Permit CI TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00410
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/10/2007
PARCEL: 2S114AB -02800
SITE ADDRESS: 09260 SW MILLEN DR ZONING: R -4.5
SUBDIVISION: KNEELAND ESTATES LOT: 015 JURISDICTION: TIG
PROJECT: CLARK
Project Description: Install HIP
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
AMBER CLARK Description Date Amount
9260 SW MILLEN DR
TIGARD, OR 97224 [MECH] Permit Fee 7/10/20W $72.50
[TAX] 8% State Surcha 7/10/2007 $5.80
Total $78.30
Phone: 503- 708 -8953
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 620 -1953
Reg #: LIC 151847
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 B,,: Li � Permittee Signature: t pfi c l 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.
07/10/2007 16:01 5036709064 THERMAL FLO PAGE 01
Mechanical Permit A,pplica> f Received FOR li [ K [)I' 1 I(:1:: USE ONLY
City of Tigard osteBY:
13125 SW Hall Blvd„ Tigard, OR 97223 JUL 1 0 2007 h I w
' C . Phone: 503,63x,4171 Fax: 503.598.196(1 Plan Revi r
/g Other Permit;
TIGARD Inspection Line; 503.639.4175 .
Internet; www.ligard- nngriv C��Y ' ° T f� .
� °�D pate Ready/By! tor' See Page 2 for
BUILDING DIVISION NodIlcd/Mclhod: SupplementnI information
TYPE OF WORK COM4lERCIAL 'FEE* • SCHEDULE — .USE CHECKLIST
❑ New construction rgAddition /alteration /replacement Mechanical permit fees* arc based on the value of the work
performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, equi mcnt, labor, overhead, and profit.
CATEGORY OF CONSTRl1CTiON Value: $
Ld`lo and 2- comity dwelling ❑ Commercial /industrial Li Accessory building RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
Far' special information 14Se checklist.
❑ Multi - family ❑ Master builder 0 Other:
Description Qty, I Ea. I Total
JOB SITE INFORMATION ANI) LOCATION . _ Heating /cooling
Job site address: (I2 5.A.) � 1 t I n Or Air conditioning Or heat pump
- (requires site pint showing placome,u) 14.00 i �.
City /StateiZlP: Ti d. O "772 `� ff Furnaec 100,000 BTU 1.4 14,00
` � �^ 1' heat 100,000+ BTU (dur ts/vente) I
Suite /bldg. /apt, no.. r ck,i- 1�
` Project nan,c: (r
Gas heat pump 14,00
Cross street /directions to job site: Duct work 14,00 _-
Flydronic hot water system 1 4.00
r _ Residential hailer (radiator or _
, dronic) 14,00
Unit heaters (fuel -type. not electric),
in- wall. in -duct, su pendcd. etc. 10,00
Subdivision: . Lot no.; Flue/vent for any of above 10,00
—
Other: 10
Tax map/parcel no.: — Other fuel ap fiances
DESCRIPTION OF WO Water heater 10.00
j - `` Gas fireplace � 10,00
l "P. Flue vent for water heater or gas
fireplace _ 10.00 _
— ^ Log lighter ( a� s) 10.00
— __. Wood/pellet stove 10.00
Wood fire lace /insert 10,60
❑ PROPERTY OWNER I ❑ TENANT
Chimney /liner /floe /vent 10.00
Other: 10.00
Name: Q C`r., J Environmental exhaust And ventilation
� � (� Ranee hood /other kitchen
Address:
'o�J 5 . If t tiler, or. equipment 10,00
City /State /ZIP: 1 fl C 02 972 Clothes dryer exhaust 10.00
�� 7U4 3 , 5 _
Single-duet omp rt exhaust (bathrooms,
6.80 Phone: ) 7 Fax: ( ) toilet compartments, utility roo _
in APPLICANT ❑ • CONTACT PERSON Attic/crawl rams 1 0,00
Business name:
Other; 10, 00
Fuel piping L
Contact name: ___ SS.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heal. pump
City /State /Z l P:
_ Wall /suspended /unit heater -
Phone: ( ) Fax: : ( ) water heater
F -mail:
---
-- Fireplace
Rang
_ CONTRACTOR Barbecue
^ C3usincs5 name: Thermal Fit). Inc. Clothes dryer (pas)
-- Other:
Address: 7230 SW Durham Rd
MECHANICAL PERMIT PEES*
City /State /ZiP: Portlo-tnd, OR 97224 Subtrrtal
Phone: (503) 670 -8343 Fax: (503) 620 -1953 Minimum permit fee ($,72,50) -17' C-
Plan review (25% of permit fee)
'C'IS lie,; 15U147
C State surchar8e (8°%of ponnit tee) S -'
—f TOTAL PERMIT FEE . 070% — if Authorized signature: This permit npplicntlon expires itn pertrtll is Ant nhtuined wilhin 1110
day niter it bat been accepted ns cam plele.
Print name: Brenda Estes 7 _ lc _ t 7 " gy tel by itdi n • Indl ,s
Uatc V I Fee mcrhntlnlo cc! h rri-
Cnpnty Bu b c tr)' Service Amu!
0711012007 16:01 5036709064 THERMAL FLO PAGE 03
Site Plan
Prepared b
y �cs Date: 1. - o .- q _
Customer Narne: t om Address: �} s <�.,.� -3, .
Custome' Phone • 7
Property Boundary Line
/3( r
5
Fi
0 ( - 3C. ter
�{
House
)(-
Street
CITY OF TIGARD
BUILDING DIVISION PERMIT #: iViEC2007-0041 I.5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/10/200?
Phone: (503) 639- 4171 pypil 1.
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AM PAGE: 51
SITE ADDRESS: 09260 SW iMiILLEN DR CLASS OF WORK:
SUBDIVISION: KNEELAND ESTATES LOT #: 015 TYPE OF USE:
PROJECT NAME: CLARK
DESCRIPTION: Install HIP
OWNER: CLARK, AMBER PHONE #: 503 -703 -8953
CONTRACTOR: THERMAL FLO PHONE #: 503.670.6343
Inspection Request Scheduled For: Date: 8/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 054420-01 503-670-8343 V
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V 4 Date: P_. Phone #: (503) 718-