Permit CITY OF TIGARb
MECHANICAL PERMIT
i A DEVELOPMENT SERVICES PERMIT #: MEC2006 -00227
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/23/2006
PARCEL: 2S1 10 B B -05200
SITE ADDRESS: 14104 SW 121ST AVE ZONING: R -3.5
SUBDIVISION: ARLINGTON RIDGE LOT: 029 JURISDICTION: TIG
Project Description: Install exterior A/C unit
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
DEAN, PAUL G + KRISTIN K Description Date Amount
14104 SW 121ST AVE
TIGARD, OR 97224 [MECH] Permit Fee 5/23/200€ $72.50
[TAX] 8% State Surcha 5/23/200€ $5.80
Total $78.30
Phone: 503- 620 -6804
Contractor:
THE HEATING SPECIALIST
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 257 -7000
FAX 503- 257 -7702
Reg #: LIC 56628
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: . /J
�/ Vii
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.
;-
1VI nical Permit Ap acatton � f FOR OFFICE USE ONLY
t ti it-j, k � �- 1 ..,,:- t .. Received
f Tigard Date /By: Permit :.r, 4276- s
' H all Blvd., Tigard, OR 97223
r,. Plan Review
• P11, 50 3 . 639.4171 Fax: 503.598.1960 MAY 2 3 2006. 4 ' 1 Date /By: Other Permit:
Inspection Line: 503.639.417 e! Ready /By: /B : Date Read Jsris: ® See Page 2 for
Internet: www.ci.tigard.or.us
(vy dA . T -, Y Of f fiki Notified /Method: TI T Supplemental Information
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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: mechanical materials, equipment, labor, overhead, and profit.
' ' CATEGORY'r'QF. CONSRUCTION•
;RESIDENTIAL EQUIPMENT' %'SYSTEMS FEES * "' "
X 1 - and 2 dwelling g ❑ Commercial /industrial 171 Accessory building
For special information use checklist.
El Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total
3= ,.,
JOB' "SITE:INRQRMATION - AN D-- LOATION.:a� �� -�'' Heating/cooling
' �� L Q Air conditioning or heat pump
Job site address:
�' - 1 I o t _ ' ( , ) 1 p.. 1 - �-f t (requires site plan showing placement) / 14.00 /c
City/State /ZIP: `T� Q_ '17 ,2t. Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no:. Project name_ „'l Gas heat pump 14.00
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
fi _,, -„ . , i , Water heater 10.00
�4 %'', ,x�� -, D:� BT10N OF . W , R >„ °Y -� ?�� <
ESC RI O IC ; -�;
�:' .n .a.: �� ..< >_„ � a °>"P,.'` - ' � ,..
Gas fireplace 10.00
--A ` •- " d ti '' i o - A-- , Li_ �-n 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
, -,- ,>
,;, a., er /flue %vent 10.00
PROEERT V.O, ;a e ;, .,,, ❑•T
r;- ..,..,.,. _ „. .__. .wEN
..' .... ....... .....r Other: 10.00
Name: (6... u_ ( ∎ ,e_(,_ . Environmental exhaust and ventilation
Address: 1 y (U 4 (_,__) I <21 ° "` A�/,� Range hood /other kitchen
equipment 10.00
City/State /ZIP: ' j , G d C r " - 7 ,2-- ..)...Li Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (S ) (o , , (, � Fax: ( ) toilet compartments, utility rooms) 6.80
f
r• .= < >z - Attic /crawlspace fans 10.00
;�t� ® APPLICANT °•;; ''.�;:, �_� GOTAGT "PERSON � ° � =
.,mn ., xn, .3 .... , , :eeum,r ,...c ?:., a..:,. s%i�lE? �� • < '•,1;3' ,,,�� ",d�'� „„, ..�. N ,_ 5. , ,. .n.:k� "T,� -r -,_ .,. .
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. •
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
h>i . " -.'3 1- 'vA��• �\ „Ia°, ".
t, ,�.�� 5�;�u�CONTRACTOR ,,s, Barbecue
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Business name: �f�p_, 1--4 2[.UT _. Clothes dryer (gas)
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1 Other
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Address: 9uo 1"\ a L Ct. l5e _ � .wg -. ...... f:� %''_:: „i,a•
y ;;;; A ' `�< .. ECI- IASNICALKPER1vI7T<FEES ` �- '_
,._ �,�� �.�__�. ___ , <.z..�:,.� -T_.�� = :eta;: -,,
City/State/ZIP: c (2 1 i -iiJ 2. 9 7 U . Subtotal 7.Z..5d . .
Minimum permit fee ($72.50)
Phone: (Se03) ., 5 - -) Ue, - Fax: (5(>3) ,..S" - 7-- - 77 0- "
Plan review (25% of permit fee) .
CCB lie.: S Co W •-8' State surcharge (8% of permit fee) .• So
TOTAL PERMIT FEE 7 F.3
This permit application expires if a permit is not obtained within 180
Authorized slgnature_--y ,---\--, _ _ - _ C32./ - tt� /7 �._9n� days after it has been accepted as complete.
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Print name: \.___ J am - ,. , , , , u E Date:= / 9- , JO 4> * Fee methodology set by Tri- County Building Industry Service Board
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CITY OF TI.GARD Aok
BUILDING DIVISION PERMIT #: Iw1EC2005.00227
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/21/2006 TIME: 7:02AM PAGE: 73
SITE ADDRESS: 14104 SW 121ST AVE CLASS OF WORK:
SUBDIVISION: ARLINGTON RIDGE LOT #: 029 TYPE OF USE:
PROJECT NAME: DEAN
DESCRIPTION: Install exterior NC unit
OWNER: DEAN, PAUL G + KRISTIN K, PHONE #: 503-620-61304
CONTRACTOR: THE HEATING SPECIALIST PHONE #: 503
Inspection Request Scheduled For: Date: 9/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036750-01 503 - 257 -7000 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: s . Date: q- Phone #: (503) 718- 244S-
CITY OF TIGARD . ..- ._, --
BUILDING DIVISION PERMIT #: MEC2005 -00227
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5123/1006
Phone: (503) 639 -4171 goo l�� a 4�' 1
Inspection Requests (24 Hrs.): (503) 639 -4175 A. �' T L.
INSPECTION WORKSHEET FOR DATE: 8/1/2006 TIME: 7 :02AM PAGE: ti(;
SITE ADDRESS: 14104 SW 121ST AVE CLASS OF WORK:
SUBDIVISION: ARLINGTON RIDGE LOT #: 029 TYPE OF USE:
PROJECT NAME: DEAN
DESCRIPTION: Install exterior A/C unit
OWNER: DEAN, PAUL G + KRISTIN K, PHONE #: 503 -620 -6804
CONTRACTOR: THE HEATING SPECIALIST PHONE #: 503
Inspection Request Scheduled For: Date: 8/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 034047 -01 503- 257 -7000 N
Corrections /Comments /Instructions:
C
i ri6c74Gd,L f t.,, p .u:n;e-- 4 .5 47ei v44 C - c�c:-
y 4),,6 A" �> v 5 �7" -- OA-' i ff.1 -( ■60) -`•grc - JT fir?"
-1 iA -I 4'-< ?c —
❑ PASS 1�i1 PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL CA L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: P P/--e6 Phone #: (503) 718 -