Permit Alb CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2005 -00206
DEVELOPMENT SERVICES DATE ISSUED: 5/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 04 DA -09500
SITE ADDRESS: 13195 SW RAPTOR PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - WEST LOT: 081 JURISDICTION: TIG
Project Description: Installation of A/C unit.
CLASS OF WORK: O'R 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
PITSINGER, MARLEEN Description Date Amount
13195 SW RAPTOR CT
TIGARD, OR 97223 [MECH] Permit Fee 5/3/2005 $72.50
[TAX] 8% State Surcha 5/3/2005 $5.80
Total $78.30
Phone: 503 -521 -9539
Contractor:
THERMAL FLO
14865 SW 74TH AVE. #190
TIGARD, OR 97224 REQUIRED ITEMS AND REPORTS
Phone: 503- 670 -8383
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 By: / Permittee Signature:,
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.
05/02/2005 01:02 5036709064 PAGE 02
Mechanical Permit Application rt)11 OH- I,tir. ONLY Received
pity of Tigalyd r 1 v �' r
v ew 3 Q S" " i 1 i ,
13I25 SW Hall B1vd., Tigart, OR 972 "' G Date/By: Phone: 503.639.4171 Fax: 503.598.1 v
` ('::• DetelBY: Other permit:
Inspection Uric: 503.639.4175 11 . _e t i, • _i I �
�Ql � Dete Ready/By; Bf See Page 2 for
Internet: ww'•t',ci.tigard_or.us 2 L NotiSed/Method: Supplementallnformatloe
1 ,B D
•f t; .1 ,„Temt 7.17"T rf )7.7.7 -, 14V T,T ' R "_.7 t. - td` , 11r� f , ..-r n r.;'y
..X : 7Jh o •- . .1" ;� • , • r „r f J,. ,, L' ,. Qif ' 'r a I f i n 'Trvr ^c[TTo - , . Y f /fr , nI
,7. ` ; =ft� -/ � : . + 11..•1{17 - �t_ rt I'f t tf ^.. 1�jt 2, t j l - ,.,1 1 1 ,,,I.,%,...,... r '22 •rt :ZP)'7;:).' t f l f iii 1��'� : , L s .. �: ( §I tL
4 4 ?,, ) �f l. k k ' n 71 .r lr° t t, �
{ n 7� r, ?'4,7:',:,,,!;,.:(11.,L,;!", �� t :V t h, � ,i t 1 a I � � .�
... .. a t: � Se.• s: ;:.1 .�Z.,J � ., u f,. k ,1 r,J „�l i� L.t L liti��-dlY��' r. �.: H:_. s d . zdi I ,su�i't�k•na �aR.v °`.^• ;. ;
❑ New consmiction Add � ation/replacement Mech permit fees* are based on the value of the work
performed. Indicate the value (rounded to the neatest dollar) fe all
❑ Demolition Other: _ mechanical materials, equipment, labor, overhead, and profit.
)-4''''''' - / ` t rrce i� 1 r�r - f. 1 s ' !'' T'! r . 5i r 6 y" - , ,,F, ; 77 ip. 7,1z r,,:
,. 1A � P •'1 .1i 4 lr. { 1 ,. .1 4 Y S, li f t 47 Y X17 1 1 y� 1
� .fi �:I i l u it i t ? ' r � � D,li;�7+, t ' *l �/ i� 1 1,� � Value: ! , ` „, . ,v:_.r,16'17rn,i:,,lri : y7. "t .;t:.,_� �. o.i: t� T M. 1 r h „u:lw.:.,.a_:tu_m,�..l mr 4 f1 l: f { 1 full 1 •*11t fiat t 1 71f41u7r 97f L. Il ) �i t l I ti1 1 1 ii.,: % I tl .I J.7.i7 �
�1 -and 2- family dwelling ❑ Commercial/industrial ❑Accessory building
I. r (4 1! p. :?PS:..,u _r:i. :,x,_..... rrex ,L' r.Y', {w. ,{tr - .. . .:i
For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: I
Description Qty. f Ea. I Total
` •N •,'M 7: , e l l 1,
{ ' :17 1fl 7i1 ' 1 , t! l7 1 1fi l { I f(v h v v7 7 f V( fs i g .Y`J�I II
N - ,i, , ,i.t. 1i, X165,: f. 2r7%1.,.10. 3...u>.t.4 0 0,. -1 . .t.. .•: -).t ,1 ' '' . 15 .•` f a r :Vb,t. :1 :Ltrr! +t'.' ' ?' 1,1 :�G1•L s`R;7 Hesting / -
Job site address: / ► - 94./ I ... /� Air co nditioning orheat p r 14.00 ��
( site Olen ehowina alact:mentl f
City/state/ZIP: t / m j ... Furnace 100,000 BTU (ducts/vents) 14.00
Sul tr./bldg./apt. no.: Project name: C 2 Furnace 100,000+ BTU (ducts /vents) 17.90
V c 3� 1,--'
Gas heat pump 14.00 _
Cross street/directions to job site: Duct work _ 14.00
Hydrvnic hot water system 14.00
- - - Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, auspeoded,etc. 10.00
Subdivision: I Lot Flue/vent for any of above 10.00
l Other. f 10.00
Tax map/pareel no.: Other fuel appliances
"` r r l
�n'�`�1I1 b l "r l r I 1II �r] tl l !17 Li l Water heater 10.00 • . : , :!,a,aw�iula ?, 7. ...Ga„. ,,.nt,; r •., ,,... ,dL�d;, nlll � .., 1 . d1�F ,.., ',.. � ., n il1 T., '
£ 1t rAti/ /�! (l l
Pte vent water heater or gas 10.00
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10,00
Wood fiplece%uasert • 10.00 __.
