Permit •
CITY TIGARD MECHANICAL PERMIT
Alf 'I DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00075
ll 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/6/2006
PARCEL: 1S135DD-04400
SITE ADDRESS: 11900 SW GREENBURG RD BLDG 1 ZONING: C -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Install (2) mini split ductless AC for spot cooling. Value: $10,936.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: 2 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
STEVENSON, MICHAEL J + KAY L Description Date Amount
2825 DELLWOOD DR [MECH] Permit Fee 2/6/2006 $245.00
LAKE OSWEGO, OR 97034 [TAX] 8% State SurcharE 2/6/2006 $19.60
Phone: Total $264.60
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact #: PRI 503- 640 -3607
FAX 503- 681 -0793
Reg #: LIC 66578
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. 77jj
Issued By: ° Permittee Signature: 6
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.
Mechanical Permit Application r , E FOROFFICE•USEONLY. - •
City of Tigard i L Date/By: ' Per n t No _ ®vd
13125 SW Hall Blvd., Tigard, OR 97223 '`�fi
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ;yiy„y,,,, „,r i r te/B Other Permit:
Inspection Line: 503.639.4175 ` ii. 2 '' ►'.te Ready/By: 1 s . El See Page 2 for
Internet: www.ci.tigard.or us Notified/Method: ” L(i'1 Supplemental Information
CITY OF 171 __ �V .
s; a. ,
..,. ;�, - -- ::,.. ..- ...` =`� - Ol�Itl'4ERCI ?I'`EEE* SCHEDULE - `USE *CHECKLIST
"T
E�OF�.WO
❑ New construction /- ddition/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.
' , "= i ; f y • Value: S f0 ,..°':" ,..°':" 4; :.� ; ,,„„ . - - - CATEGORY,; OF 'CONTRU,CTIOY�e, � - -` /
: RESIDEN :TIAI; E / SYSTEMS FEES*
- ...,�,.. ;: - ❑ Accessory build sa^ � - ,;.
❑ 1- and 2- family dwelling Commercial/industrial building
EQUIPMENT
'
d For spec:al information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. Ea. Total
,sg '.JOB - ' ::SITE:'INFORMATION iND :LOCATIO 3 ,.' Heating
/cooling
- � cooling
- Heatin, f
Job site address: / /960 �-k/ 6"X._. eN g viz C /fi/j Air conditioning or heat pump +
(requires site plan showing placement) -- 14.00
City /State /ZIP: �j 4 ,g a/ 2_ Fumace 100,000 BTU (ducts /vents) 14 00
Fumace 100,000+ BTU (ducts /vents) 17 90
Suite /bldg. /apt. no.: Project name:5yil, / 4 / _
� i y f rie et //- Gas heat pump 14.00
Cross street/directions to job site: Duct work I 14.00
Hydronic hoc water system 1 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
�,.�- �... -, ...mom :. g;
"., :, ;- j „ ,,1;D< „-...: Water heater 10 00
<... ; �� �.�. DESCRIH.T'IO�f =OFD "WORK.': y r ,�, . - i I
L /,/ �2 /�, 5/ /� /� 7Z f 5-5 Gas fireplace 10.00
'•1 .5/9 / /� L- Flue vent for water heater or gas
L ()9 a 7 Gv2 G),y1,4 fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
k -r is y , v p *„ Chimney /liner /flue /vent 10.00
•
°2ROEERTY' -ER ` :' ;t,: i'.: ;; ,, : U TE ? AN i , :., :.'` t, :•
.._.. . .._.. ,.:rx,. 4...,.... -„ � ,i- ,.. r. .ae�,- _ . -- _ ,,.�..„ ....z . Other: 1000
Name: 13 e yv <7 Z Environmental exhaust and ventilation
Address: ?, li b /' n'. Range hood /other kitchen
ddress:
// 1>.� � ° �/ w v equipment 10.00
City /State /ZIP: /OZ. e- 0$ t„,ze . ¶ 7 O3 Clothes dryer exhaust I I 10.00
/� oo�- Single -duct exhaust (bathrooms,
Phone: (9)3 ) ' ,...if ( I Fax: ( ) toilet compartments, utility rooms) 6.80
: n r °. _ .„ is ace tans I 10.00
C' VT,iiiii a 75, .: ' 1 ; _ ni NTA Atuc /craw I
-- - �- - � -..._ APPL'I � C01 E &RS ON -, P
R / Other: j 1 10.00 I
Business name:
, / ' C - ( �( E ( ( " t Fuel piping
Contact name: � v ( �• C `� $5.40 for first four; $1.00 for each additional
Address: - )- S C L S Furnace. etc.
L. - ( ( L t- - (' G i Iv` v - eD1. /12 CI Gas heat pump
City /State /ZIP: f ( C ,\ 0 l e_ _ • C1 1 - Z , Z 3 Wall /suspended /unit heater
?. (_• -
Phone: Fax:: ) Water heater
(S�s) L.. t �._�� off- (��s (�� "( -`; -f- l�
Fireplace
E -mail: Range
. jr: _ .,,4:1,.. ONTRAGTOR : g y Barbecue
:.t, ..t -. :rte... ; ..._ ...,rod' _ _�.,. .,... . ..,- .,.,- -. ;tip , , . ,_ :;�i�, : :� " :. .....N , -�s: ,
Business name r..,. l ; `' _- '+' Clothes dryer (gas)
C i....
d..-L±� j (- - i< -- .--
J 1 J ) Other: i
Address:
,,. `• MECIi_ ANICAti PERMIT <FEs S
City /State /ZIP: Subtoti.l %i
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50 ' i
Plan review (25% of permit fee)
CCB lie.: C; (is S State surcharge (8% of permit fee) 1 a
TOTAL PERMIT FEE I by. (
Authorized signature: This permit application expires if a permit is not obtained within 180
�" I� - � - C ��t - --1 days after it has been accepted as complete.
Print name: ,L1 ( , - SL I , ,,` 1::1 , C I Date: ' Fee methodology set by Tn- County Building Industry Ser ''e Board
i :'Budding\Permits\ C- PermitApp doe 12/03 140 -4617T (I l /OJCObL'WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: OOH G O D 75
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
•
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: // 9 OD CJ /cOLAS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
ft tti
Inspection Request Scheduled For: Date: 3 _ 3 _ Rohe /L ;
Code # Inspection Description Confirm # Contact # Message
?
Corrections/Comments/Instructions:
ete16
►' 1 _ tom
, /1
PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIc AL ES ASSESSED
Inspector: !1 Date: Phone #: (503) 718 - ��