Permit C ITY OF TIGARD MECHANICAL PERMIT
111 i COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00558
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/13/2008
PARCEL: 2S103BB -10700
SITE ADDRESS: 12110 SW 123RD CT ZONING: R -4.5
SUBDIVISION: YE OLDE WINDMILL LOT: 027 JURISDICTION: TIG
PROJECT: LEE
Project Description: Heat pump installation.
CLASS OF WORK: ALT 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 0 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MARTIN & CAROL LEE Description Date Amount
12110 SW 123RD CT
TIGARD, OR 97223 [MECH] Permit Fee 11/13/20C $72.50
[TAX] 12% State Surch 11/13/200 $8.70
Phone: 503 -590 -7341
Total $81.20
Contractor:
AAA HEATING & COOLING
5017 NE GRAND AVE
PORTLAND, OR 97211 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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
Call 0 . 39.4175 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.
From: 11/13/2008 08:37 #529 P.001/004
. 1�
Mechanical Permit Application FOR O (TICE: USL ` • City of Tigard �� Reserved
• 13125 SW Hall Blvd., Tigard, OR 9722 Dete/By' / / ��
f L � �_ '•
Phone: 503.639,4171 Fax: 503.598.19
Phone: Plan Review
O Date/By:
Other Permit;
T I G A R D Inspection Line: 503.639.417 11 3' 200
• Internet: www,tigard or,gov �� V Date Notified/Method' 7uri9: Supplemental See Page 2 for
��g +,s���,1as� �ypQ G , , Notified/Me Supplemental Information
'GCR **VMS kat� i 2;�� , r O7' • L.., 1: 4.1:'° � - r . a orx,.n:..�s� A' �Na�d 4 ' „ frw . m ..
�, C 1 �• a � .+�m� ,nMxao..
`F^"'.Ti�L:...,..wr" a «i '
❑ New construction ZAddition/alteratioa,,. = :c Mechanical permit fees* are based on the value of the work wry^
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
Other: mechanical materials, equipment, labor, overhead, and profit.
a! 3 > ° rti � z m
?di t, s , o a I ' ' O CONSIAIIMO . . • ..v1.� - .4*;• 4rti Value: $
l - and 2- family dwelling ❑ ❑ Accessory .; ry buildin g i B''
❑ Multi- family ❑ Master builder ❑ Other: _ For special information use checklist.
:., 774;; , a _ Description Qty. I Ea. J Total
,:, '=: ^e , �1-dOBP TJ& ,i 1 n Atr.011 ` , f Ni .t z.?" Heating/cooling
Job site address: Air conditioning or heat pump
Z t 1 D StA k Z 3,a I✓ 4 -
City/State/ZIP: 1 4 ( h <- nQ Furnace s1 ,0 plan showing u cccme is 14.00
J v ti . �� 2_2:6 Furn L 00,000 BT (ducts /vents) 14.00
Suite/bldg. /apt. no.: 1 Project name: �� Furnace 100,000+ BTU (ducts/vents) 17,90
Gas heat pump 14.00
Cross street/directions to job site:
Duct work 10.00
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. _ 14.00
Subdivision: I Lot no.: Flue/vent for any of above 6.80
Tax map /parcel no .
Other: 10.00
Other fuel appliances
a tti "-' .v • '' it : µ � ,lI ,069,* Wii K. T; A a ti # " 1i4 Water heater _ 10.00
l Lp ? (..- it j iv ( i
Gas fireplace _ 10.00
.
� � V 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
��yy((:� 5x y ,.. T ii :�. ; ; c , r Chimney /liner /flue/vent
r .. . .«. ,.._ . , .y}9Yt , Y �C ® '� w.. f 4; S 1 I_ 10.00
Name: �-t , (� i 10.00
MCO ` A ` - " C ��� ` Environmental exhaust and ventilation
Address: t'�i O s tom' `2 .I�� C..---t- Range hood /other kitchen
equipment 10.00 ■
City/State/ZIP: T\ c cd - C.( Z. . 3 Clo thes dryer exhaust
cJ `' 10.00
Phone: ( Pig, ) ekb _ 1 � �1 Fax ( ) Single duct exhaust (bathrooms,
E �R ,� 1 7 toilet compartments, utility moms) 6.80 _
: ; q , i? i+ rr i .;,'�, iii ', Q. t " a uti Attic /crawlspace fans 10.00
Business name: 10.00
Fuel piping
Contact name: _ J L, j S'''g 22,Pr
r r $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
City/ State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( ) [Fax: ( ) Water heater
E -mail: Fireplace
Range '
rt g ,t ... - ;`� , 47, ai ` :" „ '1'7 * ',; A - Barbecue
Business name: A. A �� ,- tot) k `�1 Clothes dryer (gas) -
-
� up a
Address: raj 0 l ' � t/`e e L Other
City /State /ZIP: Pa «-� ' ' . , ta � a! CAIiF'�.,�z.�
4 , ` 1 Subtotal I t � •
Phone: 'Z u•1 3 ( ax: ( Z24. (t •� Minimum permit fee ($72.50) Z t Gj t7
D `� Plan review (25% of permit fee)
CCB tic.: -2.7..... State surcharge (12% of permit fee) $
TOTAL PERMIT FEE S 4 ` r
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: Vt rkt.Q�t� t { 1 2...--r)
�� O Date: 1 l - . Fee methodology set by Tri- County Building Industry Service Board
IaBuildmg /Prrmits \MEC- PermitApp.doc 01/19/07 440.4617T (II /02 /COM/WBB}
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° Alrconditioning tHeatpump Site Plan
AAA Heating and Cooling Inc. �/
Portland, Oregon 9721:1
503-284-2173 �_...:.
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CITY OF TIGARD , ..
BUILDING DIVISION r PERMIT #: MFC2008- 0O55t1
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2008
Phone: (503) 639 -4171 ad i
Inspection Requests (24 Hrs.): (503) 639 -4175 II s ' IL
INSPECTION WORKSHEET FOR DATE: 12/22/2008 TIME: 7 : 00AM PAGE: 7
SITE ADDRESS: 12110 SW 123RD CT CLASS OF WORK:
SUBDIVISION: YE OWE WINDMILL LOT #: 027 TYPE OF USE:
PROJECT NAME: LEE
DESCRIPTION: H pump installation.
OWNER: LEE, MARTIN & CAROL PHONE #: 603-690.7341
CONTRACTOR: AAA HEATING & COOLING PHONE #: 503 -284 -2173
Inspection Request Scheduled For: Date: 12/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes•age' / 1 44/‘'
69 Mechanical final 079180-01 503-284-2173 N
Corrections /Comments/ Instructions: Z44
1 d gle-fAe; .40. iakverii e t s / D - 3 6 ( . /
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PASS ❑ PARTIAL APPROVAL fl CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: \/ (/l v Date: Phone #: (503) 718- '