Permit C ITY O TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 5/19/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PERMIT #: MEC2006 -00215
PARCEL: 1S135CD-10900
SITE ADDRESS: 09735 SW NACIRA LN ZONING: R -4.5
SUBDIVISION: NACIRA PARK LOT: 009 JURISDICTION: TIG
Project Description: Installation of 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
BRIAN HOLMAN Description Date Amount
9735 SW NACIRA LN
TIGARD, OR 97223 [MECH] Permit Fee 5/19/200E $72.50
[TAX] 8% State Surcha 5/19/200E $5.80
Total $78.30
Phone: 503- 639 -9062
Contractor:
OREGON HEATING + NC INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
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 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: - » j 2_j ,6a7 Permittee Signature: _ Q c)
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.
May 19 06 1O:37a MS Rentals, Inc. 503- 537 -2172 p.3
'Mechanical Per 1 ',y, t a ,l C' • irg! Fr
' FOR OFFICE USE ONLY
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City of Tigard Da rs i9_ 6 „ a
Permit �f o
13125 SW Hall Blvd., Tigard, OR 9723 Plan Review puler Permit ` �� C+ �
IDSp Phone: 5 Line: 503 9 503.598.196M 3 9 200 _ _ If i Date Re
Rupee ion Line: 503.639.4175 M ■ Date Ready.IBy: J � V I S See Page l for
w•w.ci.tigard.or.us NotifeO/Method. PP mcntallaformati
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Mechanical permit fees* are based on the value of the work
❑ New construction i ' . anion /alteration/replacement performed- Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
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and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special infonrarion use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. I Es. I Total
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A CL COt) Job site address: `� � � � L i 14.00
City/State /ZIP: �A $ Furnace 100,000 BTU (ducts /venm) 14.00 _
�� A.40/ - V L ' J 'n am` Furnace 100,000+ BTU (ductslvents) 17.90
SuiteJbldg. /apt no.: / / �JJ Project name: i
Gas heat pump 14.00
Cross sceet/directions to job site: Duct work 14.00 ,
Hydronic hot water system 1 14.00
Residential boiler (radiator or • hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above I 10.00
Subdivision: 1 Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances - -
- _r.,r w .,„..: v::-,.r: ,., l : ;i∎V Y.. Water beater 1
yii` : y':; . Y°+.i. . :,k• _ ti=t _ .. , �X.r,' : �elr,. 0.(]o
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�^ : A . Gas fireplace 10.00
r✓/ I 'K �'� I . ` ( %, r ' '' �-1 rn 'e.7 Flue vent for water heater or gas
C V L L fireplace 10.00
Log lighter (gas) 10.00 -
r Wood/pellet stove 10.00 .
Wood fireplace insert 10.00
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Name:
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� � � ��/� Environmental exhaust and ventilation I
] �� Range hood /other kitchen
Address: i ,v, t-t� l i r equipment 10.00
City/State/ZIP: p n - n V7 2�3 Clothes dryer exhaust 10.00
` - �u 6„2-_ toilet iet compartments, nt (bathrooms,
al
Phon
e: ) /LIJ_ V Fax: ( ) - rooms) g toilet utility ro ins
'l n8 : !31i;: if. • Attic /crawlspace fans 10.00
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:'!:; ]'- ... Other. 1 t 10.00
Business name r / A/ . _ i / . J1 . t c4-- l .�i. J f tAI Fuel piping
Contact name: U1 i K y ei 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address: e l- f � 8 ,,,, I ` Gas heat pump
City/State /Gil': � 0 1 ' ` I J� walL/sespendedsuni; heater
-7 11 Water heater _ .
Phone. �. - • �■ 1 _ _ 2 Fireplace ,
E -mail: �e
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Clothes dryer (gas)
, Business name: / / ry' , / ` - 0- 1())7 . 1W , O dter. 1
e. Address: , i .... E . *'- -,' T .
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City/State/ZIP: .1 it ' 6 1 1 �� I L� Subtotal �� r •
I Minimum rmit fee $72.50
Phone: • • I.u. Fax _A / 2 Plan review (25% of permit fee)
CCB lic.: 9 , / State surcharge (8% of permit fee) J x lv
TOTAL PERMIT FEE [ .
Authorized s ` • tore: ' i t f a 7 L • ) ���
, 1 1 , ' � .. 16 This permit application expires if a permit is not obtained
` within 180
111 days after It has teen accepted as complete.
' ij • Fee methodology set by Try. -Coup Building vice Board
Print name: y . . 1 , , Date: 41�1� 1 j,,, ry s Indus Service
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CONTRACTOR A/C — HEAT PUMP — UNIT SIT.I; PLAN- DIRECTION
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CUSTOMER INFORMATION
NAME:
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ADDRESS: 4l3S S a vAcit 6- (41
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PLEASE FAX APPLICATION WITI-I SITE PLAN
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CITY OF TIGARD
BUILDING DIVISION , ' ' PERMIT #: MEC2006-00215
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/19/2006
Phone: (503) 639 -4171 W
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I (—
IN WORKSHEET FOR DATE: 7/1212006 TIME: 7:05AM PAGE: 54
SITE ADDRESS: 09735 SW NACIRA LN CLASS OF WORK:
SUBDIVISION: NACIRA PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: HOLMAN
DESCRIPTION: Installation of A/C unit.
OWNER: HOLMAN, BRIAN PHONE #: 503-639-9062
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503. 538.2963
Inspection Request Scheduled For: Date: 7112/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 032930-01 503 -538 -2953 Y
Corrections /Comments /Instructions:
4et i,
j 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CAI P Date: 7 /Z' UG Phone #: (503) 718- ____9___r