Permit CITY TIGARD MECHANICAL PERMIT
fit; DEVELOPMENT SERVICES PERMIT #: MEC2005 -00292
„ I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/1/2005
PARCEL: 2S110BB -05900
SITE ADDRESS: 14199 SW 120TH PL ZONING: R -4.5
SUBDIVISION: REDWOOD VISTA LOT: 001 JURISDICTION: TIG
Project Description: Install heat pump.
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
<= 10000 cfm: OTHER UNITS:
FURN > =100K BTU: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MONTY WISEMAN Description Date Amount
14199 SW 120TH PL [MECH] Permit Fee 6/1/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 6/1/2005 $5.80
Phone: 503 620 - 0129 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 - 538 - 2953
Reg #: LIC 125815
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- -2344.
Issu d By: , I 4 OP Permittee ignature:
Call 503 - 639 -4175 by 7:00 a.m. for in : -c ions tha •usiness .• .
This permit card shall be kept in a conspicuous place on th : site until completion of the project. •
Approved plans are required on the job site at the time of each inspection.
Jun 01 05 10:14a 503- 537 -2172 p.2
i `
✓ Mechanical permit ' , : $ � i tl FOR OFFICE USE ONLY
-
City of Tigard DatetBy: r It 5 � Permit No.: N -_ /A::�. _. A Received
13125 SW Hall Blvd., Tigard, OR 97223 p� y Review 503.639.4I71 Fax: 503.598.1960 I JUN 01 20054.0„,.,. Plan Plan eview
R Other Permit.
Inspection Line: 503.639.4175 � � eel y:
(( Date Ready/By: El Sec Page 1 for
Internet: www.ci.tigard.or.ns CITY OF TIGA II . Notified/Method: Supplemental Information
: • . IVISIOI ....
COMA'IERCIAL : :Fl?E SCHEDULE = .TJSE CHECTCLTST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
:::. :.. CATEGORY. OF CONSTRUCTION: • . • . . • Value: $
1 - and 2 - famil dwelling .RESIDENTIAL .EQUIPMENT / SYSTEMS' FEES*. • •
y e ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. I Ea. Total • JOB SITE INFORMATION AND LOCATION. Hcating/cooling
y. 1 � Air conditioning or heat um
Job site address: J (.1 e, I t/ r 1 /� - C (requires site plan showing placement) 14.00
A
J
City /State /ZIP: /), s -j (. 0 ( ) e9 2-7-73 Furnace 100,000 BTU (ducts/vents) 14.00
L y " Furnace 100,000+ BTU (ducts /vents) 17.90 1
S
Suite/bldg. /apt, no.: Project name: A ,
Gas heat pump / 14.00 I `
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
Tax map /parcel no.: Other fuel appliances
b N F: W Water heater
�C ri O
ESCRIPTIO :O RK `
/, i x � fi _ � ;7' t n� • t f -_/ Flue ven�t water heater or eas 10.00
j fireplace 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
,, y mer. flue/vent
.... Chimney/liner/flue/vent • . ' '- ROPERTY: OWNER , ::. . i ❑ TENANT ::. - . . .
. .. , ( Other: I 10.00
Name: ' t� A V 1 1% ‘Ai I { t j7 , j,�_ Environmental exhaust and ventilation
Address: i G ! I ' / i} Range hood/other kitchen
1 l-,� / / ) ' ! )� Y _ equipment 10.00
City /S /ZIP: ' i 1. Cr a_ 6I V) L �7 .� Clothes dryer exhaust 10.00
` y _ b+ � C �` t Single -duct exhaust (bathrooms,
Phont( e/-' i t .
, ) 7 C Fax: ( ) toilet compartments, utility moms) 6.80
�
. :.. A,d'APPLICANT ' ❑CONTACT PERSON • :' : Attic /crawispace fans 10.00 • Business nm
ae p " , �j Other. 10.00
P ` � 1 q- l. v ! 1 - � ., Fuel piping
'' }/ �
Contact name: � r01. e) $5.40 for first four; $1.00 for each additional
Address: � 4 Furnace, etc.
1111 6t,g_ Gas beat pump
City/State /ZIP: 4 ° b C. (1 L S Wall/suspended/unit heater
Phoner(� - >) 63g a : V Fax:6).3) s3-7 Z1 -Z Water heater
Fireplace
E -mail: Range • ` ' - CDNTRACTOR .:.:. . Barbecue
•
Business name: , k4r / / On sJ 11,v ✓ Clothes dryer (gas)
Other:
3 .
Address: I MECI INICAL. PERMIT iFEESr' .; .c' ': :. '
City /State /Z1P: Vlit i /M -'�' / 6 &j 11 l L S Subtotal )
: 7 t Fax t I Minimum permit fee ($72.50) 1
Phone:
�' '+ e'`� ✓ r .3-7 111 z_, Plan review (25% of permit fee)
CCB lic.: d t �V State surcharge (8% of permit fee) W I ` / i t TOTAL PERMIT FEE `• ,M -
a 1-141..D.) 1, I I ,� / I t / This permit application expires if a permit is not obtained within 180
Authorized S
1 ` �1- F tir `6 / 1
�� -p,
days after it has been accepted as complete. •
Print name: 'Y } ���� Date. �� r - a Fee methodology set by Tri- County Building Industry Service Board
1 t/ 1'
is \Buitding.Permtts\.MEC•Permi t.4pp.doe 12/03 440.4617T (I l /02 /COM,WEB)
Jun 01 05 10:14a 503 - 537 -2172 p.3
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Site plan for : 10 d sEii)1,34.)
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CITY OF TIGARD
BUILDING DIVISION • • PERMIT #: MEC2005.00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1/2005
Phone: (503) 639 -4171 � "r'
Inspection Requests (24.Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/17/2005 TIME: 7:11AM PAGE: 41
SITE ADDRESS: 14199 SW 120TH PL CLASS OF WORK:
SUBDIVISION: REDWOOD VISTA LOT #: 001 TYPE OF USE:
PROJECT NAME: WISEMAN
DESCRIPTION: Install heat pump.
OWNER: WISEMAN, MONTY PHONE #: 503 -620 -0129
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 - 536-2953
Inspection Request Scheduled For: Date: 6/17/2005. Pour, Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009671 -01 " 603.538 -2953 Y
Corrections/Comments/Instructions:
•
•
I, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: (O 7 - 09 Phone #: (503) 718-