #: MEC2005 -00740
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/7/2005
PARCEL: 1 S133AC -11500
SITE ADDRESS: 10845 SW BRIARWOOD PL ZONING: R -25
SUBDIVISION: HAWK'S BEARD TOWNHOMES LOT: 033 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
NAOMI TSUNODA Description Date Amount
10845 SW BRIARWOOD PL
TIGARD, OR 97223 [TAX] 8% State Surcha 11/7/200f. $5.80
[MECH] Permit Fee 11/7/200f. $72.50
Total $78.30
Phone: 503- 957 -5820
Contractor:
FORECAST HEATING & AC
12816 NE AIRPORT WAY
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Phone: 503- 253 -7020
Reg #: LIC 152194
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: 77 7-- Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspectio that busines ay.
This permit card shall be kept in a conspicuous place on t job site until completion of the project.
Approved plans are required on the job site the time of each inspection.
Mechanical Permit Application FOR OFFICE: usi: oNI..VV
• City g Of Tigard 4 � 2 -� ` /� �, �� Permit c Received Ir// ../. /.1
�� C , � l� ' ,� I � �/ Date/By: ' ermt No . .r_, "V $ g1 7 ' L)
13125 5 SW Hall Blvd., Tigard, OR 972 — Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175
'c
Inspection t „ / �� I `t Date.B :
pate Ready /By: See Page 2 for
Internet: www.ci.tigard.or.us , � Notified/Method: Supplemental Information
CITY OF t: /1 -
,Wy:.k;;Rl Wf?J.K,;0 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
, New construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
.❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling ❑ Accessory RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
41_ and 2-family g ❑ Commercial /industri Accesso building
M builder For special information use checklist.
M ulti -famil
❑ Multi-family ❑ ❑ Other:
Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ' L1 5 S W ib P- -Pt Air conditioning or heat pump ,/ r r
O 0 (requires site plan showing placement) --- 14.00 I 4 -
City /State /ZIP: 71 0 ` op, cki ate. Furnace 100,000 BTU (ducts/vents) 14.00
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
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
"I'ax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
77 C�L`L1 T► (� �l / Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: /VQo n ", , --r,„ r_,,,,, ` 1 Environmental exhaust and ventilation
Rge
Address: 1 C) 11 S j w ' 0. ko,cd quip en od/other kitchen 10.00 t
City /State /ZIP: 11 Q.c p, a t r) p 9 i as Clothes dryer exhaust 10.00
U Single -duct exhaust (bathrooms,
Phone: (SD') Cl S� 5 8 .o Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
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: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
d
Business name: �(b p e� S A't cF Wet � c Clothes dryer (gas)
_ Other
Address: ! a g I (3 N E. Airs - R -1-- V et MECHANICAL PERMIT FEES*
y 3p. 4 t . ii 6 , 0 q � Subtotal 1
Cit /State / "LIP:
Minimum permit fee ($72.50) 72.5
Phone: (' Ct) 4 S) - 100 0 10 Fax: ( J 4S a _ L S q Plan review (25% of permit fee)
CCB lic.: ) 5 oZ 1 C� 14 e k, 7 - J �' State surcharge (8% of permit fee) S . $t)
TOTAL PERMIT FEE 7 „ 30
(��--
Authorized signature: elk I I fk- Thi pe rmit application expires if a permit is not obtained within 180
/00 days after it has been accepted as complete.
Print name: A L 7 NA Date: li 6 * Fee methodology set by Tri- County Building Industry Service Board
i \Building \Permits \MEC- PermitApp doc 12/03 440- 617T (I I /02 /COM/WEB)
CITY ®F TIG��® 5��5 - X3071. bt/iaA4 ? - 2 g ,a��.r1 . .
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BUILDING DIVISION PERMIT #: MEC2005 -00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s A
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 8:22AM PAGE: 14
SITE ADDRESS: 10845 SW BRIARWOOD PL CLASS OF WORK:
SUBDIVISION: HAWK'S BEARD TOWNHOMES LOT #: 033 TYPE OF USE:
PROJECT NAME: TSUNODA
DESCRIPTION: n5 a •land.
OWNER: TSUNODA, NAOMI PHONE #: 503- 957 -5820
CONTRACTOR: FORECAST HEATING & AC PHONE #: 503 - 253 -7020
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022013 -01 503-253 -7020
Corrections /Comments /Instructions:
6.6,11,4„, 3-17/4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL g CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
k I
Inspector: Date: i` . 1 1) Phone #: (503) 718-
CITY OF TIGARD --
BUILDIN(G DIVISION - PERMIT #: (MEC200 -00740 /
11/1/2005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
(503) 639 -4171 � n,�d `- --
Inspection,Requests (24 Hrs.): (503) 639 -4175 �':!r'IL
INSPECTION WORKSHEET FOR DATE: 11/23/2005 TIME: 7:00AM PAGE: • 74
SITE ADDRESS: 10845 SW BRIARWOOD PL " ( r --: - . ---- CLASS OF WORK:
SUBDIVISION: HAWK'S BEARD TOWNHOMES L #: 033 TYPE OF USE:
PROJECT NAME: TSUNODA
DESCRIPTION: n atrAie - Unit
OWNER: TSUNODA, NAOMI PHONE #: 503 - 957 -5820
CONTRACTOR: FORECAST HEATING & AC PHONE #: 503 -253 -7020
Inspection Request Scheduled For: Date: 11/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022013-01 503- 253 -7020 fl'- p i\q e .. t ( icy, t ' 1 /),e - A cY 4
Corrections /Comments /Instructions:
) 47-- #0 7 fi 4 0 . .eJz ,,e.) c - A' a-It ,4__Le.i. Aa__74_,
_2) (:_G_CL im.7 a liG ..L v77 e 04 a _ . 2),, , 1/2d e/'W // 5 P 7/ ? - Z Iii 0
gd AM- Ce v 3 SS ? -- 7/
v
❑ PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[X] FAIL X CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,------- _ -
( InspectorN (ice Date: f / /z3 ) 4 Phone #: (503) 718-
27o;G
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MEC2005-00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2005
Phone: (503) 639 -4171 ApglpicirtiA Requests (24 Hrs.): (503) 639 -4175 'I:`
INSPECTION WORKSHEET FOR DATE: 12/6/2005 TIME: 7:02AM PAGE: 76
SITE ADDRESS: 10845 SW RRIARWOOD PL CLASS OF WORK:
SUBDIVISION: HAWK'S HEARD TOWNHOMES LOT #: 033 TYPE OF USE:
PROJECT NAME: 1SUNODA
DESCRIPTION: Install A/C unit. Per Planning Department, setback for this unit is 3'.
OWNER: TSUNODA, NAOMI PHONE #: 503- 957-5820
CONTRACTOR: FORECAST HEATING & AC PHONE #: 503.253 -7020
Inspection Request Scheduled For: Date: 12/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022964 -01 503-590-5893 N
Corrections /Comments / Instructions:
PASS ❑ PARTIAL APPROVAL fl CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION 11] ADDITIONAL FEES ASSESSED
Inspector: Dater Phone #: (503) 718-
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