Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES
PERMIT #: MEC2006-00266
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°I'll 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/12/2006
PARCEL: 2S109DA -11300
SITE ADDRESS: 12972 SW BLACK WALNUT ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 102 JURISDICTION: TIG
Project Description: Install a/c.
CLASS OF WORK: OTR 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KATHY CHENG , Description Date Amount
12972 SW BLACK WALNUT
TIGARD, OR 97224 [MECH] Permit Fee 61121200E $72.50
[TAX] 8% State Surcha 6/12/200E $5.80
Total $78.30
Phone: 503- 730 -7345
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503- 692 -1565
Reg #: LIC 5193
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.
Issu d By: 1♦ �+' j '.. 2L if Permittee Signature: \ 009
Call 503 - 639 -4175 by 7:00 a.m. for inspections t a • . .
This permit card shall be kept in a conspicuous place on the job sit- . til completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application -. FOR OFFICE .• • FOR USE ONLY , • -. . -
•
Received
City of Tigard • . . '. Date/By: /_ oe , , I Penult No.:
13125 SW Hall Blvd, Tigard, OR 97223 • . Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
Datc/By: Other Permit • Inspection Line: 503.639.4175 Z111( Date Ready/By: El See Page 2 for
Internet: wytvv.ci.tigard.orus Notified/Method: ' riMi Supplemental Information
IMMEgg, 'tfgcqgg:MMKfatfaaeifg-VlararRAa-Ma .5t2,015IngtalgtiONIAAVilAnaka;
0 New amstriiction - ' '''. iii . -Mechanical Oennit fees* are based bathe of the work
• _ , ..,. • . • . .• - .
performed. Indicate the value (rounded to the nearest dollar) of all
1:3 Demolition Other mechanical niiteriai equipment, labor overhead, and profit.
• ? r, ' ,--v : .: ' ,;-- i i:z W - ';•A•Tifs - ' • " - ? -1 •• z i 4 ' z f z ii - '; i, ?' - ` . 4%Wii';' .2 . - P;•*' = V:i"-'7 4 •7;'-&:•.W•Vg , T1'14 ., .- - - - - , f4;: -- -• ,-, z7, 1, zc:-*Ar•.? • . v .' .1" • '' • , :, -,
Value $ '••:,- . --
17.,:ial';';!i"K-Ita-:„.•'S.-.7-?:-.';:Z=0;ZZ:t"-IVA-!;.4A-,ca,t,-:5S4-,g..-!;AW-f.,.-1-IAAJW,VAriMifiiiV:Vaifit.`,/g2i: ::,..,,,,,-.1--,•,--,;-.Tv,-,_-,4:;.--,-,--,1,-,7:,--:3,;•,,,,z...-,,s-,--,..•,--fis--w..-;•,n-...;;
%Ig4.,•?:1'kitli faitIW, I V.Z.ii i, ,,A11,c,
Lig 1- and 2-family dwelling ' El ConirIeteirmilustrial El Accessory building
,. - For special information use checkfist.
