Permit C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00251
Ah.,,,, DEVELOPMENT SERVICES DATE ISSUED: MEC2006-00251
,�- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA - 05600
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 033 JURISDICTION: TIG
Project Description: AC install
CLASS OF WORK: ACS 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm: .
Owner: FEES
IOANA CHRISTUREAN Description Date Amount
12785 SW SUMMIT RIDGE ST.
TIGARD, OR 97224 [MECH] Permit Fee 6/1/2006 $72.50
[TAX] 8% State Surcha 6/1/2006 $5.80
Total $78.30
Phone: 503- 866 -7030
Contractor:
• PACIFIC NW HEATING & COOLING .
16609 NE 80TH ST.
VANCOUVER, WA 98682 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 793 -0807
FAX 360 - 828 -9157
Reg #: LIC 150253
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 • the project.
Approved plans are required on the job site at the time of each inspection.
l
M 2. echanical Permit ApplicatL t . c II- FOR OFFICE USE ONLY
Received
City of Tigard Permi No.:
q 13125 SW Hall Blvd., Tigard, OR 97223 Date/By. 62 /, ab g8 M6c�aob
o • Phone: 503.639.4171 Fax: 503.598.1960 Date/By. 2006 Plan Review Other Permit: Date/By.
TI G A R D Inspection Line: 503.639.4175 �� OF �vl�► Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov yy-�� OF Notified/Method: � Supplemental Information
rite mil Tx, 1Ttt TO'N
TYPE OF WOR COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition/alteration/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 Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2-family g ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
1
� ( Air conditioning or heat /23 /5 /C/J r Job site address: � �� � r regai es site plan showing P place m ) / 14.00
v ' '-
City / State/ZIP. ', C_ T— O R Q 22/7 • • i /; I' J ' %„; ,,/ ace 0 TU ( ducts/vents) 14.00
ll Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street /directions to job site: .' Q � , �/�, Duct work 14.00
.,(� r 14.00
r r i `e\ f 7 0 40 a E i Ave Residential Hydronic hot boiler wate (radiator system or
f r n r j , 4 J q e , J_ , 7- hydronic) 14.00
7U "7-L( g Unit heaters (fuel -type, not electric),
� �( P1 T 1 t 7D e" ../7 - / in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
C I - J 1 Gas fireplace 10.00
1n % �' �, 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
Chimney /liner /flue/vent 10.00
PROPERTY OWNER I ❑TENANT Other: 10.00
Name: / 0 4 j s. j A. (S f ) t A kr Environmental exhaust and ventilation
Address: 1 2 7 4.) a W 5u p/1 t/1 I j p ' o- sr Range hood/other kitchen
equipment 10.00
City /State/ZIP: 776)9- / 7 " log q 72 2 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (: $ 7 p 7030 Fax: ( ) toilet compartments, utility rooms) 6.80
�� x APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: /� t fle 6t all Co l l r„ Fuel piping
10.00
Busin
T Cf rag d � I / "J Fuel
Contact name: /'u / Ch er $5.40 for first four; $1.00 for each additional
Address: /6C 0 7 au- y ! yi-- Furnace, etc.
�r � vvv ifQ /__ Gas heat pump
City / State/ZIP: V/jl% Cn(t of / ui W �� WalUsuspended/unitheater •
Phone: ( 7q,3 02 07 -. Fax : : : (, ) .2,, - q i' 1 Water heater
- Fireplace
E -mail: Sct 44, fC (✓
I,,,, , c, Range
C NTRACTOR Barbecue •
Business name: j Q-M C A- R.4. � t JT Clothes dryer (gas)
J �� Other:
Address: MECHANICAL PERMIT FEES*
City / State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax:( )
/ Plan review (25% of permit fee)
CCB lie.: 15-0 . - 0 . � State surcharge (8% of permit fee) �
� �5 p TOTAL PERMIT FEE 2
Authorized signature: , This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: / I G 4 (G ®/e I Date: 64/1/0/6 * Fee methodology set by Tri- County Building Industry Service Board .
1:\ Building \Permits \MEC- PennitApp.doc 04/06/06 1 I /02/COM/WEB)
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits\MEC- PermitApp.doc 12/30/05 2
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CITY OF TIGARD .._
BUILDING DIVISION PERMIT #: MEC200G -00261
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1/2006
Phone: (503) 639 -4171 ' I 4`
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 6/2/2006 TIME: . 7 . 08AM PAGE: 66
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE OT #: 033 TYPE OF USE:
PROJECT NAME: IOANA CHRIS"TUREAN
DESCRIPTION: AC install
OWNER: CHRISTUREAN, IDANA PHONE #: 503.8(.6.7030
CONTRACTOR: PACIFIC NW HEATING & COOLING PHONE #: 603.1t33.0t3r11
Inspection Request Scheduled For: Date: 612/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 030972 -01 503 - 193-0607 N
Corrections/Comments/Instructions:
C.,-1 ri/MaA
X( PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date: 6 Z to. Phone #: (503) 718- 270