Permit L.
CITY TIGARD MECHANICAL PERMIT
•
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -00362
DATE ISSUED: 8/2/2006
- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 135D D -05400
SITE ADDRESS: 11500 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Installation of 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:
WOODSTOVES:
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
THOMAS DOLL Description Date Amount
11500 SW 90TH
TIGARD, OR 97223 [MECH] Permit Fee 8/2/2006 $72.50
[TAX] 8% State Surcha 8/2/2006 $5.80
Total $78.30
Phone: 503- 639 -3773
Contractor:
COST PLUS HEATING + AIR
7132 N FESSENDEN ST
PORTLAND, OR 97203 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 286 -2009
FAX 503- 286 -6552
Reg #: LIC 47978
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: Permittee Signature: 1
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.
Mechanical Permit Application y K :..,: ` :': FOR�OFFICE :USE ONLY :; :
D a t e 13y: -4/0 y � Mechanics / , agi ' 6 ) ;`
Date/13y: Q � cnnit No.: �
City of Tigard REGE�® Planning Approval Building
Ff � ®� I)ulc /Ity: it Nu.:
Other
13125 SW Hall Blvd. Plan Review Other
Tigard, Oicgon 97223 2 006 Uatc/li _ Permit No.:
Phone: 503- 639 -4171 Fax: 503\144-1960 Post - Review Land Use ..
Internet: net. WWW.G.tigal'd.Ul'.Uti ofTIGAR 4/40 1110411 4\ 1 . Y Case Jil J j p, Ei See Page 2 for
G Y Vl ., 01
mo ' Date /n Contact
24 -hour Inspection Request: 50 {3 9aft11S5�1 Name /Method: e V Supplemental Information.
;�' �'�a • • TYPEtO WO.RKh;�- ..tiff., } i': : t:; r ,i M :.,,- V•, ti �:�., A
' " .,� " '� ' ,.,,, _ ., COINMERCIAL TEE �SCHED. UL• E�, USEi ,GHEG'K'L'TS.Txz:�',t
❑ New construction ❑ Demolition Mechanical permit fees* are based On 'the total value of the work
0 Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
-'`' • it tt' ` CATEGORYTOF `CONSTRUCTIOI∎IPi ` rri r W mechanical materials, equipment, labor, overhead and profit.
Egi 1 & 2 Family dwelling ❑ Commercial /Industrial Value: $ , See Page 2 for Fee Schedule
❑ Accessory Building (l Multi - Family k IARESIDENTIAI;": EQUIPMEN: T/ SY; STE11 %ISI:1FEE,*SCIIED111.t0:1;l�r
Description I Qty 1 Fee(ea.) 1 Total
ID Master Builder ' II] Other:
°'';; Heating/Cooling
- '1:3011iSITE INFORMAT:IONrand LOCATION : A(( yRl(„ Furnace - add - on air conditioning ** / 14.00
ill
Job site address: I( Sbo 5w90 Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00 '
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duel, suspended, etc.) 14.00
•
Flue /vent (for any of above) • 10.00
Subdivision: Lot #: Repair units 12.15 _
'Other-Fuei :Appliances:c;' : 'j'....!! , • - ,'1::•
Tax map /parcel #: Water heater 10.00
' ',''.,, ' ;,,q "i ' DESCRIPTION WORK. ?;i . ,��'r;� i�''�' Gas fireplace 10.00
A j,�• 1 r r 1, Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood /Pellet stove 10.00
Wood fireplace /insert 10.00
' Chimney /liner /flue /vent 10.00
Ig'P.ROPERTY OWNER.:.; .:! TENANT • "` "' ';;:� ;` "'cx":" ,' ""`'rx Other:
r., � ?i- F:i`t��� 10.00
Name: j } etyt0 .� Thor.' iI • I-L Environmental Exhaust & Ventilation 1 ";
Range hood /other kitchen equipment 10.00
_Address: 1 i cyo 5i.., RO
Clothes dryer exhaust 10.00
City/State/Zip:.' t o2. v7 _z-3 Single duct exhaust
Phone: 563-6V1- 3713 Fax: (bathrooms, toilet compartments,
' ®'APPL:ICANT . ,-- ',` *'sl; "' :'.if: `. 'CONTACTt'PERSO1Vd It('{i,i` utility rooms) 6.80
Name: S-Le t S1vt tic-Fs-0c.) Attic /crawl space fans 10.00
Address: Other 10.00
C11 /State /Zl ** ;:' Fact Piping : ": y , , . ; : ' -' ,
City/State/Zip: p ($5.40 for first 4, $1.00 each additional)
Phone: 5y.- 7 81 -9oFo Fax: Furnace, etc. **
Gas heat pump **
E-mail: Wall /suspended /unit heater **
CONTRACTOR ' "'''''''f".. Water heater
Business Name: c_9„,s'T et us tJ-ke, Fireplace **
Address: 7t •J t-e)Sc.„ 44,-. Rang_e **
Cit /State /Zip:tP - cnz el ' r,
Clot ') z 3 ** —
ol
he_s dryer (gas) **
Phone: 5)- - 7 -gage, I Fax: ( 4 , - 4 ' 5 - 1 - Z . . 'Z Other: ** _
CCB Lic. II: Ljxf 7 E _ Total: V
Mechanical Permit Fees*
Authorized
Signature:: < ar,1 Date: 2---O Subtotal: $
�.- — - -- -- - -
Minimum Permit Fee $72.50 $ z-so
•_. - - _�. S4ev'2. __ 4 " r _ Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $
_ TOTAL PERMIT FEE, $ •7� c�J '
Notice: This permit application expires if a permit is not obtained within 'Fee methodology set by'1'ri- County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
is \I)sts \l'erniit Fornls \Mccl'ermitApp.doc 01/03
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CONTRACTOR NC -HEAT PUMP ---= UNIT SITE PLAN
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1(3z °i SSet -"' . -} ~cei TO BACK PROPERTY LINE
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A�4a 9 AUG 2 2006
de- ' 3' CITY OF TIGARD
a BUILDING DIVISION
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CUSTOMER INFORMATION
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CITY OF TIGARD :..... ,-
BUILDING DIVISION .„ .. ,•
: PERMIT #: MEC200G-00362
13125 SW Hall Blvd., Tigard, OR 97223
A DATE ISSUED: 9/2/2006
Phone: (503) 639-4171 41 . 1 4 /4/ 1 vulti i i it\
Inspection Requests (24 Hrs.): (503) 639-4175 , A,-Illok '11...
INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7:02AM PAGE: 79
SITE ADDRESS: 11500 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: DOLL
DESCRIPTION: Installation of A/C unit.
OWNER: DOLL, THOMAS PHONE #: 603_639.3773
CONTRACTOR: COST PLUS HEATING + AIR PHONE #: 503•286-2009
Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: / fpf
1.1
Code # Inspection Description Confirm # Contact # M age
699 Mechanical final 034399-01 503-781-9090 Y
Corrections/Comments/Instructions:
..._
L pAss I I PARTIAL APPROVAL I CANCEL n NO ACCESS
i FAIL 1 I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: k7(; CP — Date: ' Phone #: (503) 718- 7-/V 2- 7
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