Permit CITY TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00273
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/2/2008
PARCEL: 1S125DD-08500
SITE ADDRESS: 09720 SW VENTURA CT ZONING: R-4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT: 093 JURISDICTION: TIG
PROJECT: COUNTRYMAN
Project Description: Installing NC.
CLASS OF WORK: ALT 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
DERAL & KARLENE COUNTRYMAN Description Date Amount
9720 SW VENTURA CT
TIGARD, OR 97223 [MECH] Permit Fee 6/2/2008 $72.50
[TAX] 12% State Surch 6/2/2008 $8.70
Total $81.20
Phone: 503- 245 -9225
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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.
_ r
Issued By: / fi Permittee Signature: ' a?
Call 5' ' . 175 by 7:00 a.m. for inspections that busin ss 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.
JUN -2 -2008 08:43A FROM: TO:5035981960 P.1
Mechanical Permit Application - FOR OFFICE USE ONL1 ' s .
City of Tigard V Received
rhilIII q 13125 SW Hall Blvd , Tigard, O 2 Q O� Date/By. n Rview I / I �^it No ,) O ?
r'h Phone: 503 639 4171 Fax 50 Ki Dte/13 Other Permit l
T I G A R I) Inspection Line 503.639 4175 1 �, ® ill t - a y:
ate Ready/L)y trrr See Page 2 for
Internet: www tigard- or.gov �e_ alt
Notified/Method. Cp Supplemental Information
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TYPO OF WO COMMERCIAL FEE* SCHEDULE - USE CHECIQ tST
❑ New construction Addition /alterali 7 acemen[ Mechanical permit fees* are based on the value of the work
'�'l
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
I. and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 8720 ow YerttM u_ Cou Air conditioning or heat pump
(requires site plan showing placement) 1 14 00
C j, City /State /ZIP. Na gi 2 rf 5 Furnace 100,000 BTU (ducts/vents) 14.00
r^ '" �� Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: "',' Q� 7 � rntVwl Gas heat pump _ 14.00
Cross street/directions to job site: Duct work 10.00
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. 14 00
Subdivision: Lot no.: Flue /vent for any of above 6.80
— -- - - -- - -- _ Other: 1000
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
WILL 1 I Cur C(rldiri 0 I fireplace 10.00
Log lighter (gas) 10,00
Wood /pellet stove 10.00
Wood fireplace /insert 10 00
A PROPERTY OWNER 1 ❑ TENANT Chimney /liner /flue /vent 1000
Cbtrymaun
Other 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address. PAM() equipment 10.00
City /State /ZIP. Clothes dryer exhaust 10 00
Q ��� Single -duct exhaust (bathrooms,
Phone. "Irk- rl Fax: ( ) toilet compartments, utility rooms) 6 80
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10 nn
Business name. Other 10.00
Fuel piping
Contact name: IlW t, MOOCH $5.40 for first four; 51.00 for each additional
Address' Furnace, etc.
Gas heat pump
City/State/ZIP. Wall /suspended/unit heater
Phone: ( ) F :: ( ) Water heater
E-mail. Range
Range
CONTRACTOR Barbecue
Business name:Trl GG//'�� (� • rjmo5 ( vi-T {)l� ) Clothes dryer (gas)
I :J t50 V f 1�L v 1 � u � Other
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Or eg`^ ' Odd -4 5 04 Subtotal •
505 ] � '"� Minimum permit fee ($72 50)„ 51
Phone: ( 557 Fax: ( ! oa Plan review (25% of permit fee)
CCB tic.: 12.42 State surcharge (12% of permit fee) te � 7j y�Ji
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Authorized signature: 2;2 TOTAL PERMIT FEE • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete,
Print name: al ', �Y, Date: , nrj � • Fee methodology set by Tn -County Building Industry Service Board
I Vtuddmg4Permots.MEC•PeermttApp doe 01/19/07 440.46i7T (11 /02/COM/WER)
JUN -2 -2008 08:43A FROM: 70:5035981960 P.2
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CITY .OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00273
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6,/212008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' IL.
INSPECTION WORKSHEET FOR DATE: 6/1012008 TIME: 7 :01AM PAGE: 27
SITE ADDRESS: 09720 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SOUARE ESTATES NO LOT #: 09.E TYPE OF USE:
PROJECT NAME: COUNTRYMAN
DESCRIPTION: Installing NC.
OWNER: COUNTRYMAN, DERAL & KARLENE PHONE #: 503
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 557 - 2220
Inspection Request Scheduled For: Date: 6/10/2008 Pour Time:
Code # Inspection Description ' Confirm # Contact # Message
699 Mechanical final 071153-01 503.557 -2220 Y
Corrections /Comments/ Instructions:
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❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ei Phone #: (503) 718-