Permit c.
CITY TIGARD MECHANICAL PERMIT
j1� DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00304
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
DATE ISSUED: 6/7/2005
PARCEL: 2S 109DA -06900
SITE ADDRESS: 15089 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 046 JURISDICTION: TIG
Project Description: AC install.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DAVID FLOCEY Description Date Amount
15089 SW GREENFIELD FDR. [MECH] Permit Fee 6/7/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchaq 6/7/2005 $5.80
Phone: 503- 887 -3972 Total $78.30
Contractor:
PREMIER HEATING + AIR COND
PO BOX 86295 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97286
Phone: 503 - 233 - 6566
Reg #: LIC 96473
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: It . , � Permittee Signature: Gc `l°"`"
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
UN -4 -2005 01:48 FROM:P 5032394998 T0:5035981960 P.
0 5/04/2005 11:13 FAIL 503511811100 CITY OF TIGAIW IRIOUl /UUJ
ech meal Permit A U : ` all a lEi 1 `.,.' r FOR OF FLC I:. I_ S1: U \1_.1
City of Tigard __ > .. Fteeeirsd�n i Pematrto: N /� / /�
13125 SW Hall Blvd .Tigard, OR 97223 pp �� pD=d ri r M a.. -w /lam �� ^4.
Phone: 503.639.4171 Fax: 503 _598.1960 I II I V Ib 0 3 2O 3 - , oatetby: Odra Permit
Inspection Lune: 503.639.4175 1 %H f Doe HnmoyrBy �� et See 1ra8e 3 for •
Internet tW w.ci.tigard.or u$ V. NobSsdrMethod: \ 7 3n ppsmue tal lafar ueatioa
•
•
CITY OF TIOrr
R..li'bz:s?° ': 4.- -' ' ' COMMERCIAL FEE' SCHEDULE – 115E CHECK
0 Now construction Addition/altrxation/rcplabaernc rt Mecbamcsl vomit foss' are based on the units oldie weak
❑ Oemalitiou 0 Outer. . p e ca e:
Indite the value (sounded to th nearest dollar) of ell mechanical materials, e nut imen1, labar, overhead, and moth.
CATEGORY OF CONSTRUCTION Value.: S
• ❑ 1- and 2- family dwclltng ❑ C L znn ial/mdutrinl ❑ Accessory building RESIDENTIAL EQY}YpMEN1' / 3 SfST FEES'
p Muhl -family ❑ Muster builder ❑ Oth For 'pedal frlfhematiaa rrne cJmek�rt
Demaiplion Qt I Ea. i_ Total
1011 SITE INFORMA.TIoN AND F ooc ioN I [�
J°13 /lire nitres' f 51,\, ( re' f 61?) ) , AI.'( sbow'ma vt Wit) i 14.00 (" f ,
City /State/ZCP: f t r j lJ 1\ � � q ' 722 Furnace 100,000 B7i/ Pincer ) _ 14 - 00
Spite ibldgJapt am: 1 Ptvjeatname: Punnet 100.000 HTTI (dn /vusta) 17.90
• Gas hest pimp _ 14.00
Crew attoct/directiaoF to job it Ductwork 14.00
Frydmnio bet water system 14.00
Rerad/leltisl boiler Nader or
hydic) 14.00
Unit haters (fuel-type, not electric),
in -gall, Maud, saspcnded, err. , . 10.00
Subdivision: i s Flue/vent for az1yof above 10.00
J _ Otircc ` 10.00
Tax map/parcel no.: Other bid appliances
_ DESCRIPTION OF WORX Wafer heater , 10,00
GIs Emplace , 10.00
0 ■ i - ' . e_ .tg Flue vent tar water heater or gas
ftssplace 10.00
Los Ughka f8ar� , 10.00
Wood/pellet stave 10.00
Wood fireblstxfnsert 10.0
ROFERIY OWNER 1 ° 3 uturrr Chirrmesllia�Que/vent . 10.00
• Other: � 1
Name: `.. i S. ' _ Environmental ,bait and ventilation
Address: 150 VA
< i{' �1P � Rangeboodexffitchen
/ equipment htm 10.00
CZty/SnWT.
rIP: 1 f 1 � CI 722' er
Clothes. dry= 10.00 ,
�/�, – Y – 1 Single -door Est (badanoms.
Phone: {9)) RS – 3 61 7 2 – Fax. (----1— toilet compatmeaa, volley roor m) 6.80
❑ APPLICANT 0 CONTACT PERSON tube/crawls fans 10.00
• Business stasnt: 0 _ 10.00
Blrel ptpiag
con= name: 55.40 for Hest foar41.00 for each additional
Adds : Fttrvacr, etc .
Gas heat pump
City /State/HP: Walllhuspendedfunit hem
Phone; ( Fax.: ( ) Water heater _ _
E—mail: Fireplace
>a
=AMR. Barbecue Btuiness skein < / NG * '/ i t .. C es (gam) "dim: P O . SAX (0ZgS _ ' Other l►�cHb3rliCA.L kE RkU -
T FEES*
_ City/Stabs/2M 'ppl7�l � 0(Z, q72 Minimum permit foeSubton) . ��.
1114114' 3 _ / ^ G pare ) 2 } ' f - �f" I `7 l F lu review (25% of pared fete) •
OCR lit,: q(0U 7 3 �K State ne chsyse (856 ofpae+rrt �j,
TOTAL lemma FEE
^ i/�7' l
This permit appileatten b Mai es if a permit toe O witaia 1
Authorized 6 days OW It has beta scupeed as chaplet
Print > \/1/4„, i (I i R- I 'Date /' - 3 r �
p I • Foe fwsbuiogy set by T Cmm.ti 8 eY 1d3Qind is - Board
rillir , . . '
- 4 -2005 01:49 FROM:P 5 @32394998 TO:5 035981960 P.4
® e ff P.O. Box 86295
Portland, Oregon 97286 CCB# 96473
/N . TINOANDAIRCONO/TION /NO, INC./ Ph.: (503) 233 -6566 Fax: (503) 239 -4998
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CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: MEC2005 -00304
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/27 /2005 TIME: 7:09AM PAGE: 67
SITE ADDRESS: 15089 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 046 TYPE OF USE:
PROJECT NAME: FLOCEY
DESCRIPTION: AC install.
OWNER: FLOCEY, DAVID PHONE #: 503 -887 -3972
CONTRACTOR: PREMIER HEATING + AIR COND PHONE #: 603 -233 -6566
Inspection Request Scheduled For: Date: 6/27/2005 Pour Time:
P q
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010156 -01 503- 233 -6566 Y t'lj
Corrections/Comments/Instructions:
•
RI PASS a P' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • C - FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
42- / ?`'S
Inspector: Date: Phone #: (503) 718-