Permit •
CITY TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC2006 -00225
a 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/23/2006
PARCEL: 2S109DB -02400
SITE ADDRESS: 14995 SW BLACK WALNUT TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 062 JURISDICTION: TIG
Project Description: Installation of A/C unit.
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: WOODSTOVS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ERIC SOREM Description Date Amount
14995 SW BLACK WALNUT TERR
TIGARD, OR 97224 [MECH] Permit Fee 5/23/200€ $72.50
[TAX] 8% State Surcha 5/23/200€ $5.80
Total $78.30
Phone: 503- 624 -1626
Contractor:
CENTRAL VALLEY AIR
6699 SKYLINE RD S
SALEM, OR 97306 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -589 -9429
FAX 503- 932 -8304
Reg #: LIC 127032
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: — Permittee Signature:
Call 503 -639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM :CE�lTRAL VALLEY AIR FAX N0. :5035899429 May. 22 2006 10:01PM P2
Mech Permit A • Nica'tio�a . jr City of Tigard U i' Dews: !'(►1� i ►l a' i(1' i ,r �• i .�
13123 SW Hall Blvd., Tigard, OR 97223 — Da (eJB • / , Peerait No .
phone: 503.639.4171 Aux: 503.598.1904 Plea Review �� 1 � _ . A ��_
Inspection Line: 503439,4175 MAY 3 200 "'''� -' ''��1' Datair , OtherPennit:
Internet: www.oI.tlgnrd.O\.us l�eteltegdy/J3y:
N
Rai otified/Method; ® tree Pep l for
�!° 1+ i .,• u I 1'p I r , TV • -` y ',) +
Supplemental lreformation i1l , . ,, 1r�:Il6f; . jl i' S1J ' 4!il;lfl�;� Jtlr�;i lama, ,it.�Ehh�i.l.;lr�i.,iynrp:�l"u, r�tll I ! l"'
'I�.J;1',!'ii. '' ;i,.I l lrldllislltlldll�,ktiil���r�1�� : 11, ': 1! iJ djnrlrtiAAtL :ilUln �� 1. 1 .'` 11 ' 1 .r '$ fj! ' f'..lir l Viirk ' M1 1"'' r ri l ,
, R 1. I ! � 7 , }I�i�� f • � 7 11 I ro17 "I'll . l •
❑ New construction It:: t T s ' t 4tl d tA i diii46, r�J .; ,; :: :s: ;I 6 '1,1 . r t ; x, 141 • i ; 4 t Onti t. ° " sr'It3ry. , •
Addition/alteration/rep Aoem•nt Mechanical permit fees" are based on the value of the work —
Q Demolition Q Ot her: p erlbmtod, Indicate the value (rounded to the nearest dollar) of all
....sp.-
, 1 i '; r.1 ' ! ' r :I; ;t + i' ' 111 ` 1 p , I I i '' Sir; 1'I' urn y!iiiir CtIrr:llttllllnq,';u l 1f , + moohgntoal mater{ais, cQtti tltpn {. lab a
I 4r, over
I .li lii,o illihili..t,l t {Ij' i a 1 , q. 1: r r h : t l{: 1, f ` I �i S ' ` 1 ; tip 1 '. had atltl P TOfit.
i 1 n:l! i.,:�Jlll i i1i„3l
uilaGsl,ltlinl rGlo I, :;�iPu�lt�(� N,f ���Eil i'?'rFt � eV rue: $
1 �� � . ra l�lr W urtA p AYp
i 1 - and 2 -fhx lily dwelling E) Commercial /industrial l y y .. ; ( :.,,,,m�p1p I K'l; au ,� °x r,� 4'l
❑ Accessory building i t leala7nt,i e . 1 i ,1 , l 'PE 41 :4'''' , • l 1;''.°* g.
c
M111ti- fimaly 0 Muter builder For s acral In r t
0 . P 1b +nation use checklist.
li4iJ'] t Iti; 1 L'''1F`:,ip:•u, 'plfil,,lill.a lIAT II., Rl' pll, 1)eacr!
