Permit r•,' ' �y CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00040
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/28/2008
PARCEL: 1 S126DC -04601
SITE ADDRESS: 09970 SW GREENBURG RD ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 006 JURISDICTION: TIG
PROJECT: E PRINT
Project Description: extend supply ducts into office space. Valuation: $1850.00 Other unit is duct work.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
O'DAY, F BRIAN + SUSAN A Description Date Amount
9970 SW GREEENBURG RD
TIGARD, OR 97223 [MECH] Permit Fee 1/28/200E $72.50
[TAX] 8% State Surcha 1/28/200E $8.70
[MECPLN] Plan Rev 1/28/200E $18.13
Phone:
Total $99.33
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897 EXPIRED
/e/2 / .12tfi
,C '
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: r //�
Y i `ermittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections tha a sin-ss 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
• FOR OFFICE USE ONILY• .
City of Tigard Received ; ""
Permit No t •
, s'.. 1 a C))0
41 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: m ar -m
el"' Nan Revw
M .: '• Phone: 503.639.4171 Fax: 503.598.1960 , c;ENNI _,__ ieM
Date/By: /A ti .„, , Other Permit: iSC. P XV --) ,_ - •
f 00 0
Inspection Line: 503.639.4175
TIGARD Date Ready/By: • , lil See Page 2 for
Internet: www.tigard-or.gov ck.-co . bt'0"u Notified/Method: /57771 ; . i Supplemental Information
WORK 2,
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- L..., • , . - ,. • ..' ,.‘ , e: ' wt/ ''- ::-. tOt f
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ivo OF .,01■111 SCHEDULE 1, -
I: New construction cgj Addition/alteration/se, Mechanical permit fees* are based on the value of the work
. : , ,,,...
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
raiEb±iiiircfetrikicol
effoN Value $ jr.5-- tp,
' '';: ,,: 57' 7 ' ''.' ,,,,.' ,1 . ,
:.,Ilksiiiiisii**(214P 0 -. 1yr;,'/§yl'Els10„
0 1- and 2-family dwelling x Commercial/industrial 0 Accessory building ,
For special information use checklist.
0 Multi 0 Master builder 0 Other:
Description Qty. Ea. Total
; -: '''', '', 4,0"13,:stii;:t$IiO4:10*I01■i::411):::diiatiOSic:7":-.;::,';'1:1 Heatingicoan
Air conditioning or heat pump
Job site address: 9r Sui e ay. (requires site plan showing placement) 14.00
City/State/ZIP: I i q poilev 6(2_ q Furnace 100,000 BTU (ducts/vents) 14.00
,
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: e Op i A t_
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
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00.
Tax map/parcel no.: Other fuel appliances
DESCRIPTION ' Water heater 10.00
Gas fireplace 10.00
TNt 0 ca14 M4,04 iktP) Oft i t SOlifft, - Flue verit for water heater or gas
fireplace 10.00
(11 1 12%TuivId //,esi 0 4014 O Log lighter (gas) .. 10.00
---., --
-1 2 --IVIAT t„.ciA/k Wood/pellet stove 10.00
Wood fireplace/insert 10.00
• - - --- - - , - v -- . - :- - ,,- - - .,,, Chimney/liner/flue/vent 10.00
..*: ; ' ', ,.—:, ''A' r•• .,,, z • - Other: 10.00
Name: e , - ri„,L(- Environmental exhaust and ventilation
Range hood/other kitchen
Address: 9970 S't' 6 ,14!ktk i o4r4) w
equipment 10.00
City/State/ZIP: • - 1 - 1 e eye q7g? 3 Clothes dryer exhaust 10.00
-"WI Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
_
„
r ''''";:- • . • -.;1111: APPLICANT', ' '', ' • --..: . la 't ONTA CT P ERS ON , ., , Attic/crawlspace fans 10.00
Other: 10.00
Business name: Am (,,01„. w 1 007314 Fuel piping
Contact name: Oki. AiSe3Y 1 , $5.40 for first four; $1.00 for each additional
Fumace,
Address: L1) A l, _ i 44tic as te
or -1.- etc. - • Gas heat pump
City/State/ZIP: KA/Z,1-1p 49 eyl___ (4'i9-f7 Wall/suspended/unit heater
i • Water heater
Phone: (1 ) A ...# Fax: : (95 ) Af ......5
Fireplace
E-mail: V e.I e 61,rie,filk iar., . (',em.. Range
CONTRACTOR" I - ' .- - '' ::— ,4 . ' , 1 : ' := - '• Barbecue
Clothes dryer (gas)
Business name: sa Att e .,, et g a we.,
Other:
Address:
4 ' ' ': '''' ''''' '''TqiCialsireitIPPEfilVIIT Ali*" `: '!'''''.
'•, , 4, •,,—, : • • : ..,c.::••Y.
City/State/ZIP: Subtotal 7 '
Minimum permit fee ($72.50) 72.,
Phone: ( ) Fax ( )
Plan review (25% of permit fee) /S. I 3
CCB lic.: 446), State surcharge (12% of permit fee) ,
t _ / Date: ?ti
TOTAL PERMIT FEE
Authorized signature: This permit 1.-- --e
CigAir _
application expires if a permit is not obtained within
days after it has been accepted as complete. 18
Print name: it
* Fee methodology set by Tri-County Building Industry Service Board
Ai_ pci\j„ein i — —Of
IABuilding \ Permits \MEC-PermitApp.doc 04/06/06 440-4617T (1 I /02/COM/WEB)