Permit C ITY OF TIGARD MECHANICAL PERMIT
_AV IV DEVELOPMENT SERVICES PERMIT #: MEC2006 -00185
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/8/2006
PARCEL: 2S103DA -04600
SITE ADDRESS: 10570 SW PARK ST ZONING: R -3.5
SUBDIVISION: FANTASY HILL LOT: 001 JURISDICTION: TIG
Project Description: Install A/C unit & attic fan.
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
CLAYTON & PUGSLEY Description Date Amount
10570 SW PARK ST
TIGARD, OR 97223 [MECH] Permit Fee 5/8/2006 $72.50
[TAX] 8% State Surcha 5/8/2006 $5.80
Total $78.30
Phone: 503- 281 -0752
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
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: _ �/� Permittee Signature: _ p, c) Q
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.
FRAM : • ANCT IL Heat ing & Coo 1 i n 9 PHONE NO. : 503 282722 May. 04 2006 04: 14PM P1
. .
Mechanical Permit Application :,-..,,••,. ,. ‘• .:1' 6 ., , '..,-• FOR OFF10EX■SE''Clls;LV-',..';:.'
,
City of Tigard
FEREIMPA Permit N. lic e. __. y
€•., € - ‘ € - , • .
13125 SW Hail Blvd., Tigard, OR 97.cza . , - . " P w
ir
Phone: 503.639.4171 Fax; 503.598 - Other PCITIl
1960'
" h t I ' f it 0)1111 I
Inspection Line: 503 1 841.639.4175 ....,..A Dare Ready/Ry: ions. 10 See Page 2 for
Internet: www.ci.tigurd.or.us or 7U3 Notified/Method. ..# ..# 6- I Supplemental IntoetuatiOu i
i
fig 40: gleaktOWIIVi&4,1
Mechanical permit fees* arc based on the value °idle work
0 New construction
.. .1E1,.. 4 ,911• 'ticr(altoratitmlfitPlialent
perfomied. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 'L mechanical matcriak, equipment, labor, overhead, and profit.
Value: $
maim -.=1
1 .,!41.3.4.:d:,,f
fal - and 2-family dwelling 0 Commercial/industrial 0 Accessory building !,,
For special Ittfornicuion use check/is!. a multi-famil 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
, , - -i . ,is1T 13 ' . ii r r;'7vritit?'!: ' r;
Hooting/cooling ■
Job site address: 10 5 -40 ,. . ..b \c '5- • Air conditioning or hcat pump
(requires ski plan showing placement) - 14.00 I
t -1-
City/StnteIZEP : , ) \ tarok /0[ / 9 2.2 Furnace 100,000 BTU (de/) 14.00
, Furnace 100,000+ BTU (docts/vents) _ 17.90
Suite/bldg./apt, no.: I Project name: - p os3t , \e
, CiaS heat ptunp 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
...._ ,
Residential boiler (radiator or
' ..
hydronic) _ 1400
, ..
" Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. etc. 10.00 .
_ -
Subdivision: I Lot no.: Flue/vent tar ny of above 10.00
• Other: 10.00
Tax map/parcel no.: - - - -- -
Otter fuel appliances
IMIESIVINMjA
Water heater 10.00
,.,
Gas fireplace 10.00
3- \ /VC-- 4 cc\ Cav\ Flue vent for water heater or gas
fireplace 10.00
..-
.. Log lighter (gas) 10.00 .„
r Wood/pellet stove 10.00
•
. Wood fireplace/insert 10.00
r ;, pgf,.r.,gr.v,t;v;T Chinmey/liner/fiue/vent
.. 1000
.i. • ' other 10.00
9
Name: C v, ,e1 C\ eAkA - • . \eu,
_ _ _ knvironmental exhaust and ventilation
Range hood/other kitchen
Address: SO S 5 'd . p \ -_6,V-
equipment 10.00
City/State/ZIP: -- 2. r .; ck i - o k . /cw., / 91_ 22..,
Clothes diyer eaust __
Single-duct exhaust (bathrooms,
Phone: (5c)) ... (-.)--+ 5 2., Fax: (6)3 ) LK- 51 22 toilet compartments, utility rooms)
- „.,- . 7 ' , 1• 1.0...,. '•:',U.', ),...,•-•••71,,117d179.r44- '4•4',Itl'iqi:VriPg I 10.00 10 •fa
6Falf A t.{. C ..4Z1...,1 lega ;;::,4,,.•% , y.)tn,; D .'",',1-$ Y LAIgp07 u , r . 6.044 , 3).4:10 , 10ciq ■• ......1: Attie/crawlspace fans
..... ‘-itsmi ' "0 ‘11
Other: 10.00
Business name: A 1..l i
• • Fuel piping
Contact name: 4 c ., I yi, ----- " $5.40 for first four: $1.00 for each additional
.. .. .
