Permit . CITY OF TIGARD MECHANICAL PERMIT
` . COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00451
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/23/2007
PARCEL: 2S 111 AB -07500
SITE ADDRESS: 09390 SW INEZ ST ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT: 020 JURISDICTION: TIG
PROJECT: MALLETT
Project Description: AC 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:
ELE 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MICHELLE MALLETT Description Date Amount
9390 SW INEZ ST.
TIGARD, OR 97224 [MECH] Permit Fee 7/23/2007 $72.50
[TAX] 8% State Surcha 7/23/2007 $5.80
Total $78.30
Phone: 503- 624 -7777
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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: 1 /57 Permittee Signature: e 2 /a ..��( 04 -
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.
Jul 23 07 09:52a Oregon Heating & A/C 503 - 537 -2172 p.1
Mech Permit Applie FOR OFFICE USE ONLY
City of Tigard eived it ) 71 ` J g .:cs C \ 1. ∎lea . Date /By: p?3/6 7 17 ['emit Not lee _.
.1 13125 SW Hall Blvd., Tigard, OR 9 `2 !/
Plan Review
Phone: 503.639.4171 Fax: 503.598. t960 Other Permit:
JUL
Inspection Line: 2007 Date/By:
T I GARD Ition Li 503.639.4175 Date Ready /By: tuns: @See Page 2 for
Internet: www.tigard or.gov Notified/Method: / Supplemental Information
CITY Of' i AR
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TZ'P i e a � v n, .niVISION CO FEE* SCHEDULE - USE CHECKLIST
❑ New construction ® Addition t er t on /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.
CATEGORY OF CONSTRUCTION . Value: $
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES* -
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑Master builder For special information use checklist.
❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: q 3q0 sw T • ez Air conditioning or heat pump 1 1 (p A
LJ (requires site plan showing placement) 14.00 't .00
�
City/State /ZIP: (fl L Furnace 100,000 BTU (ducts/vents) 14.00
^� ^ p 1 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
Subdivision: Flue /vent for any of above 10.00
Lot no.:
Other. 10.00
Tax map /parcel no.: Other fuel appliances
.DESCRIPTION OF WORK . Water heater 10.00
IIVAC 1 Gas fireplace 10.00
1 11^Jf Q l Ac. 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
zi PROPERTY OWNER • El TENANT Chimney /liner. /(luelvent 10.00
• Other: 10.00
Name: Michelle.. M1tal le i {- Environmental exhaust and ventilation
Range Address: q 3c SW T Sf equipment 10.00
oodeotherkitchen
J"1e2 1 equipme
City /State;ZlP: �') c rd q 7 L _Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone:
503)6a - 1 - 717 F ax: ( ) toilet compartments, utility moms) 6.80
. ® APPLICANT - El CONTACT PERSON . Atticlerawlspace fans 10.00
Business name: Oregon Heating & A/C Other: 10.00
Fuel piping
Contact name: Fa h,e.Ule S5.40 for first four; $1.00 for each additional
Address: PO BOX 297 Furnace, etc.
Gas heat pump
City /State /ZIP: Dundee OR 97115 WaWsuspended/unit heater .
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater
E -mail:
Fireplace
Range
CONTRACTOR Barbecue
Business name: Oregon Heating & A/C Clothes dryer (gas)
Other:
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City/State /ZIP: Dundee OR 97115 Subtotal
Phone: (503) 538-2953 Minimum permit fee ($72.50) ^
( ) Fax: (503) 537 -2172 Plan review (25% of permit fee) 7oC
CCB lie.: 172126 State surcharge (8% of permit fee) 5.10
^ TOTAL PERMIT FEE ,
Authorized signature:‘'/:2 / This permit application expires if a permit is not obtained within 180
6 � A 11 0 , % .•CSIw days after it has been accepted as complete.
Print name: 2a5I„ e J' e Pj pt Date: ,25�. Q7 ' Fee methodology set by Tri- County Building Industry Service Board
laBuilding \Permits \Iv1EC- PermitApp,doc 04/06/06 (fy 440 4617T(11/02/COM /WEB)
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Jul 23 07 09:52a
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.4 -..I. Oregon Heating & A/C 503-537-2172
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CITY OF TIGARD 110
BUILDING DIVISION l PERMIT #: MF_f; 417 0 1
13125 SW Hall Blvd., Tigard, OR 97223 V ( � , DATE ISSUED: 7/23/2007
Phone: (503) 639 -4171 V- 6,0 " Aga i t A v . . &
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7:00AM PAGE: 65
SITE ADDRESS: 09390 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 020 TYPE. OF USE:
_PROJECT NAME: MALLET I
DESCRIPTION: AC install
OWNER: MALLETT, MICHELLE PHONE #: 503 - 6247777
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 -536 -2953
Inspection Request Scheduled For: Date: 8/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 053651 -01 503.538-2953 Y in ^
Corrections /Comments /Instructions: t � "
( ."--- (7 . - - :1 ,/ ,
K pASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
0 7 Inspector: 11 Date: Phone #: (503) 718-