Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005-00502 A II DATE ISSUED: 8/12/2005
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S103AA -03000
SITE ADDRESS: 10485 SW CLYDESDALE PL ZONING: R -4.5
SUBDIVISION: CLYDESDALE LOT: 010 JURISDICTION: TIG
Project Description: A/C 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:
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
JANETTE BROWN Description Date Amount
10485 SW CLYDESDALE PL
TIGARD, OR 97223 [MECH] Pennit Fee 8/12/200E $72.50
[TAX] 8% State Surcha 8/12/200E $5.80
Total $78.30
Phone: 503- 626 -7571
Contractor:
SKY HEATING + AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Phone: 503- 235 -9083
Reg #: LIC 50244
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: ! 1lti 12,t,46 Permittee Signature: lQ e \(1,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da
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.
Aug 11 05 01:58p Sky Heating 503 -236 -3320 p.2
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Mechanical Permit Applicatiai FoR oFFlc E USE ONLY
Receive !1 J 'k
i. _ �. _ J 'rO
City of Tigard O�p l J `) Permit No.
13125 SW Ball Blvd., Tigard, OR 97223 Pla Plan Review
Re view
r
Phone: 503.639.4171 Fax: 503.59. 900 � „ � , F` �'� (
1 Other Permit:
,
Inspection Line: 503.639.4175 �'� ;, �O V ` t 1U • 11
Date /Hy: Date Ready/By: UM 65 See Page 2 for
Internet: www.ci.tigard.or.us \ ”` Notified/Method: Supplemental Information
1,\ :0-, � - c\ \
TYPE OFek1' gi4 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
El New construction Q?Ad replacement •
Mechanical permit fees' are based on the value of the work
\�. performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Othey. mechanical materials, equipment, labor, overhead, and profit.
CATEGORY 01? CONSTRUCTION Value: S •
pi- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi - family ❑ Master builder For special information use checklist.
❑ Description _ , Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /V 4; Suo `p Air conditioning or heat pump ``
,. `6 / (requires site plan showing placement) 14.00 1 i f
City/State/ZIP: k a\a ,/ 8 r 7-'23 Furnace (ducts/vents) ( ) 100,000 BTU d/ts 14.00
1
j v l I U A W 1^ Fu 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: I 1 Gas heat pump 14.00
Cross streeudirections to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
. in - wall, induct, 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 i
y V I 1 n ( \�l 11 �` A (c Gas fireplace 10.00
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
PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 10.00 •
Name
qt
r f 1 W Other: 10.00 ._ Environmental exhaust and ventilation
Address: 10 � t✓ sw GAyd � � 1 equipmood/otherkitchen
equipment 10.00
City/State/ZIP: '--- Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (603) (7 ---1 Fax: ( ) toilet compartments, utility rooms) 6.80
WAPPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
� � Other: 10.00
Business name: 1✓`/ Fuel piping
Contact name: $5.40 for first fouri for each additional
Address: Furnace, etc
Gas heat pump
City /State/ZIP: WalUsuspended/unit heater
Phone ( ) I Fax: : ( ) Water heater _ I
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: / Clothes dryer (gas)
_ .t��l i 1 \ Other:
Address: „dip S ��j�M, MECHANICAL PERMIT FEES*
City /State/ZIP: .'^ a q , G2-- Subtotal
Phone: ( 905) 2 -- �Q� � \ x: ( 933) 2 3S-- �jl{GJe-f Minimum permit fee (572.50) � �5e�
Plan review (25% of permit fee)
CCB lic.: 5 c-5ZLzi State surcharge (8% of permit fee) G j -' CI
/ /I •
!I t TOTAL PERMIT FEE '] a3(:)
()
Authorized signature: A, ( " l ' 4 Urn This permit application expires If a permit is not obtained within ISO
days after It has been accepted as complete.
(---1 a .' /(n/�(PI 11
Aug 11 05 01:58p Sky Heating 503 - 236 -3920 p.3
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LPS
CITY OF TIGARD
BUILDING DIVISION % PERMIT #:
MEC2005-00502
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2006
Phone: (503) 639 -4171 invu��6ylm�H�ll ' l .
Inspection Requests (24 Hrs.): (503) 639 - 4175 ±+ 11.
INSPECTION WORKSHEET FOR DATE: 8/19/2005 TIME: 7 PAGE: 97
SITE ADDRESS: 10485 SW CLYDESDALE PL CLASS OF WORK:
SUBDIVISION: CLYDESDALE LOT #: 010 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: A/C install.
OWNER: BROWN, JANE( I E PHONE #: 503.626 -7571
CONTRACTOR: SKY HEATING + AIR CONDITIONING PHONE #: 503.235-9093
Inspection Request Scheduled For: Date: 8/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013697 -01 503 - 620-7571 Y
Corrections /Comments /Instructions:
Cf"-
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CI 0 D .
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V I PASS ti'• •AL ❑ CANCEL ACCESS
n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Date: W Phone #: (503) 718-