Permit �w
CITY OF TIGARD
In. DEVELOPMENT SERVICES MECHANICAL PERMIT PERMIT #: MEC2005 -00535
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/30/2005
PARCEL: 2S102CA -00921
SITE ADDRESS: 13235 SW VILLAGE GLENN DR ZONING: R -4.5
SUBDIVISION: VILLAGE GLENN LOT: 021 JURISDICTION: TIG
Project Description: A/C installation.
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:
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
SCOTT TEPEDINO Description Date Amount
13235 SW VILLAGE GLENN CIR
TIGARD, OR 97223 [MECH] Permit Fee 8/30/200E $72.50
[TAX] 8% State Surcha 8/30/200E $5.80
Total $78.30
Phone: 503- 639 -0591
Contractor:
KENTEC HEATING CONTRACTOR
PO BOX 233
WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS
Phone: 503- 982 -6082
Reg #: LIC 63621
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: , SZ Permittee Signature: et
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.
, Mechanical Permit AnplicaAm
m F OR OFFICE USE ONLY
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City of Tigard ,i.
ate/By.
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13125 SW Hall Blvd., Tigard, OR 97223 - Plan Review
Phone: 503.639.4171 Fax 503.598.1960 lop : 0 IS - 7: — 4 W flt Date/By: Other Permit:
Inspection Line: 503.639.4175 4tIk ' " N W; .q.1( Date Ready/By: grill . See Page 2 for
-.....
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
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0 New construction xi 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
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
0 ,1%;*Itt::OP:t6tOttitjettiMiv:::::::::::::::::::::::::: - ..::::: , :::::::::::.::::.:....- - ,.: , , , , , ::::::::::::::::::: , :: -,
-04,1144:10V44011044$8,t0iigAtS:x:':'
. P 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building ......................................... ........... __..._. ...................................... ..........
. .. .,
.................................. . ..... ..............._........ ..........................
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description Qty. I Ea Total
::::::::::::::::i::::::::::::ii:::::::::::::::::'•::'::: Heating/cooling
Air conditioning or heat pump
Job site address: 13?3s 54) V ;lisle C . k,r3 (,--7 (requires site plan showing placement) / 14.00
City/State/ZIP: 7; i 4 ex g 7 22 3 Furnace 100,000 BTU (ducts/vents) 14.00
/ Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: 7y elf:-., //C 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.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
.......- ..............................................
:= Water heater 10.00
............................................................„......................................... ..........................................................:...::.„-..„...„.....,.....„,...„,...„:„...„....,...,..,.......:......„.....,..,....... ..„:.„,...,.,.:..
Gas fireplace 10.00
Flue vent for water heater or gas
kill Al c_ Fl
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert . 10.00
. .l :: , :.: „. i -,.,:;: i: :: ? :- Chimney/liner/flue/vent 10.00
.:*;.m.r..,J;Ipm■ i:;:;:;:;;;:ii.:iii:::::
Other: 10.00
Name: See 7 1/ r ,,, a Environmental exhaust and ventilation
Range hood/other kitchen
Address:
5 a/i/n-,t equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( Sb3 ) 631-os-1 Fax: ( ) toilet compartments, utility rooms) 6.80
Attic/crawlspace fans 10.00
Ma'r':: 1 ..
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail:
. . Range
............ ,..... . ... „. „...... . . . .. .. .... „.. „............... . . . .. .. ... ........ . ...... .
................................................. ..... . . .. .. . ..................................................... ...............................
. Barbecue
Clothes dryer (gas)
Business name: ir e...p , l t e c If ea / ,i,„,,
Other:
Address: fl deX c123 . . .„.„,..„.. . ....... ... . . ,. . ... . ...... , . ...... „ ...
563 11:04......004
City/State/ZIP: i re7 6 7 ?'/ Subtotal /4 0 0
Minimum permit fee ($72.50)
Phone: ( 2 ) Y% 2 -5 7 Fax: ( 523) 7 r ) ..-e) gq
Plan review (25% of pennit fee)
CCB lie.: 6 3 ( .)-1 State surcharge (8% of permit fee)
d
, e_56_,,,- w TOTAL PERMIT FEE 7 ,. 3
Authorized signature: 6
This permit application expires if a permit is not obtained i in 180
days after it has been accepted as complete.
I Print name: i Date: I * Fee methodology set by Tri-County Building Industry Service Board
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CITY OF TIGARD
,BUILDING DIVISION r, . PERMIT #: MEC2005 -00535
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2005
Phone: (503) 639 -4171 j
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' °- L.
INSPECTION WORKSHEET FOR DATE: 9/6/7005 TIME: 7:06AM PAGE: Q6
6, 'pewit /1 ; F Zc-\1I' 1
SITE ADDRESS: 13235 SW VILLAGE GL NN DR CLASS OF WORK:
SUBDIVISION: VILLAGE GLENN LOT #: 02.1 TYPE OF USE:
PROJECT NAME: TEPEDINO
DESCRIPTION: A/C installation.
OWNER: TEPEDINO, SCOTT PHONE #: 503-639 -0591
CONTRACTOR: KENTEC HEATING CONTRACTOR PHONE #: 503.982 -6082
Inspection Request Scheduled For: Date: 9/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 014958 -01 503 - 710.0365 N
Corrections Comments /Instructions:
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M,N K. 2.-4�� y fi z 1-
Ii PASS pg ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL C FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4,. Inspector: row Date: � S Phone #: (503) 718 -