Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00469
,ill 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/3/2005
PARCEL: 2S115AA -10000
SITE ADDRESS: 10920 SW BRETTON CT ZONING: R -4.5
SUBDIVISION: BRETTON WOODS LOT: 005 JURISDICTION: TIG
Project Description: AC install.
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:
ELE 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
ZACK BECK Description Date Amount
10920 SW BRETTON CT. [MECH] Permit Fee 8/3/2005 $72.50 -
TIGARD, OR 97224 [TAX] 8% State Surchar€ 8/3/2005 $5.80
Phone: 503- 267 -8196 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 - 557 - 2220
Reg #: LIC 72623
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: ii . / 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.
Jul 30 05 09:08p T Count y Temp 5035570919 p. 1
yMe,c airicai Permit Application
:.., :_ =. F`OitOEb'PCE'II5EONtit,- ,.-;.,, :_. -.:: ,.- ._�.
City of Tigard AUG 1 20� I Datc.By: • ' 3�OS Permit No.:49 05 _ � A
13125 Sir! Hall Blvd., Tigard. OR 97223 Plan Revwe
Phone: 503.639.4171 Fax: 503.598.1960 i Received r Other Permit:
Dale /BY
Inspection Line: 503.639.41;5 CITY OF TIG J. R�1I�" Date Ready /By: Surfs: E See Page? for
Internet: www.ci.tigard.or.us BUILDING DIVISION NorifedMcihod: Supplemental Information
,. , .. .. '` f3Rr : - ., i;;:;r:,: -' - -. .., C OYIlVIEI2C � .REE . .SCHED'UGE - L[SE'CHE'(:'KLLST
❑ New construction Addition/alteration/replacement 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, overhead, and profit.
. Value:
-. • :_ ::"?__::..:. . , ":, -: :CATEGORY' OF' CONSTRU,CTION:;',:'.;'... .'•• :,:,;t : ;;'. :: .
dwelling .. RESIDENTIAL EQMPMENT: /%SYSTEMS FEES*
X1 - and 2-family g ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty Ea. Total
.
JOB .SITE ORMATION: AND LOC 14,10, i , : °:". Heating/cooling
Air
Job site address: 4g $ 4 1 • [` 4 ' , f al eq conditioning
it ite pi n or het pump _ •• ♦ \ . (requites site plan showing place'men[) i 1 14.00
Ciry /State/ZTP: i I gr, Furnace 100,000 BTU (ducts/vents) - 14.00
Suite/bldg./apt. no,: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
1 Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
i
Hcdronic hot water system 14 00 •
Residential boiler (radiator or •
hydronic) 14.00
Unit heaters (fuel -type, not electric), I
in -wall, in -duct, suspended, etc. 10.00 I
Flue /vent for any of above 10.00 '
Subdivision: Lot no.: •
Other: 10.00
Tax map /parcel no.: Other fuel appliances
.,.• : - ! ;;V: _ Water heater - • ,..:... _: -_:.,. _... ..�. -;... DES ON.:O;F: WOT2K:; -i ;'.;.:;�,.';
a e er
1 natal 1 *MC Gas fireplace
Flue vent for water heater or gas 1 1100
I fireplace I 10.00
Log lighter (gas) 10.00
1 Wood /pellet stove 10.00
. Wood fireplace /insert 1 10.00
c ". .. . .., . Chimney/liner/flue/vent
' _, :. 7VROPERTY :_OWNER : ,'::, :.:.:• :� �_, :y` ..,".,,L:•.-'..:;.: .❑: >E
T
,::
::.,:•;.,:.::,.,.. .• ;....,.. _,....� ............:_. ., ,,_._ _... ... 10.00
u. 10
IA NT.;. _ ,, . _ , `_. -,
Name: Z C f ' , Environmental exhaust and ventilation ,
Range hood/other kitchen
Address: aline) equipment 1 10.00
City /State/ZIP: Clothes dryer exhaust I 10.00
21 4/ Phone: I / Single -duct exhaust (bathrooms, r rooms) ( Fax: ( ) toilet compartments, utility rooms) 6.80 •
;, ? " .:'t '+ - " Attic /crawlspace fans 10.00
'.. `❑��PLICAl`IT'i:�i. � ','• :.. ." . ,.. : +
..... ,.. _ /�` piping
j ] Fuel i I Other: 1 10.00
Business name:
r� Cctu Tmp COl�t 1 1 1 ue pp
Contact name: XI lclJi J ^ r� V J 55.40 for first four; 51.00 for each additional
Address: 0 0 6. [v C ac k .U�11 t;-� 4 . r . V �) _Furnace, etc. •
Gas heat pump
City /State/ZIP: tJ (gCr) CL.' I i e q 4 ) Wall/suspended/unit heater
Phone: (0-.6) J57 - � 0 Fax: : ( ) ,.5-7.....C11 r! q Water heater
Fireplace i
•
E -mail: Range
>t Barbecue
.... 'dt:"" t .. ^= ""�� -.- .i iC 'r�cj. -'/,,,[1:
" :F.•s. .� v - t �., r ..,,,, p4 - .: .... -. w� .. _ _
Business name: Clothes drye (gas) _
I Tri �C�/1 Temp Cry � (� , Ot
Address: � i )C, � mQ\S � t l n ';'MECHANICAE',PERbII'T I'E
Ciry /State/ZII': Oy e( )f 7 ( c L �70� ✓Iinimum Subtotal 1 .
Phone: ( St ( 5. - ;&) 3) 55� 2 L 1 I Fax: (G(F)C-5 7 - f (1 p `rmlt fee ($72.50)
I ✓ I Plan review (25 /u of pemit fee)
CCB lie.: 72 State surcharge (8% of permit fe . j
�
(/ /� TOTAL PERMIT FE /
�y f , /f t 0 Cid This permit application expires if a permit is not obtat within
Authorized signature: , t I days after it has been accepted as complete.
I P r i n t name' Ll QJ2 E J V L3 V) , Date: I 109 '. Fee methodology set by Tri- County Building Industry Service Board
f:\ Building \Perrrots \MIEC- Pnr:nitApp.doe. 17/03 4410 -4617T (11/02 COI
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CITY OF TIGARD
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BUILDING DIVISION s PERMIT #: MEC200&00469
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/3/2005
Phone: (503) 639 -4171 / „,, h lI!i� � I I
Inspection Requests (24 Hrs.): (503) 639 -4175 '__�
INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:06AM - PAGE: 65
SITE ADDRESS: 10920 SW BRE 1 l ON CT CLASS OF WORK:
SUBDIVISION: BRETTON WOODS LOT #: 006 TYPE OF USE:
PROJECT NAME: BECK
DESCRIPTION: AC install.
OWNER: BECK, ZACK PHONE #: 503 -267 -8196
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503657 -2220
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013572 -01 503 -557 -2220 Y
Corrections /Comments /Instructions: r'
611-1:.
P PASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL / 0' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: gi
. Date: 16 ~OS Phone #: (503) 718-