! 1 4l� I h, +I ,; 9 : 2 r 1 ', a 1z Illflalf,vil , rr ption
� n1L!..l A.r.;IU :10 td.IllIJllJ Ji ilLilllIvl ollis IJ,1I 1141. I t ;�iItI � fl 'fFh�,tllAl f Il ,l I : lYj ' : t ` i
u•I Ui +uir � a hn Iival,wAn:t,ialJt:d nl,dai� UtUUni,J. • �I I i' i� � JI:��KCr,f ' � �I ! 1 . 1 , . � �' i
Qty. $a• rota
Job site address; �rk a " '' '�1+1 •T ' I �,1� � 1 '� r I HentlnA/eoefinp
._L j S �Q/ --� Air Oonditiening or heat pump
cic��suttor�l�: e nt.;� : a,•l•Q.c� / //��
)' � (requires alts plan showing placement) / 14,00 ,/./' '��'
oy. � f2/e_ r. 7.2,2 I' Fum 1000 00BTU .,..__onto 14.00
Sllite/bitlg, /apt, no. I Prof sot name: Porcine 100,000+ BTU (duote/venta I9, 90
Cross aheetldir to job site: � ' - a9 lhat purity - • .. • 14,00 •
2,1_, Duct work 14.00
IHydropio hot water system 14.00
Residential boiler (radiator or
l_iydr,tinlol 14,00
Unit heaters (feel -typo, mot electric),
in.wall, in -dOct, susgended, etc, 10.00
Subdivision: Lot no,; for anypt above 10.00
Tax tt,tttp/paroel no.: Oilier _ 10.00 •
Other foal a .. If
' I , ll�.;,n .I 1. s:d7 ?, +I,'Ij 1, r� 'I (lll ''l l� ' rr n)T u I n +p .. l
li. l lfu( on n; u; 1 . r � t i��q 1 l'.01:441 anCea
l I ' •r11 J ,. 1 f. . 1 +:! , 1 , J „ h; ,.1:.1mi ; k i Iii' . ; ;; 1 : h i , sl. J 4 a J∎c $ .!' r ` j l it lkl U l � �� ri, +itt , Water heater 1
t T:1 ,ltL•If,1 I,�,{ ' ; 1 . ,,1, 0.00
� ' ¢ �� �� ap8ne _ 10.00
Flue vont for water heater or gas
fireplace 10.00 __
LOB lighter (ties) 10.00
Wood/pellet stove 10.00
•
— Wood flreplace/Insert 10.00
! „ 1J I . 4 I.. yrr,m { rtrt ' y1 ?j ' Ir{ l I t NUUI r
;•L;.,. •,' .:::1„,;‘,4.1k, l i ' I �I., •i - ,. I i, l l l l 1 . � o !t, SYp JJ 1 I I:� i1 6( r tt „,,, r . . ; ,, l , i , Chimnevniner/Put: /vent 10.00
nib!) • N,1,0ehiw:14,..n I �, G i3.1i 11a:.1.., . illkl. r,u I;thJJi!a'' .., ' I ' „ A • ,I Other
Name: Yi°�� c.....1 10,00 y
u `� \ Environmental exhaust and ventilation
Addteea: 9 �.� �� /�� - ,! Range hood /other kitchen -
_ 4 h. L, .( o w A e ..C% equipment
City/State/ZIP: /1, �1 7 A? Clothes dryer 10.00
/ [ t ` ryer exhaust 10.00
•
Phone: (�) td it., G Fax: ( ) Single -duct exhaust (bathrooms,
P rr'r” •'r;! g 1' ;;!;,1,)j,u';r'I nprrpr�ryw , 'r�,r N�l' 1t ''5:: +':•rl fa ll ct R^n toilet corn arnnents utili t'o91711t _ 6.80
i',,• ,,.. w . ,, . ,,,', 1;,. ,,..., , (li .:.C1 . ! .. •i I.. t y l l i IJ n .U4 I':I � " ALtiC /Craw18pa0G fans 1 0.00 •
la min name: a Lulu w , I. ► UIF ' , « �. ■
Other: �_ 10.00
ttot name:
�vtt Fuel piping
/ �►.* / - j � '-a � • $3.40 for first four; $1.00 for each additional
Addreq,ts 6 (p f /, _ �� Fumace
Ll- - - Gas heat gutnp • T
Ility/State/ZIP: ` J / oL. 73 0 (. I Wall/ suspended /unit heater
___,
thong: ( j ell ) 93 a - 83 D I }� Fax:: ( ) Water heater �~
1-ms31s Fireplace
,, i .� ` t,w • r, • hrl ll, ,e 'u � a +In . iJ: nt'., YUlv 1;i!I r' Range
! i A( I '' I i f :J)' h b' } ( li ! , 1., i ,' r
;, , 'Y' :' ' , i1 • • �1�Ilct 1; il�li i la vi''):u; 1 t �, ,f� l� I l( I � ' I ) Barbecue
• (1 ;4'111. $ J>d {,l1; . i 1; ■ —. 1f� l'ii.i. ;Ii 1.11 11 �;1 J iP, ua
luainese name: ./ .a J )'� Clothes dryer (gas) ^�
'alma; / �— oilier;
'alma; 6 cf4.'e / ,ad � • — / r � .. ril�l''II^^!,;' S Iyy �� I , Ii +�Inru, r a: vu'}Il mcgr!r'at / a�fr�,r j 4,a, ul h,.'ra, *..., . . • • • 1 I;Jiflkll�'I 11Uk[f1li l� } (<vl�nn',kibl�r wni'I�;yb S , d . .
:11Y/State/ZIP; ,� c-c/ +- c �y i I � 1Hd �Jiv�
hone: ( '•) �' S p . 'f• Fax! y.0 s7,— 9* c f Minimum permit roc 1572. 0) �' r o
�y � Plan review (259k of eerm;t Fee)
!CD lie.: /� / ,D �� f State surcharge (8% of permit fee) $r I
` _ ;\ / �--� TOTAL PERMIT FEE , C.3 _�
n�h.wtr>raA eiA�on�• /1 This permi application expires If a permit is rat obtained within 180
FROM :CENTRAL VALLEY RIR FAX NO. :5035899429 May. 22 2006 10:02PM P3
•
CITY OF TIGARD
BUILDING DIVISION V PERMIT #: KU .0022S
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 N Yl�l �n
Inspection Requests (24 Hrs.): (503) 639 -4175 . FL .
INSPECTION WORKSHEET FOR DATE: 12/21- O( TIME: PAGE:
SITE ADDRESS: 14cicIs• 6u) B1A,cKWskL.t.hiPi e CLASS OF WORK:
SUBDIVISION: rG` � LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: S - PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 12'21 - 0 ‘ Pour Time:
Code # Inspection Description Confirm # Contact # Message
WEc F-; Is AL •
Correcti ns /Comments /Instructions:
41C -- 0 Z(____
Itio
1,N 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (" c-i F Date: /Z 1 °C Phone #: (503) 718- Z6-