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Permit M 1.' CITY OF TIGARD MECHANICAL PERMIT OMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00575 TIGARD C DATE ISSUED: 11/16/2006 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S136DD -00900 SITE ADDRESS: 06830 SW ATLANTA ST 100 ZONING: MUE SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG Project Description: Registers and Grilles install. 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: 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES MALCOM ESLINGER Description Date Amount 11575 SW PACIFIC HWY PMB 160 [MECH] Permit Fee 11/16/20C $95.50 TIGARD, OR 97223 [TAX] 8% State Surcha 11/16/20C $7.64 Total $103.14 Phone: 503- 620 -9515 Contractor: ROTH HEATING & COOLING P.O. BOX 1265 CANBY, OR 97013 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 266 -1249 FAX 503- 266 -3478 Reg #: LIC 14008 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: 4 0 G, Permittee Signature: " Ari d ,V Call 503.639.4175 by 7:00 a.m. for inspections that business This permit card shall be kept in a conspicuous place on the job site until comple ion of the project. Approved plans are required on the job site at the time of each inspection. ' Mechanical Permit Application FOR OFFICE USE ONLY �=' City of Tigard Received Permit No. 'a 13125 SW Hall Blvd., Ti RECEIVED Date /By� I l t ' /er j 4 66 Q( — ' 7 . D Phone: 503.639.4171 Fax: 503.598.1960 n Other Permit: Inspection Line: 503.639.4175. f Date /By: / y:j ..75.780:45./ Y" TIGARD NO� 1 U 2006 Date Ready /By: Juris ® S Page 2 for Internet: www.tigard- or.gov ly eo Notified/Method: Supplemental Information CITY <, •. -zR- ;t'r Y aP> O .#0: AL F EE ;SCIIEDULE ; - :USECHECKLIST 4p}�[r{r�� < a . � w - /''� OF TIGARD li . i, t S t F .SS "- +* • t .i .- . ....a. -,f. t�..x.,d��v„ .. ->,,.. y.. y..i.... tt�< ., a .,.. v..'. .... x.64- .< -: ,. �<, �''td2.. ,c � .w. -..., .rr .zx New construction El 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, ,r,, overhead, and profit. .... '�''," ATE CORY%OF, UCTIONs- „��; Value: $ 00 RESID L E NTIA EQUIPM / SYST.EMS FE ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building �.,p.a >�;- .�. -, ... . For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total ` ' '` ` "° '> ` ` „'.'JOB;- SITE -= INFORMATION ;;AND' „LON:. Heating/cooling Job site address: © /I CATIO'; Air conditioning or heat pump � (requires site plan showing placement) 14.00 City /State /ZIP: 1 9av ' !' 1 "7� Furnace 100,000 BTU (ducts /vents) 14.00 Fumace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: ZOO I Project name:�,l��l',,t Gas heat pump 14.00 Cross street/directions to job site: 8 ("� 4- 4 4 Duct work 14.00 // 0 � - , , Hydronic hot water system 14.00 �O Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: I Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances £ i '' '' ''- '''` DE OF WORK - ','' ' er „' * ° Gas fireplace 10.00 "`' Water heater 10.00 �; e =,-,:., a, * 6e1 1 6 • 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 . i, : N Ott y iner /flue /vent ROPERTr r QWNER Ier: 10.00 t 1 0 ,�s � �' ° � :;. , .. � . . > ' T t „ l'i. �A � ® , T E NA N T ^.; m .5 :°•,: . t .., �,,/) Other: Name: ��r iA 5. J't Ti 1 ��� -(..: a......0_, Environmental exhaust and ventilation Address: Il 75�' ` 9 � l � ^ ► � t */ / e j_„) Range hood /other kitchen � � (C• quipment 10.00 City /State /ZIP: / t ' f� t ( Clothes dryer exhaust 10.00 Phone: (3) 95 7 -- �t'zg Fax: `� 6 2 _— 9475 Single-duct compartments, rtm e n ts (bathrooms, room, b7O� 1 � I toilet com artments, utilit rooms ) 6.80 ' a APP *" ' " ” � a i � F ;;'` ” Attic /crawls ant 10.00 ace ��= o- .,...� >_:�..,,:- _... - i;x:. < ... x � _ , CONTACT • PERSON �> P Fuel 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 „` i :i i. ;4.1 _.Z', .:... <CO ,L, -.1,, _.. ._ .,.'._ Barbecue Business name: Roth Heating and Cooling Clothes dryer (gas) Other: Address: P.O. Box 1265 - MECHANICAL - City /State /ZIP: Canby, OR 97013 Subtotal Phone: (503) 266 -1248 Fax: (503) 266 -3478 Minimum permit fee ($72.50) 05; (t) Plan review (25% of permit fee) CCB lic.: 14008 State surcharge (8% of permit fee) .--), ep it /^)/ TOTAL PERMIT FEE /03 Authorized signature: = ,�.. - 1-`Glq,Le',_� This permit application expires if a permit is not obtained within � Sl r' days after it has been accepted as complete. Print name: Jason Hansen Date: 11/14/2006 * Fee methodology set by Tri- County Building Industry Service Board (:\Building \Perm its \MEC -Penn, •PP.u�.. '",,,,,,,,,, 440 -4617T (I I /02 /COM/WEB)