Permit CITY OF TIGARD
�1
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00651
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/22/2006
PARCEL: 2S103DB -11500
SITE ADDRESS: 11210 SW ARBRE CT ZONING: R -4.5
SUBDIVISION: GENESIS NO. 3 LOT: 062 JURISDICTION: TIG
Project Description: Furnace install.
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: DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KIRBY CARROLL Description Date Amount
12210 SW ARBRE CT
TIGARD, OR 97223 [MECH] Permit Fee 12/22/20C $72.50
[TAX] 8% State Surcha 12/22/20C $5.80
Total $78.30
Phone: 503- 670 -9672
Contractor:
OHAC, INC.
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 538 -2953
FAX 503 -537 -2712
Reg #: LIC 172126
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.
.�( S
Issued By: /L �'GaZ Permittee Signature: �",Y> ra t �17✓"L.
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.
Dec 22 06 02:13p MS Rentals, Inc. 503- 537 -2172 p.1
Mechanical Permit App :: "" FOR OFFICE USE ONLY
. i City of Tigard Dat I � a.,- of, ,B Permit No .aBp
13125 SW Hall Blvd., Tigard, OR 97223 p lan Review
Phone: 503.639.4171 Fax: 503.598.1960 DEC k Date; B Other Peru
Inspection Line: 503.639.4175 1 ; ,1 - " ' I) Date Ready'By: El Sec Page 2 for
Internet: www.ci.tigard.or.us C Notified/Method: Supplemental Informat
1 41W be 4I r TT ' 1, , . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
S F � . ► t 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: $
• RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
. .:. JOB SITE INFORMATION AND LOCATION ,. Heating/cooli g
Air conditioning or heat pump
Job site address: t 1 Q1 6 5u,) I\ re. (A (requires site plan showing placement) 14.00
City/State /ZIP: ---5 e -Ard , OZ Cr Q' 3 Furnace 100,000 BTU (ductsivents) 1 1 4.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydro/tic 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 I 10.00
Other. 10.00
Tax rnap /parcel no.: Other fuel appliances
'DESCRIPTION OF V. Water heater
Gas fireplace 10.00
I A v RCr Flue vent for water heater or gas
h �� A� fireplace 10.00
1
- lr N( r� Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
.. .,.
Chimney/liner/flue/vent veal
PROPERTY; OWNER ❑TENANT. 10 00 • X Other.
Name: lc( -b, ` , crw ," Environmental exhaust and ventilation
Range hood/other kitchen
Address: JJJ p
atc� .•• :I.,..12) NI - I 1)te C:-- equipment 10.00
City/State /ZIP: 1 1.�.I i I aR 91 9 , 3 Clothes dryer exhaust 10.00
t Single -duct exhaust (bathrooms,
Phone: 0 - q �' . `i Fax: ( ) toilet compartments, utility rooms) 6.80
. cra fans
''El: PERSON Attic/crawlspace ❑APPLICANT : . : Attic/ 10.00
Other: 10.00
Business name: Oregon Heating and Air Conditioning
Fuel r m�
PP g
Contact name: 'R as1',- (e111•e_ 55.40 for first four; $1.00 for each additional
Address: PO Box 397 Furnace, etc.
Gas heat pump
City/State /ZIP: Dundee OR 97115 Walllsuspended/unit heater
Phone: (503) 538 -2953 Fax:: (503) 537 -2712 Water heater
Fireplace
E -mail: rashelle @oregonheadng.com Range
CONTRACTOR Barbecue
Business name: Oregon Heating and Air Conditioning 0 t____-- Clothes dryer (gas)
Other:
Address: PO Box 397 * .. :
)MECHANICAL PERMIT FEES
City/State /ZIP: Dundee OR 97115 Subtotal
Minimum permit fee ($72.50) -ia .'5C
Phone: (503) 538 -2953 Fax: (503) 537 -2712
Plan review (25% of permit fee)
CCB lie.: 4,11)&4035 1i a , State surcharge (8% of permit fee) 5 , EsC)
TOTAL PERMIT FEE -7 S' , ,?
atuie ( � This permit application expires if a permit is not obtained within 180
Authorized sign
A 0 0 ci 0 Z a .']�P 0 .. days after it has been accepted as complete.
Print name: ' -P' a ,�vtlJ`�- oet U Date: la .22-,.,0C, ` Fee methodology set by Tri - County Building Industry Service Board
i :`.6 P
uildivy \urrni u • ` ,5 C PcnnitApp.do.: 12/05 440 -4617T (I1 /02 /COMI'.VEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006.00551
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/22/2006
Phone: (503) 639 -4171 / nAipvtliti
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/4/2007 TIME: 7 :00A # . PAGE: 12
SITE ADDRESS: 11210 SW ARBRE CT CLASS OF WORK:
SUBDIVISION: GENESIS NO. 3 LOT #: 062 TYPE OF USE:
PROJECT NAME: CARROLL
DESCRIPTION: Furnace install.
OWNER: CARROLL, KIRBY PHONE #: 503 -670 -9672
CONTRACTOR: OHAC, INC PHONE #: 503 - 538-2853
Inspection Request Scheduled For: Date: 1/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Egg • Mechanical final 041806 -01 503 - 636 -2963 Y
Corrections/Comments/Instructions:
w4-
[ S iQ L/ � / L a , i _ - r / / L -LJi [ Ua [.. .via
•
n Pi t PARTIAL APPROVAL I I CANCEL n NO ACCESS
10 FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Ins ector: -; Date: / — Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEC2006-00651
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/22/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1111/2007 TIME: 7:03AM PAGE: 19
SITE ADDRESS: 11210 SW AKRE CT CLASS OF WORK:
SUBDIVISION: GENESIS NO. 3 LOT #: 062 TYPE OF USE:
PROJECT NAME: CARROLL
DESCRIPTION: Furnace install.
OWNER: CARROLL, KIRBY PHONE #: 503-570-9672
CONTRACTOR: OHAC, INC. PHONE #: 503
Inspection Request Scheduled For: Date: 1/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
S9 Mechanical final 042017-01 503-538-2953
Corrections/Comments/Instructions:
•za ',V 44 11■10 S — 1 9 y
- 2;1 - 1 5 4 - S El PARTIAL APPROVAL CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: - Date: / Phone #: (503) 718- tcl-c1-\--.