Permit .. 4 C
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CITY OF TIGARD
MECHANICAL PERMIT
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Ij� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00370
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/21/2005
PARCEL: 1 S135DC -02600
SITE ADDRESS: 11665 SW GREENBURG RD ZONING: R -7
SUBDIVISION: MLP85 -0007 LOT: JURISDICTION: TIG
Project Description: Installation of heat pump.
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
KAHALOA, HERMAN Description Date Amount
11665 SW GREENBURG RD
TIGARD, OR 97223 [MECH] Permit Fee 6/21/200E. $72.50
[TAX] 8% State Surcha 6/21/200 $5.80
Total $78.30
Phone: 503- 639 -0767
Contractor:
OREGON HEATING + NC INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Phone: 503 -538 -2953
Reg #: LIC 125815
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: r / Permittee Signature: ,1-, n
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.
Jun 21 05 01:37p 503 - 537 -2172 p.2
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AZechaui Tigard A l a l� i ' q� FOR OFFICE USE ONLY -
City of g Date/By: ► f 1 - �� PermitNo..\ � 4 65 O& f7 i
13125 SW Hall Blvd., Tigard, OR 97223 1 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUN 2 1 200 {''A Date�By_ Other Permit.
Inspection Line: 503.639.4175 a• F Date Ready /By: El See Page 2 for '
Internet www.ci.tigard.or.us CITY OF TIGA it Notified/Method: Supplemental Information
BUILDING DIVISION
T . E :OF, ;%YOTiI{ :.'. _ EE* SCHE
"CO)\�1VIE32CL'�T; F DULE - ;.iISE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
a
, ,. C_ TEGOI2X- CONS` TYtUCT14N :;: :. : : ;.. „ :' ; : S - ES •
• _ :. :.. RE IvEIVTIAL:EQTIIPIVIEI!1T / SYSTEMS FEES! _ ..
and VyK 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
.- , - ;.'.:z.JOB SITE ; LhPORMA.TIOIY AN]) LOCATION " : :... i, Heating/cooling ,
Air conditioning or heat pump (�
Job site address: li `+ c Sli �1 r jib ,1r n (requires site plan showing placement) 14.00 1 1 c
City/State/ZIP: ` a'C�^ , .J UI ( 11 Furnace 100,000 BTU (ducu/vents) 14.00
,r Furnace 100,000 BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions 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, 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
,.: Water heater
>nESCRlp�iori >; � z::�= "; > •:��
/�,� Gas fireplace
Flue vent for water heater or gas 30.00
� y � t • j
ttt fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
P . ` OWNE}2 10.00
Other
10.00 '
Name / 1 Environmental exhaust and ventilation
1,9 ,1 t fib' ac .
Address: r(� f (`g e ange hood /other kitchen
1 l l I 7� r ` f� / ! Al f� �yLU/ �J equipment 10.00
City/State/ZIP: . )r v� v° 0 1 - u z C lothes dryer exhaust 30.00
Phone) + �I I t Fax: ( ) toilet compartents, rooms) 6.80
.:: r ,;�.,�.�:... _.,:., . " : , ! . . cra p ce fans
AppLiCAN I .:a : ® •COIVTAC..1 . . ON_ ...:;, ; ; Artic/ wls a 10.00
� _ Other. 10.00
Business name l�r au+, yv i„ 4 J ,® Fuel piping f
Contact name: ( ) }1.41 j $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: say) Gas heat pump
City/State /ZIP: i'l ku V Gin t `S� Wall/suspended/unit heater
Phone( 3 �
) ttt��� S _ v Fax: 61 S3-7 Z1 ---2- Water heater
� `1 ^- - �s� Fireplace
E -mail: Range
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:
Business name: ( is / h '�. t/r CC lathes dryer (gas)
Address: V ,...... .
MECHANICAL PE1lZM1'I F EES";z ...:
/� � � ? � f
Phone: } 7 �. U` - t ' ! � � � � n l L ` Subtotal f
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City /5ta[eZLP: '� '"
U Minimum permit fee ($72.50) t -
� ��U
� ,� t , Fax 6 r � J / Plan review (25% of permit fee)
CCB lie.: t1 . �� State surcharge (8% of permit fee) c K '
TOTAL PERMIT FEE I 'S�.r�A • --- This permit application expires if a permit is not obtained within 180
Authorized s l . ture:
' i / " /,> // II days after it has been accepted as complete.
Print name:
t- I , g Date: �rFR ;T ` Fee methodology tel by Tri County Building Industry Service Board
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idnuitelino\PnmitsvtEC- Permit nn.doc 12103 440- 4617T(11 /02 /COM'WEB)
Jun 21 05 01:37p 503 - 537 -2172 p.3
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CITY OF-TIGARD ,,,, ..
BUILDING DIVISION PERMIT #: MEC2006-00370
13125 SW Hall Blvd., Tigard, OR 97223
i DATE ISSUED: 6/2112005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 A
INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7:06AM PAGE: 77
SITE ADDRESS: 11665 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: MLP05 -0007 LOT #: TYPE OF USE:
PROJECT NAME: KAHALOA
DESCRIPTION: installation of heat pump.
OWNER: KAHALOA, HERMAN, PHONE #: 503 -639 -0767
CONTRACTOR: OREGON HEATING a- A/C INC PHONE #: 503.538 -2953
Inspection Request Scheduled For: Date: 8/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012644-01 503-- 538 -2953 Y
�Co /Comments/ Instructions:
X72 /(.4-1, t /vax- ivev.0 L 1S 5 2 7g ' / C', /Cl
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❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: g—.3--- - e 3' sc -.------
- :3—sc -.------ Phone #: (503) 718-