Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00520
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/29/2007
PARCEL: 2S112BA - 00800
SITE ADDRESS: 14460 SW 80TH PL ZONING: R -
SUBDIVISION: WAVERLY MEADOWS LOT: 044 JURISDICTION: TIG
PROJECT: HAYS
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: WOODSTYERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
•
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
HAYS, JAMES E + Description Date Amount
SHELLEY P
14460 SW 80TH PL [MECH] Permit Fee 8/29/2001 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcha 8/29/2001 $5.80
Phone: Total $78.30
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 By /���i / � / / Permittee Signature: Perfic\-k 61>
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.
Flug „ „28 07 04:22p Oregon Heating & R/C 503 - 537 -2172 p.l
C Permit Application ,' -: FOR OFFICE ONLY : , : .._: ;
Me
Mechanical P pp . ” . ;: ;� -: ' ... ... _... ..... ...
Cit of Ti and ED R E iew Penttit 13125 SW Hall Blvd, Tigard, �!
' l Phone: 503.639.4171 Fax: 503.598.1960 Date By: • Other Permit:
Inspection Line: 503.639.4175
TIG All U tZ (l, 200 Date Ready /By: r !�J See Page 2 for
. • Internet: www.tigard or.gov Notified /Method: , I Supplemental Information
GV O F TIGP RD
-
` • . ' T 'Y ' pC ' a lT; 1r1(�Ci Dw'` COMNIERCIIAL'FEE* • SCHEDULE:. _
USE CHECKLIST
10 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.
, , , ' •GAI'EGORY :OF CONSTRUCTION
Value:
. ' RESIDENTIAL EQUIPMENT) SYSTEMS FEES* • :. .
® 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building -
For special information use checklist.
Cl Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION '.:.:. Heating/cooling
Job site address: Air conditioning or heat pump 1 �
' y b � , (requires site plan showing placement) l 14.00 1 y ,
City /State /ZIP: e n r_ Furnace 100.000 BTU (ducts /'vents) 14.00 Ct ! Fumace 100.000+ BTU (du:ts /vents) , 17.90
Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Ductwork 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
Water heater
Gas fireplace 10.00
HVAC- � � jr) 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
..., 1 t: flue• vent
.. t y n
';.;..;:.:' .. PROPERTY.:.O :OWNER:.::. ; :.• .•... , ❑ TEi�FAIYT ; • ... ` Other 10.00
.,; Chtnne t e
Oth
Name: 0 ti_ /' .) Environmental exhaust and ventilation
Address: L f 1. 46 V a ��� ` Range hood /other kitchen 10.00
equipment
City /State/ZIP: �i re q -� U _ Clothes dryer 10.00
1 Single -duct exhaust (bathrooms,
Phone: (SQ3) ic, „q� Fax: ( ) toilet compartments, utility rooms) 6.80
craw sp
tttc ce fans a • . .. ....: � 'a , :..' .'❑ CONTACT PERSON;.' r 10.00 Other.
Business name: Oregon Heating & A/C Fuel ng t i
P�P�
Contact name: $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 Wall/suspendediunitheater
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater
Fireplace.*. --
E -mail: Range
N Barbecue
CONTRACTOR becue
Business name: Oregon Heating & A/C Clothes dryer (gas)
Other -
Address: PO BOX 397 141ECHA.NICAL PERMIT FEES*
City/State /ZIP: Dundee OR 97115 Subtotal �l.;,Q
Minimum permit fee ($72.50) a Z�7i
Phone: (503) 538 -2953 Fax: (503) 537 -2172 Plan review (25% of pennit fee)
CCB lic.: 172126 State surcharge (8% of pennit fee) Gg O
TOTAL PERMIT FEE 1 9 3 a
This permit application expires if a permit is not obtained within 180
Authorized signature: ' days after it has been accepted as complete.
Print name: Sou 5'Q h / , I Date: ? 1$(d ) ” fee methodology set by Tri- County, Buildta8 Industry Service Board
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CITY OF TIGARD
, BUILDING DIVISION PERMIT #: MEC2007 -00520
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/ ?007
Phone: (503) 639 -4171 40,00,
Inspection Requests (24 Hrs.): (503) 639 -4175 "
INSPECTION WORKSHEET FOR DATE: 9/11/2007 TIME: 7 :0OAM PAGE: 44
SITE ADDRESS: 14460 SW 80TH PL CLASS OF WORK:
SUBDIVISION: WAVERLY MEADOWS LOT #: 044 TYPE OF USE:
PROJECT NAME: HAYS
DESCRIPTION: Install aft unit.
OWNER: HAYS, JAMES E +, PHONE #:
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 - 538-2953
Inspection Request Scheduled For: Date: 9/11 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # M- .sage AlAl
699 Mechanical final 055466 -01 503-538 -2953 Y
Corrections /Comments /Instructions:
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PA ps "ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 FAIL //CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
Inspector: Date: q I o / Phone #: (503) 718- 7.0 W