Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00354
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/15/2007
PARCEL: 1S134DB-11200
SITE ADDRESS: 11326 SW 110TH PL ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 014 JURISDICTION: TIG
PROJECT: BELL
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: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JEFF & JENNIFER BELL Description Date Amount
11326 SW 110TH PL
TIGARD, OR 97223 [MECH] Permit Fee 6/15/2007 $72.50
[TAX] 8% State Surcha 6/15/2007 $5.80
Total $78.30
Phone: 503- 639 -3698
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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 B • /. _ Permittee Signature: S
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.
Jun 14 07 04:51p p.2
`:.` _#. \ Z l i> tr" e
Mechanical Permit A • ;; : ' 2 i V - . FOR OFFlCE=lSE
R eceived / ++ Pe rmit No.: Jam/'
City of Tigard Date/By: I L A" vv
13125 SW Hall Blvd., Tigard, OR 97223 Plan R eview O her Permit
Phone: 503.639.4171 Fax: 503.598.1960 JUN 1 4 'ZOO/ 1 paea Y ,. - Date /By:
Inspection Line: 503.639.4175 u "III - Date Ready /By. reds: 21 See Page 2 for
Internet: www_ci.tigard.or.us CITY Y VF TIGA ,. Notified/Method: 11 off SuppLemental information
BUILDING DIVISION
V ;_ a MMERCI.4I: FEE" SCHEDULE CHECKLIST _
- _ -. TYPE OF - WORK - .: A .':
t::. • - cal permit fees are based on the value of the work
❑ New construction] Addition/alteration/replacement . • (y - () armed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: iechanical materials, equipment. labor, overhead, and profit.
Value: S
CATEGORY ..OF:CONSTRUCTION, . -. ;
...g - _
'• REStHENTIAL :EQUIPMENTPSYSTEMS:FEES * ..
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special in use checklist.
Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. i Total
.' -JOB . SITJE ,INFORMATION :4:141) `LOCATIO!V Heating/cooling
1 3 � 12 ` I �� ale__ Aigoning or heatp pump
Job site address: u9 t e_ (requires sit conditioning
lag or he placement) 14.00 I y. CO
City/State/ZIP: t t c' cu-cL 9 �T Z2 3 Furnace 100,000 BTU (ducts/vents) 14.00
_ t .0k Furnace 100.000+ BTU (ducts.wents) 17.90 •
Suite/bidg. /apt. no.: 1 Project name: Gras heat pump 14.00
Cross street/directions to job site: putt work 14.00
Hydrorlic hot water system
I 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: 1 Lot no.: Other. 10.00
Tax map /parcel no.: Other fuel appliances
.
: " :' DESCRIPTIQN tt)iF WOR
;K : Water 10.00
heater
Gas fireplace -
FlF ( /•q Flue vent for water heater or gas
1 ` fireplace 10.00
Log lighter (gas) 10.00
•
Wood/pellet stove 10.00 '
Wood fireplace/insert 10.00
. , .
: -_: . tner /flue/vent 10.00
Other. OteY •
_ ,.: , ; ":. 10.00
{
. :,..- � :eIZOr:E�Tar�tivtflv�u ":: :: ;� :-�> _ : . `. :, :: ".; , - ; D :� ., °. : ,__ " :. ; :
pp
Name: �� J p') y1 1 r �3Q� l Environmental exhaust and ventilation
Range hood/other kitchen
Address: ,, 1 \ Q (;),A () ) JQ _ equipment 10.00
City /State /ZIP: --- r, Ccu , bp_ 91 a.:2--.. - Clothes dryer exhaust 10.00
- Single -duct exhaust (bathrooms,
2 toilet com arttnents, utility moms) _ 6.80
Phone: &I'," ) 10�� � � Fax: ( ) _ . p
- CT 011 .. :. :..; - Attic /crawlspace fans 10.00
.
Ar>PI IC t��lz : :.: . . Other: 10.00
Business name: Fuel piping
Contact name: $5 -40 for first four; $1.00 for each additional
Furnace, etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Water heater
Phone: ( ) Fax: ( )
FireQlace
E -mail: Range
a
.::. • .- _ Barbecue
COT")IRACTOR':.: , Clothes
n �, tie
I ... l --�iJ� l o es dryer (gas)
name : Other: I
Address: /2 / 2L :TvIECHANICAL.pERD1TT.- FL.f:S* , •
PD , . • .. p, 70/3 Subtotal k 4 •�,,0D City /State /ZIP: >n 40� f ej�� J /
f fee ($72.50} /� �-� // e'7:- y Minimum 72, .50 (5t6) p� —j �T J Fax: (�UJ) G (�G� — � �4 Plan review (25 %ofpemutfee)
CCB lie.: / 1.- DO permit State surcharge (8% of fee) 'j.
. TOTAL PERMIT FEE Z $ .-,
/�y'�/�1 This pernut application expires if a permit is not obtained within 180
Authorized signature: '1' • \ 1/ days alter it has been accepted as complete.
f J l ' ti( I � r ' Fee methodology set by Tri- County Building Industry Service Board
I P ri nt name: L i s li f ryt,„ L ba I V
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/150007
Phone: (503) 639 -4171 ������ j��l
,,
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 6/27/2007 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 11326 SW 110TH PL CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 014 TYPE OF USE:
PROJECT NAME: BELL
DESCRIPTION: Install alc unit.
OWNER: BELL, JEFF & JENNIFER PHONE #: 503.639 -3698
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503.266.1249
Inspection Request Scheduled For: Date: 6/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 051027 -01 503-266-1249 N
Corrections/Comments/Instructions:
`�.SA �Lfi✓ reacm- U.t, L.Azv g- . se —13 /?'/2
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: l Date: 6--2 > --e-f7 Phone #: (503) 718 - � 'J