Permit ,
� , CITY OF TIGARD MECHANICAL PERMIT
,;: r` DEVELOPMENT SERVICES PERMIT #: MEC2005 -00289
ref I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/1/2005
PARCEL: 2S112BC -13300
SITE ADDRESS: 08084 SW LEISER LN ZONING: R -4.5
SUBDIVISION: LEISER PARK LOT: 002 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
<= cfm: OTHER UNITS:
FURN > =100K BTU: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DAVID MULLALY Description Date Amount
8084 SW LEISER LN [MECH] Permit Fee 6/1/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 6/1/2005 $5.80
Phone: 503 -598 -8532 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 -538 -2953
Reg #: LIC 125815
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 • - ° 101-0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 ;10- 332 -2344.
Is- ued By: , / Permittee Sign Lure: ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that' iness - /.
is permit card shall be kept in a conspicuous place on the jo site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 31 05 02:52p I O 503- 537 - 2172 p.2
2
'MIVieciian Permit A I ! ` J FOR OFFICE USE ONLY
City of Tigard 0 Date/B y. l • No.: -
I3125 SW Hall Blvd., Tigard, OR 972'3 5 Plan Revieu /J / r / ,, ✓'• ,.......no, Phone: 503.639.4171 Fax: 503.598.1960 1 i , � 4 i Date/By. Other Pc . Inspection Line: 503.639.4175 \ +Vl. �j Date Ready /By: r El See Page 2 for
Internet: www.ci.tigand.or.us O � �( '`� Notified/Method: �t� Supplemental Information
cAN1S O
COMMERCIAL FEE*: SCHEDULE .USE CAECKI.
isr
0 New construction A 'r' , Z i b I N/
a lteration/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 .;..::...:. • a
l�1 - and 2-family dwelling :RESIDENTIAL EQUIPMENT /.SYSTEMS FEES* ..: •
y g ❑ CommerciaL'industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family
❑ Master builder ❑ O ther: Description I Qt I Fa. I Total
. JOB SIT INFORMATIQN AND .LOCATIOI+T Heating/cooling
!. ' :/ \� / � 1 r Air conditioning or heat pump /
Job site address: l� - r ��� �,� I / n , (requires site plan showing placement) l 14.00 l L4
City/State /ZIP: / '/ � Furnace 100.000 BTU (ductsivents) \ \\ 14.00
try t, -Zc u�� 1, t1
Suite/bldg. /apt no.: ti - I Project name: Furnace 100.000+ BTU (ducts /vents) 17.90
. 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
- Flueivent for any of above 10.00
Subdivision: Lot no.: Other 10.00
Tax map /parcel no.: Other fuel appliances
,: •..:
E
: ; ; • _:.:.. ... .... .......... $�RIPTION .OF WORK :' : , ,.. :::: ` : ":::r.::':_:: ' :. ' :... Water heater
�.. ,. ... Gas fireplace 10.00
1 C .� f 10-1,1____
J 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
: :
10.00
. Chitrmey/lin
erlfluPJvent
1 .,.... ,....: Other 10.00
' yk � r
Name: 41(��( I �, t6 -, Environmental exhaust and ventilation
+ Range hood/other kitchen
Address: ' } TS :M equipment 10.00
Ci /State/ZIP: ^ .� t 4 n Clothes dryer exhaust 10.00
Phone! ` r `3-7.------ Fax: ( oi let compartments, (bathrooms, 6.80
:: c fans
• � A PPLICANT., •. � :' • = .. :: �:❑ CONTACT PERSQN `. .`.:i' .:, Attie/crawls-pace ... Attrc
Other. 10.00
Business namel, �irCC0 tl "` I o�
� � Fuel piping
yL "'
Contact name: �� %�� . ,� '"""" p ""��"' Q . J $5.40 for first four; $1.00 for each additional
}�
Address: (� o (ff Furnace, etc.
1 tJ Gas beat pump
City/State/ZIP: ,,,,i,,,_ 0 e onus- Wall/suspended/unit heater
Phone`( t)3) L 5 Z 0 ac ,,,, I Fax: 3) 5 37 Z/ -q--z- Water heater
V Fireplace
E -mail: Range
C RACTOR ;....: Barbecue
Business name: r rn Clothes dryer (gas)
Address : , 6 MECHANICAL.PERMhT FEES* .
ty, i 1 01 C I i l I ( Z . )14
City/State/ZIP: ' / Subtotal
n Minimum permit fee ($72.50)
Phone: Fax / -7 Zl Z
• �. r d.' Plan review (25% of permit fee) r
CCB tic.: 11). �� State surharge (8% of permit fee) ✓ /
TOTAL PERMIT FEE 1. i
Authorized s' cure: (� �) jn / / ry This permit appllcadon expires if a permit is not obtained thin 80
� I � ( - 3 l .(1 � . l (.J (1 ,,, , " J 1 i , days abet if has been accepted as complete -
•1
Print name: .yt i °''i 4 ,4/l ern Date: - I • Fee methodology set by Tii -County Building Indusuy Service Board
lPa
ifauildiegmits GPamitA,p.doc 12/03 `T` L 4404617T (I 1/02%COM'WEa)
May 31 05 02:52p 503-537-2172 p.3
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CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2005 -00289
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/1 /2005
Phone: (503) 639 -4171 I h
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.. 42,,./001 - `'L
INSPECTION WORKSHEET FOR DATE: 6/29/2005 TIME: 7:08AM PAGE: 98
SITE ADDRESS: 08084 SW LEISER LN CLASS OF WORK:
SUBDIVISION: LEISER PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: MULLALY
DESCRIPTION: Install a/c unit.
OWNER: MULLALY, DAVID PHONE #: 503. 598 -8532
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 538 - 2953
Inspection Request Scheduled For: Date: 6/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010339 -01 503 - 538-2953 Y I► 1
Corrections/Comments/Instructions:
r`' I N8- i- L c� • s""c7 z-/ c
•
0 C./ / r "...
PASS r', PARTIAL- APPROVAL ❑ CANCEL - ❑ NO
❑ FAIL r/ if LL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: � � Date: C7 . Z-l'C Phone #: (503) 718-