Address:
Furnace. etc.
4 57 N.). ( ., 00Ark Aw.. ,
Gas heat pump
City/State/Z1P: pos- A / OR / cr '2)i '2)i 1- - Wall/suspended/unit beater
Phone: (an ) 2 I - 02.., I Fag: : (503) Zea - 5 22. Water heater , ,
Fireplace
F-mail: • r a .
Cw\C ■ AV/ . • vv'.. • Range _ -
,, -.7 . um -..Mill••1,,' '',.1?'' PM . • 6,7•- •F‘;' ,.. 1N1` , A.."1‘ , 17•3 7 • • •lic. '4" , I , '
iii- ; 4 • ‘...*4. ..44.5. c..ht '710,,,li o-f g Igi V , ,r1rt,r, p10 ri - .4440, t , rvevci... , ..,, ,, ,,;;,, , ,,Ah.,t.. , 1 .4- 4 ,,,iv.447, - .0,,AL..171 El
1.,4-7F .. !- '
R.usiPes namel Av 1-keca Coo ) P \9 Clothes dryer (gas)
I Other:
Address: .4-1 ..... k_A - -,4., \ ue , • .,.. , . 'Lvs IrctonT''
.firraaild,..4 ,FIN.,_,At ' ,••••• . 4.. i•'' }44 r: '. - • - 1
City/State/ZIP: 1 /0 R 91 (yN 2 z1-4 e.52. Subtotal Al-k ,
Phone: ( 5)5) z„51 (n 2.... . F ax: (5 _ s -4 2z Minimum permit fee (S72.50) "42 ,
Plan review (25% of permit fee)
CCB lie.: gt5 IR. Stare surcharge (8% of permit fee) S . Pi)
. .
gnature: - ' ; . - . •, 1 - .s.... . .,• , .
(37A1711 TAL PERMIT FEE
Authorized si
Ti This permit application expires if a perosit is not obtained within 180
days after it has hem accepted as complete.
I Print name: , r, r 1 .s\ e 4 . ,• ie ; 453 - 1 , \€ , b 6_ c...t_ 0 . c :::: , 1 • Fee methodology set by Tri-Cotany Building Indutery Service Board
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CITY OF TIGARD vu-I^'" .- •--• , --
MEC2006-00185
BUILDING DIVISION PERMIT #: 5/8/2006
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639- 4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 `'' L
7/21/2006 7:01AM 53
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10570 SW PARK ST
SITE ADDRESS: FANTASY HILL 001 CLASS OF WORK:
SUBDIVISION: PUGSLEY LOT #: TYPE OF USE:
PROJECT NAME: Install A/C unit & attic fan.
DESCRIPTION:
PUGSLEY, CLAYTON & CAMIE 503 - 281 -0752
OWNER: ANCTIL SHEET METAL CO. PHONE #: 503 -281 -0752
CONTRACTOR: PHONE #:
7/21/2006
Inspection Request Scheduled For: Date: Pour Time:
ag§ # IrrSefription 96T di C3AgitSit %619 MesRage
Corrections /Comments /Instructions:
Rz/i/mt,7 Z44-a ...--rL 3 2- 77 5/
_. / _ i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector Date: Phone #: (503) 718- \G.