Permit ' CITY of [ T N G ® i � MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00457
DATE ISSUED: 7/24/2007
; RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AA -91441
SITE ADDRESS: 10779 SW CANTERBURY LN 104 ZONING: R -12
SUBDIVISION: CANTERBURY CREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: MCCARNEY
Project Description: Install a/c unit.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TOM MCCARNEY Description Date Amount
10779 SW CANTERBURY #104
TIGARD, OR 97224 [MECH] Permit Fee 7124/20W $72.50
[TAX] 8% State Surcha 7124/20W $5.80
Total $78.30
Phone: 503- 692 -9298
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issue " = J . C
Z. Permittee Signature: �� �/� e�
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Call 503.639.4175 by 7:00 a.m. for inspections that business day. / '' /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jul 23 07 02:47p Oregon Heating & AlC 503- 537 -2172 p.l
Mechanical Permit Application FO of ICE USE ON Y
City of Tigard
Re
ceiv � 1 � ,
Ir
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r 13125 SW Hall Blvd., Tigard, OR 97223 - plan Review
Phone: 503.639.4171 Fax: 503.59$a960 Date,B r
Date /By: Other Permit: I
TIGARD; Inspection Line: 503.639.4175 Date Ready /By: ?a+is: H See Page 2 for
•' . - Internet: www.tigard or.gov Notified /81ethod: r /6, Supplemental Information
JAL X /
TYPE OF V('ORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction El Addition /aItiration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor. overhead, and profit.
Value: $
• CATEGORY OF CONSTRUCTION -
' ' RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: I 0 S� . [ �� b � `Q4 Air conditioning or heat pump
�/ (requires site plan showing placement) , 14.00 y. Ofj
City/State /ZIP: T i( ' Irt � (TT aa� Furnace 100.000 BTU (ducts:vents) 14.00
` � 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: 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
Subdivision: Lot no.: Flue /vent for any of above 10.00 _ •
Other: 10.00
Tax map /parcel no.: Other fuel appliances
10
r 1
• DESCRIPTION. Wate rheate . 00
Gas fireplace 10.00
HV AC- 'AS }Q,1 P( Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Woodipellet stove 10.00
Wood fireplace/insert 10.00
• PROPERTY.OWNER 0 TENANT Other. _ 10.00
Other 10.00
Name: ToYYI M cCarnee Environmental exhaust and ventilation
•
Address: 'O1"TC1 t W ` � . can re b 10�. Range hood/other kitchen
` (� equipment 10.00
City/State/ZIP: - v\ 97'��\) Clothes dryer exhaust 10.00
X 6 1 - ciac4 ( ) Sine pt exhaust (bathrooms, o
Phone: Fax: toilet t compartments, arttnentrtments, utili rooms) 6.80
• ® APPLICANT ❑ CONTACT PERSON • Attic /crawlspace fans 10.00
Other. 10.00
Business name: Oregon Beating & A/C Fuel piping
Contact name: .R l $5.40 for first four: S1.00 for each additional
Furnace, etc.
Address: PO BOX 297
Gas heat pump .
City/State /ZIP: Dundee OR 97115 • Wall /suspended /unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater
Fireplace
E -mail: Range
CONTRACTOR RACTOR Barbecue
Business name: Oregon Heating & A/C Clothes dryer (eat)
Other.
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City/State/ZIP: Dundee OR 97115 Subtotal
Minimum permit fee ($72.50) '.
Phone: (503) 538 -2953 Fax: (503) 537 -2172
Plan review (25% of permit fee)
CCB lic.: 172126 State surcharge (8% of permit fee) 5.80
TOTAL PERMIT FEE 78130
t This permit application expires if a permit is not obtained within 180
Authorized signature: o days after it has been accepted as complete.
Print name: � � Nbee- I Date: 7.. r07 • Fee tnet odology set by Tri- County Building Industry Service Board
1:\ Building 'Femits\�7EC- PermitApp.dx 04 4404617T(It;02•CONVWEB)
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