Permit 'Q CITY OF TIGARD
MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: MEC2010 00282
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/09/2010
T[,G ARI? 9 Parcel: 2S101AA06400
Jurisdiction: Tigard
Site address: 12323 SW 66TH AVE
Subdivision: WEST PORTLAND HEIGHTS Lot: 24
Project: Spec Space
Project Description: Reinstall existing roof -top unit on roof curb and connect to existing duct work
Owner: FEES
TING, ELON & SYLVIA Description Date Amount
BY WILLIAM R SOUTHARD, 20400 NE 122ND
Permit Fee 08/09/2010 $96.69
ST Plan Review 08/09/2010 $24.17
PHONE: 12% State Surcharge - Mechanical 08/09/2010 $11.60
Contractor:
CARLSON'S HEATING & AIR CONDITIONING,
INC.
1414 SOUTH PACIFIC AVE.
PHONE: 360 - 425 -4888
FAX: 360- 577 -1824
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $132.46
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800. 4.
7 ,
Issued By: S � �/ Permittee Signature: -......%11: /�
666 i /
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
06/16/2010 15:11 FAX 3605771824 Carl sons Heating Lj002 /002
Mechanical Permit Applicg ro ; ,7 - 1.-01( OF l: liti1: rllVl.l •
City of Tigard • Received Pe rmit No.:
J 16 2010 Date/By: 1(o 10 �E6200 _zing"- •
11 13125 SW Hall Blvd., Tigard, OR 972 Plan Review ,,.- 1
G . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: A to Other Permitt pg° ®/® _do if r,
f; •'•tea" Dat Re /B S Page2for 4
T t G n t: u Inspection Line: 503.639.4175 �� � • •
I •. ` r ; ;,� Ready /By: lurk. 55 See
Internet: www.tigard- or.gov 7 0: 1 i : : Notified/Method: '5 G (,) Supplemental Information
l.'.. { i ! s t I t: T � :,y,: c;,1; t S ; . .7: rr fait - ; xvl " a, u tr„! t � r f,:r a P7
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❑ 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: reconnect RTU mechanical materials, •ui•ment, labor, overhead and •roftt.
ulgt.Ritt!A ,l i u ,r i f,t1+ Ms 7 +; Value: $ $1,380.89
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
t ;y Itt .;,
at gw 'E j j r a +?'' +.. C R y 'Ai ., ii , IJt7i t`14r t
,
.,� °1hr;t�sR• `- ,z o t I I t 1. t I I(t z r .• Heating/cooling
coolia R
Air conditioning
Job site address: 12323 SW 66 Avenue (requires site plan showing placement) 46.75
City /State/ZIP: Tigard, OR 97223 Furnace 100.000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: Project name: Fa nsurance Spec Sp Heat pump 61.06
Cross street/directions to job site: Duct work 2332
H dronic hot water system 23.32
1-5 south exit 293 — Right toward Haines Street , Residential boiler (radiator or
Left onto SW 68th — left onto SW Franklin ! left on SW 66th @ 12323 SW hydronic) 23.32 .
, Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Su' ivision: Lot no.:
Other: Reset RTU 23.32
Tax map /parcel no.: j Other fuel appliances
t .Y:,: 1 {3 { I f Yt "fr: ' I [ I 77 ' 1i9A 1ri"aU1,`fl.';t'4/IFI' ? x aJ : .4 � - ' .+, Water heater 23.32
( s, l { _ ,..•� >i, .•�_.., Jet° , .� u Gas fireplace 33.39
Reinstall existing roof -top unit on roof curb and connect to existing duct work. Flue vent for water heater or gas
-- fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
1..• t, {, „I ChimOther: ne /liner /flue /vent 23.32
arl ,,:.41,1,11,..,:...._,,,,.,,,; ;s IL +!. ` at r11 ( tIE'I 23.32
Name: Farmers Insurance Company Environmental exhaust and ventilation
Range hood /other kitchen
Address: 12323 SW 66 Avenue equipment 33.39 t
City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
N+ . xw y Attic/crawlspace fans 23.32
�.: . • �r Other: I 23.32
Business name: Carlson Heating & Air Conditioning, Inc. Fuel , i , io
Contact name: Dack Carlson $14.15 for first four; $4.03 for each additional
Fumace, etc.
Address: 1414 South Pacific Avenue Gas heat pump
City'State/ZIP: Kelso, WA 98626 Wall /suspended/unit heater
Ph .1e: (360) 425 -4888 Fax: : (360) 577 - 1824 Water heater
Fireplace
E -mail: debbie@carlsonsheatingcom Ran_•e
i Clothes dryer (gas) ■.-
Business name: Carlson's Heating & Air Conditioning, Inc i Other:
Address: 1414 South Pacific Avenue _ �; " ',':;' . . ' ?. " •. •' . .
City /State /ZIP: Kelso, WA 98626 ,,(I‘‘ � . \ Subtotal 0
I ' \ Minimum permit fee ($90.00)
hone: (360) 425 - 4888 l Fax: (360) 577 - 1 8 �, Plan review (25% of permit fee) 0 IIII
C CB lic.: 59931 ® f 71!!!!! � `� ` State surcharge (12% of permit fee)
d TOTAL PERMIT FEE j
Authorized signature: t ► Permit oppiication expires if o permit is not obtained within tau
days after • ce • tad as complete.
Print name: Debbie Quick D : 6/16/2010 • Fee m • .•.o ogy set by Tri- County Building ... Service Board
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