Permit (' i
A ■
CITY TIGARD MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2005 -00357
" �� II DATE ISSUED: 6/20/2005
13125 SW Hall Blvd., T igard, OR 97223 503 - 639 -4171
PARCEL: 1 S125DB -09200
SITE ADDRESS: 07070 SW SHADY LN ZONING: R -4.5
SUBDIVISION: THE RAZBERRY PATCH LOT: 012 JURISDICTION: TIG
Project Description: AC install.
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:
ELE 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
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DAVE WEIDNER Description Date Amount
7070 SW SHADY LN . [MECH] Permit Fee 6/20/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 6/20/200f $5.80
Phone: 503 452 - 8992 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 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: �e.::, Permittee Signature: (f'7Y1 4."_„„' CSC,
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.
J/it" 16 v5 02: 39p 503 - 537 -2172 p. 2
is 6
Mechanical Permit Appli • FOR OFFICE USE ONLY
cit f Tigard Received Pertnit
t y g DateB 1 ' o / a 4 / 0 . 7 ." 5 � a ‘ 0 0 5 - 7
13125 SW Hall Blvd., Tigard O 'RECEIVED Alk A Pl a n Review Phone: 503.639.4171 Fax: 503 l re rs.:; A DateBy: Other Permit
Inspection Line: 503.639.417 �� Date Ready /By: is: El See Page 2 for
Internet: www.ci.tigard.or.us w ... NotifiedfMcthod: ��(,h Supplemental Information
i' 1 E 2005
,t,_
...:.. ....:.. .:�,:. r`_ , , :- FEE *':. US C H CI Q.IST::
....:..:.:...... ' ..:::.... ,, ��1�. I ',"'� .•. :.. _ :.. ..
. _ ...,:::,:,.. . ..::.�.••, :::. .. of the work
a 'A f��9 Mechanical permit fees" are based on the value o
El New construction `tyyv�y ltcxaC acement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
.. ..,.>:_:•,:, .: , :' <<;CATEGOIta::OF ?CONS' RUCTION;,`.:',..::;;! �::,:ri;: ,.:.':,- ° ::'�' ;r :
� IIESIDENTIAL EQII1 P 1 S'YST'EMS F EES* • • `
1- and 2- family dwelling ❑ C ommercial /industrial ❑ Accessory b uilding
Far special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
, i : . , . " '` • : iJOB ;S : 'INFORMATION :. AN D; :T OCATIOR'` : " " . ::'.:i :: ,`. ::' :': ,-::':: +.' Heatin
v Air conditioning or heat pump
lob site address: / L / J�L,,,0 4A ('Y ` (requires site plan showing placement) i 14.00
City/State/ZIP: r vrj 0 -77-7,3 Furnace 100.000 BTU (ducts /vents) ( 14.00
Furnace 100,000+ BTU (ducis'vents) 17.90
Suite/bldg. /apt, no.: I Project name: 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
Flue/vent for any of above 10.00
Subdivision Lot no.: 10.00
Other. 1
Tax map /parcel no.: Other fuel appliances
.,• . ;: ,....., _: :::: P: i;.'i:''.',;. ` Water heater
(� . Gas lace
(Al r 61--G ( � C'et t✓t Flue vent for water heater or gas
fJ p r fireplace 10.00
) i'. V •`�Lvrtg- r W1/ fide• -• r h '1 0/l1► Log lighter (gas) 10.00
OA IL Wood/pellet stove 10.00
Wood f replace/insert 10.00
-, , , i ;.: � ::...: , ,,,., _.. _: iner /flue/vent
1000
s:r .;
.. . . . ..:... O :ERT.Y_. 1.Ftf ..,...''' ...
P .... '`
_..,. ...... ........ ..... .. .... .:. ..... .. ........ _ ... . .
;:;:. : ; ; � ;: a :ri�i :, '
• Other. 10.00
Name: r Environmental exhaust and ventilation ,LI
Address: [ 07 c 0 1 _0_ vV ` p e hood.'other kitchen
equipment 10.00
City /State /ZIP: ‘,..5'I� CI '. Clothes dryer exhaust 10.00
r 7� Single -duct exhaust (bathrooms,
Phone: tr � f 5 , ., ' q C Z Fax : ( ) toilet compartments, utility moms) 6.80
.. : = -: ; .: i ,.. C7. CO..: . . Attic /crawl fans 10.00 • , .: N T�I.CT .
/'_ - FER$O N :, ; .
Business name ��r e Ct J Other.
,, Othe piping 10.00
Contact name: L) '1 1/) �1 $5.40 for first four; $1.00 for each additional e, 6 , Furnace, etc.
Address: n �� Gas heat pump
City /State /ZIP: 0 v D I� I I S— Wall/suspended /unit heater
Phone�(& 4
3) s C Fax: ) 5 3 Z j r2- Water heater
Vr Fireplace
E- mail:
:t e
C N�'R:�CI OR ;': ,. : ` ..i `'.. , Barbecue
les dryer (gas)
Business name: l,�/� / / ,
r .
Address: 1 Z Q :::: MECHANICL.PERi ffr FEES - ° s . `.i .. ::' ■ - A
City/State/ZIP: 11 (Y! C � ji I (..\, - Subtotal ,5
t
Phone: d �,jc I Fax � 63'� 2,17 Plan (25 % of permit fe tit fee ($72.5 ) e) .„
v � �� Plan re (25e 4- �j
CCB lie.: t �� State surcharge (8% of permit fee) J, D b
/ � , U fi TOTAL PERMIT FEE Authorized snature: i J ()) ln b /(I /1 yi _ `// /�, — `Phis permit application ex a m noi ll D ( t 1 brim__ t ri v�� "' `� days after it bu pires if been acce it is as comt obtapletned within 180
e.
■
Print name: ( n.11, ]..) "►'C�'iJ 6l" Dat . . Fee methodology set by Tri -County Building Industry Service Board
iKBuitdine 'd.crmits\MEC- Peroiran°.doe 17/05 440 -4617T (11102'COM/WEB)
Jun 1641o5 02:39p 503- 537 -2172 p.3
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Site plan far : O Je- :: <
back
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CITY OF TIGARD
BUILDING DIVISI PERMIT #: MEC2006-00357
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2005
Phone: (503) 639 -4171 iii, Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/212005 TIME: 7:03AM PAGE: 72
SITE ADDRESS: 07070 SW SHADY LN CLASS OF WORK:
SUBDIVISION: THE RAZBERRY PATCH LOT #: 012 TYPE OF USE:
PROJECT NAME: WEIDNER
DESCRIPTION: AC install. i f=., ae n/4-c.
OWNER: WEIDNER, DAVE PHONE #: 6034152 -8992
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503.538 -2953
Inspection Request Scheduled For: Date: 8/212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012579.01 503-538 -2963 Y All
Corrections/Comments/Instructions:
An , ay K. L P gY VP < Z.
1
,til PASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL II L FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
/
Inspector: _ Date: g . Phone #: (503) 718-