EW l �i� ` tl' yep 1 i t¢ I I r, 11 n n' I )I P t7 , r { t ncy/lined9ua/vcat 10.00
Jt'11 :1'� :Lfin. {t.f,.. ._..,iF.':. .,,7at , ,t f, 1i 1.!,, .',.,'y al r l
., b :1 :, :f�..! other. 10.00
Name: i . • .- Pit" ( 1 , Environmental exhaust and ventilation
Address: l it? • S (A/ ',ORE,- Range hood/other kitchen •
/ r- -�' equivalent 10.00
City /State/VP: 7 ? p -- q 7,v_ 3 clothes dryer exhaust 10.00 -
Phoac: (5�3) 5Al 6 - Q'�3 ` Fax: Single-duct exhaust (bathrooms,
gy�pp• '11f!s1F�"^T,.,;,.,;� . ... ... ' �
N1 17 t :. _it., .
, . :)�• ^ \ �,... �,.'�•,. �� ':F :�. . :.1 l'211.!., .I " : I •I - .Ir : - ' '. f ',..;..'):.!•:.;::,. :" 'Ir %' 4 ..
_ c07�aL77GanGS ltd rooms) .
,�.a tu,77 z ±. Ir ,, L, ; `,; � � Attic/ctawlsatcefans 10.00
Business naln _ 10.00 •
Fuel piping
Contact name: a i� ' '� - $ 5. 4 0 for first four; $1.00 for each_addidottal
Address: / Y. S () 7ii AO l R o Furnace, etc.
• City/State 1ZIP: , Gas heat pump
�1 `'r O t ct 7 .2. 4 / Wewauapmdedhrni heater -
Phone: ( 3) D - S'.3 2 Pax:: Sp 3) 4) ,_ • 4ce 4 Water beater
E-mail: 1 4 Fringe
"'t` a,t+ %) >n e•A...)..,,, :rV�,,,,1 ,, ,I v 1.,, .. ri, Tr .. T. , j : ;:; : , -, 1. }rftl., ... ., `.i1 Zi e
Business name: --/-. 624, lit Piz) h G . Clothes dryer (gas)
Address: e4 e�i Skl I it i >r ! ,
�+ .}� kV L c W� •, Jr i °1 { !, 1 Ii -;7,•,,- � t. 1 . } 1 y l r
l. l'lsik : , .
C ity /StatdZIP: l „x......I:• �5 ;.14. (1 ,1 .,_..,. � ,.. n,. i ; t - .,,..... ‘ { �‘
Phone: (5 3) 67 20 - ' 3 e.f . :3 [Fax: (6O�) f lb - 106g q Minitwm permit fee (572.50) 7 t nr.,
Plan review (25% of permit fee)
CCB lic.: I t , I ii 7
State surcharge (8% of ermit fee) ,5 ,. vt...)
K � i / J e - L, L,,,�E,I I � TOTAL PERK
Authorized ssignature: ', Ttds permit Application expires LF a permit ie not obtained withle 180
P n m days after it has been accepted as complete,
name: e .
/y <f y,ge,1 I Date: • Foe methodology act by Tri- County Builditt;t lnduatry Service Board
IAst. ld;ngtrems,a C- peneitmmeee 12103 44446I7r (11/o2/Cowwae)
. !2' .
•
)
in ..---t.........—..-"ait - ._ .
1.____EH. ---
N
N
m
cri
m
m
N
in
m
w
i . .
0n
v
m
U7
m
Q7
A
ia{ul
•
4 ,S.1 --a +�a� a���
anogav
1 5',I - )1) a • m
f a ') ua ?U11 m
w
4..
1 P 7u 4 . •h. 6A
CITY OF TIGAFRD
BUILDING DIVISION PERMIT #: MEC2005-00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005
Phone: (503) 639 -4171 /o.di
Inspection Requests (24 Hrs.): (503) 639 -4175 M- `__—
INSPECTION WORKSHEET FOR DATE: 5/23/2005 TIME: 7 :08AM PAGE: 115
SITE ADDRESS: 13195 SW RAPTOR PL CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW - WEST LOT #: 081 TYPE OF USE:
PROJECT NAME: PITSINGER
DESCRIPTION: Installation of A/C unit.
OWNER: PITSINGER, M ARLEEN. PHONE #: 503.521 -9539
CONTRACTOR: THERMAL FLO PHONE #: 503-670-8383
Inspection Request Scheduled For: Date: 5/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007417 -01 503-670-8343 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 7g. Date: S 2-3 - -e5 Phone #: (503) 718-