Permit t .
C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00542
.4114; i I DATE ISSUED: 9/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 CB -01741
SITE ADDRESS: 10455 SW HOODVIEW DR ZONING: R -3.5
SUBDIVISION: HOOD VIEW NO.2 LOT: 040 JURISDICTION: TIG
Project Description: Install A/C unit.
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
JAMES NELSON Description Date Amount
10455 SW HOODVIEW DR
TIGARD, OR 97224 [MECH] Permit Fee 9/1/2005 $72.50
[TAX] 8% State Surcha 9/1/2005 $5.80
Total $78.30
Phone: 503- 968 -1490
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Phone: 503 -557 -2220
Reg #: LIC 72623
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: 7-2,1774 fu� Permittee Signature: j � . p
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.
At 28 05 08:12p Tri County Temp 5035570919 p.1
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QFFICE I LY
City of Tigard �� I DateiB : 9 / OY' /y I Permit NA V\
i3 i25 S Hall Blvd., Tigard, OR 97223 2005 4i2i0a0 . SW Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
4- •' '� ' s• Date/By: 1 Other Permit:
inspection Line: 503.639.4175 'I A; D ate Read e
Internet: www.ci.tigard.or.us CITY OF 71GAI�Q "-46' Y' •• Suns: 0 See Page 2 for
BUILDING DIVISION Notifiei/�fethod: L17�/ i (, Supplemental Information
1 ..... •. : :. -• .= - . .: - 'i - -
EOF'Vt0 MMERC EE* SCHEDULE''
❑ New construction XAddition /alterationfreplacement 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.
- _:r : ! :4 :T C ] 4': NSTRULmsn . : -: •> i , •
X 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building . I:. :SYS"['EIvIS :FEES* 1
❑ Multi family ❑ Master builder For special information use checklist
❑ Other:
w Desc iption Qty, j Ea. I Total
{;. �', ' SOB: SITEr I (RM`AUOL:F,
' 's :; � �° `; -. t .. , '..:•.: Heatin
Job 51te address: , 04% 6W VION I Air conditioning or hear pump
, (reouires site plan showing placement) I 14.00
I City/ State/ZIP: Tiel • I Furnace 100,000 BTU (ducts/vents) 14.00
Suite bed Ja t. no.: • I
Furnace 100,000+ BTU (ducts/vents) 17.90
g P I Project Gas heatpuntp 14.00
I Cross street/directions to job site: Duct work 14.00
:1ydronic :rot. -va:er system 14.00
Residential boiler (radiator or
- hydronic) 14.00
' Unit heaters (fuel -type, not electric),
; in -wall, in -duct, suspended, etc. I 10.00
Subdivision:
Lot no.: Flue /vent for any of above _10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances
.,�
.� :^ , :; ." : ;s. "'a i" - RIPTI = F Water heater 10.00
...:.:....:. • C , ON- OE _LURK' � .: ; �;� � .::. � :� _ '�
L neAr t 1 't Gas fireplace 10.00
/ + V Flue vent for water heater or gas
' fireplace . 1 10.00
Log lighter (gas) 10.00
_Wood/pellet stove 10.00
Wood fireplace /insert 10.00
.. S ... PERTY' :O Y ER . .. .. f*.` ` _- ::r;T, .. y i •T T E ......' Chimney /liner /flue/vent 10.00
�.'. ",l:'.:« . . .. .y 14 "' :.. . :" •.. r... .. :..iL �.'•. : :
`f .f= 'a'
NAN .� 1. , :... ...
3:........ '- :�� : . - :. Other: 10.00
Name: ♦ 1t1 1 1S Nel66n I Environmental exhaust and ventilation
Address: vu � V , Range hood /other kitchen
` equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
t34 Q-t " (f fq b Fax
Single-duct exhaust (bathrooms,
Phone: ) "� D ( ) toilet t compartments, artt mentsts , utility ity rooms) 6.80 l
C)
® �APPLIC NT " Attic /crawlspace fans I
'r.,__ °c ^;; -.... ;' 3....z.'COiYTACT;EETL§ON - 10.00 I
Business name: T
1 In Th J TC Fue to
r 10.00
`� C�i�� piping
Contact name: bianc Mcison
M ` (�� !yam 55.40 for first four; $1.00 for each additional
I Address: t a E3 . C (QC k /j i f ld N i L c-
1 Furnac etc.
., i w Gas heat pump
City/State/ZIP: �(��) f'1 (1 City/State/ZIP: � 1 1 j [� WalUspended /unit heater
Phone: ()) 557.9 `� C R- q 7Q F ax: : (52) 557_/1 l 1 q Water heater
`' t Fireplace
E -mail:
Range
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r . .`;iv^'* � } t a" h.. N O S , .....r. Izi i .. Wit. • :Lim I n ,
....,',.: t
:.;t':'-:'. :aS.. .� . :- ;- . . .Y_;eY;. :�`' . . . . •. w. . ..b.,: •� - .. . . Barbecue '
Business name: TO COLD , T-C • . C ' . 1 Clothes dryer (gas)
Address: ( C0 , C I t (. Y1 l �/I C R I Nn 1� Other .
N �'..� 1 t l l�'( I t �C 'iJ RI p I : )P ER1VIi l TEES*
•
City / State/ZIP: orecQ �`'k_ Ct7 Subtotal
Phone: (,'' 0 -) r "' . 4 Fax < " �' l (- ' l i J ! - L�2s_ (V :r5 f5-7 '- C;•,.� / . .� Minimum permit fee (S 72.50) 1
Plan review (25% of permit fee ,
CCB lic.: �72- . State surcharge (8% of permit fe i h
(�
j TOTAL PERMIT F : i
Authorized signature: 7 - L 2 / C.O This permit application expires it a permit is not obtat
,Q 61 i1 days after it has been accepted as complete.
• Print name: TGQj e .,iif>5'�A') I Date: I . Fee methodology set by Tri - County Building Industry Service Board
, :tB °uilding' mutts \D {EC•Pernv :.4pp.doc 12:03 440.4 %T I 6 I I'O2 /WEB)
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CITY OF TIGARD ., . .. ;,
BUILDING DIVISION PERMIT #: MEC2005.00542
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1/7005
Phone: (503) 639 -4171 :tpun f,lrl
Inspection Requests (24 Hrs.): (503) 639 -4175 .. �� J
INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7:O6AM PAGE: 50
SITE ADDRESS: 10455 SW HOODVIEW DR CLASS OF WORK:
SUBDIVISION: HOOD VIEW NO.2 LOT #: 0q0 TYPE OF USE:
PROJECT NAME: NELSON
DESCRIPTION: Install A/C unit.
OWNER: NELSON, JAMES PHONE #: 503 -968 -1490
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 -557 -2220
Inspection Request Scheduled For: Date: 9/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016003-01 6603.5557 -2220 N
Corrections/Comments/Instructions:
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PASS I I PARTIAL APPROVAL fl CANCEL NO ACCESS
I ] FAIL //IC L FOR INSPECTION I I ADDITIONAL FEES ASSESSED
c�
Inspector: r Date: 9 '/- 0,c
J Phone #: (503) 718-
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