/1 ._ 0 Multi-family 0 Master builder 4-W 0 Other: •
Description . . I Qty I Ea. I Total
' i ' ,- s -r T* 71- W :C f . : TI W..J' ill-MCa •Vatet . 11: 7 ,-.1 4 0T e TtnitnniretTi-Te t t..3M-TP:WAY370
s'i A.,... ,'•4:4,-4,---,,--•,•3,1•..lif-a-...,:.,..,:-‘:.z.i?.11•tc&IN,Lvit•-5-`-"r=-fil
Heating/cooling
Air conditioning or heat pump
Job site address: / Z / 7 Z 5 L.,/ �t-fl C 0/4 L..4 Li,
(requires site plan showing placement) / 14.00
City/State/ZIP: 77,, g . Oe C f 7 729 Furnace 100,000 BTU (ducts/vents) 14.00
/ Furnace 100,000+ BTU (ducts/verits) 17.90
Suite/bldg./apt. no.: 1 Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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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
4 -.. , ',-4 i.:,:' Water heater 10.00
.', ... ,,,----...,` ' - -a: -- ...--.`
Gas fireplace 10.00
AD!) Ai__ 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
4 Vrif t alr1440fEgt■WW*4. - ; ,V; ' -:.:'-'4W41.11iirt's.riaritatit:-*-t Chimney/liner/flue/vent 10.00
10.00
Name: /.<4 may C )4E74(7- • Environmental exhaust and ventilation
Range hood/other kitchen
Address: A M6 . equipment 10.00
City/State./ZIP: • . Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (6;05) -7. 30 - 73y s- Fax: ( ) toilet compartments, utility rooms) 6.80
'.•.-TzW.4%;•• :&1-,ri•167-',...24g,- ii Attic/craivispace fans 10.00
Other: 10.00
Business name: Agaw . mecHA Allc,A L- Puel piping
Contact name: 3; PA LA iz $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: ) 0 33 ca 5 u ILA LAria Xr)
Gas heat pump
City/State/ZIP: 'I
/ liA (....47-70 0/2 i .766,2. . Wall/suspended/unit heater
I
Phone: ( 703) 6 2 _ / 5-6,s I Fax: : ( $b3 ) ( te?9 Water heater
Fireplace
E-mail: _ • .
Range •
;. 2"1 ' * TVITei l E , :•17:?i• - v-'"?=' , 1,___%W.41,„7.A'*.74-7-,Mtif,•*•T -Wk c l - F*W 7-4 1 ,- ;WARN3'1 1 1;30 , VgitaRRWIW".4
-ta.k.,•ir•rt.M .„%. . .,...,,44 , ----0q., ,. -.,....r.:.r.tt.,-v.-....c.-...$,..-„,,.......--•,-„,4-,... Barbecue
Clothes dryer (gas)
Business name: 4 RROr A/ / .» .
Address:
S A M_L
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. Subtotal 44 . 5
City/State/ZIP: .
I , ; Minimum permit fee ($72.50) ,
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lie.: S'i 13 State surcharge (8% of permit fee) 5- . 0
' TOTAL PERMIT FEE 7 . 3
,
This
Authorized signature: / , / / /
g
permit application expires Its permit is not obtained within 180
days after k has been accepted as complete.
I y Cox 1 • Pp.. ......linele■fount ...A Mt T..;_r-,..,..,,,, 14..0.4:.,.. ir■Avvrfr. Ca...-.A.... ch,..,,t
INSTA.LLATION ADDRESS: / 2_,9 $(J /51...46/C IJA LA JUT
) 1.7 e;'/ Z-Z9
PROPERTY LINE /
61 ors)
g„,5 FT: I A4 1
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FT: ( •
FT:
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FRONT
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PROPERTY LINE
=.* lb DE U IT R EL i
CITY Cf..TIGARD
BUILDING DIVISION PERMIT #: MEC200&00266
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611212006
Phone: (503) 639 -4171 4 �lpi�h l�
Inspection Requests (24 Hrs.): (503) 639 -4175 .._ "' I L.
INSPECTION WORKSHEET FOR DATE: 612612006 TIME: 7 :05AM PAGE: 59
SITE ADDRESS: 12972 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 102 TYPE OF USE:
PROJECT NAME: CHENG
DESCRIPTION: 1n11Aall a/C. .
OWNER: CHENG, KATHY PHONE #: 503 - 7304345
CONTRACTOR: ARROW MECHANICAL - PHONE #: 503-692-1565
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Inspection Request Scheduled For: Date: 612612006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 032121-01 503 -793 -5027 Y
7 &_1
Corrections /Comments/ Instructions:
PRA
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fir,
Pir a 1 r
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_______
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PASS [l PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR IN PECTION ADDITIO AL FE S ASSESSED A ,
- s s o
Inspector: Date: 260, Phone #: (503) 718- 1
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