Permit ' CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00276
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 2 S 110AA -91311
SITE ADDRESS: 10771 SW CANTERBURY LN 101 ZONING: R -12
SUBDIVISION: CANTERBURY CREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: BAKER
Project Description: HVAC- 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TOD & CYNTHIA BAKER Description Date Amount
10771 SW CANTERBURY LN 101
TIGARD, OR 97224 [MECH] Permit Fee 5/15/20W $72.50
[TAX] 8% State Surcha 5/15/20W $5.80
Total $78.30
Phone: 503- 746 -5614
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
•
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.
Issued B / „•�/ /� Permittee Signature: SR, pn /frzgtty) f,
a. . � /
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.
May 15 07 09:15a Oregon Heating & A/C 503- 537 -2172 p.1
Me.1Li'ianl `al Permit Application FOR OFFICE USE ONLY
Eril City of Tigard ( � Received IS s „ �, •,
Tigard aa� p,�9 Date;By": ( ,31-Al ►r �.M LI M
'r 13125 SW W Hall Blvd., Tigard OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.196 20 7 Date /By: Other Penult:
TIGARD Inspection Line: 503.639.4175 / Date Ready/By: Ell El See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/hlethod: Supplemental Information
B1flI DINe DIVISION
TYPE OF WORK COMMERCIAL FEE'* SCHEDULE -- USE CHECKLIST
❑ New construction ® 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, overhead, and profit.
CATEGORY OF CONSTRUCTION • Value: S
• RESIDENTIAL EQUIPMENT / SYSTEMS FEES* .
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 3 U'\ A I Air conditioning or beat pump 1'`
0 11 i co n- h t , N (requires site plan showing placement) 14.00 l i.CU
City /State /ZIP: j 1 c orc l M Furnace 100,000 BTU (ducts/vents) 14.00
1 ""` t Furnace 100,000- BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: V
a h Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydrotric 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 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK • Water heater 10.00
r Gas fireplace 10.00
FIVAC-
I �15't�t 1i AC. 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
0 PROPERTY OWNER • ❑ TENANT Chimney/liner/flue/vent 10.00
Other 10,00
Name:TOdca F Cl lh'Vh \3, tUCcer Environmental exhaust and ventilation
Address: 4 Range hood/other kitchen
1 V 111 D I 1.. (nlU l IA A lee equipment 10.00
City /State /ZIP:; lird U11aa� J Clothes dryer exhaust 10.00
Single - duct exhaust (bathrooms,
Phone: ( ) "7li , 1/4 Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT ..0 CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Oregon Heating & A/C Other: 10.00
Fuel piping
Contact name: R05.1e,kt° $5.40 for first four; 51.00 for each additional
Address: PO BOX 297 Furnace, etc.
Gas heat pump
City/State /Z1P: Dundee OR 97115 Wall/suspended/unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater _
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: Oregon Heating & A/C Clothes dryer (gas)
Other.
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City /State /ZIP: Dundee OR 97115 Subtotal
Minimum permit fee ($72.50) 7a _ 5 (�
Phone: (503) 538 -2953 l Fax: (503) 537 -2172
Plan review (25% of permit fee)
CCB lie.: 172126 State surcharge (8% of permit fee) S -fa,
( /t TOTAL PERMIT FEE - fa, 30
Authorized signature: +, I i ' f This permit application expires if a permit is not obtained within 180
tt days after it has been accepted as complete.
Print name: . � _ . , _ _ c ( Date: 5 07 * Fee methodology set by Tri- County Building Industry Service Board
• 1: itding%Pemrits;tit:C.Peim itA pp. doe 04.06.06 440-4617r (I 1102 /CON. WEB)
May 15 07 O9:15a Oregon Heating & A/C 503-537-2172 p'2
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CITY OF,TIGARD
BUrLENNO ®IVISION PERMIT #: MEC2007 - 00276
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/'1 /2007
Phone: (503) 639 -4171 re il l Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 612212007 TIME: 7:03AM PAGE: 73
SITE ADDRESS: 10771 SW CANTERBURY LW 101 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: BAKER
DESCRIPTION: HVAC- install aid
OWNER: BAKER, `I OD & CYNTHIA PHONE #: 503.746 -6614
CONTRACTOR: OREGON HEATING & AC PHONE #: 503-538 -2863
Inspection Request Scheduled For: Date: 6/22 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 060731 -01 503-63B-2963 Y
Corrections /Comments /Instructions:
ASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I l CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 6 ..-P_---- - D> Phone #: (503) 718- 741.?