Permit CITY O F TIGARD
MECHANICAL PERMIT
i�► DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00228
J �I DATE ISSUED: 5/23/2006
- " 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CD -12500
SITE ADDRESS: 16050 SW 77TH TERR ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 023 JURISDICTION: TIG
Project Description: Install heat pump, replace furnace
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
DENA SINGER Description Date Amount
16050 SW 77TH TERR
TIGARD, OR 97224 [MECH] Permit Fee 5/23/200€ $72.50
[TAX] 8% State Surcha 5/23/200€ $5.80
Total $78.30
Phone: 503 -515 -8787
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 235 -0454
PRI 503- 235 -9083
Reg #: LIC 50244
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: ��7- V �� Permittee Signature: � � J � ✓ � ,, - ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busine s d. y.
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.
05/23/2006 09:50 5032,350,4 4-- SKY HEATING PAGE 02
Mechanical Perm Apo U 1 3, h wi '
-.4k City O Tigard Received ' , ,: 1(112:x( 1 I i ( I '' I ' I ' () \ 111 �",-4 "' r j'
13125 SW Han Blvd.. Tigard, OR 97223 MAY 23 2006 °"'Y Permit ' - 0 -D o 2 Z
Phone: 503.639.4171 Fax: 503.598.1.960 pion Review
Inspection Line: 503.6+39.4175 Other Permit
Y H x ' -ir _ 1 1u -- Date Ru
Internet: www.ci.tigard.or.uS ur i _ (J_ i 1 , - hod J am; /+ 8! V 2 fir
Notificd/Metllod: -! f E3� Supplemental larerroAt
Rif TIT DING ; a NTON
TYPE OF W+tit
ot,t;1?t sntru tlsE:+tcUsr
❑ New constructim► ® Addition /alteration /replaeenlent Mechanical permit free are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition El Other:
mechanical materials, equipment. labor, overhead, And profit
CATEGORY OP CONS tiCIION - Value: $
El 1 - and 2- family dwelling ❑ Commercial/induslrial C] Accessory building RES/DlcN' 4I. Er' Lf F N. /SYSTE MIS) S*
❑ Multi- family [] Master builder ❑ Other
For special information use checklist.
Des cription I Qty. I Fit, ] Total
JOB SITE INFORMAT'!ON .ortt :LOCATION Fleatiup/cooling
Job site address: 16050 SW 77" TEREACE Air conditioning or heat pump
(requires site Plan showing placement) 1 14.00 i T
City /State/ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ductdvent L 14 Y
SuitclbldgJapt no.: Project name: Furnace 100,000+ BTU (ducl-Oveela) 17.90
Gas heaump 14.00
Cross strcet/directions to job site: Duct work
14.00
Hydronic hot water systcm 14.00
. Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel - type. not electric).
in-waII, in -duct, suspended, etc, 10.00
Subdivision: J Lot no„ Flue/vent for any of above 10,00
Other. 1000
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OB;WOW( Water heater 10,00
INSTALL HEAT PUMP, REPLACE, FURNACE Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10,00
r I oar 10.00
Wood /pellet stove 10.00
Wood futplacc/inscrt 10.00
fa PRO>PERT'Tt' bVti'NER. 1 G] TENANT
Cmm '/liner /flue/vcnt 10.00
Name: DENA SINGER OGhcr 1 0.00
Environmental exhaust and ventilation
Address: Range hood/other kitchen
shipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Phone: (503),415 -8787 Fax: ( } Single -duct exhaust (bathrooms,
toilet compartments, utility moms} 6.80
® 'APPLICANT brovrAcr lv AttiGerawlspacc fans 10.00
Businm name: SEE BELOW Other 10.00
1 Bel piping
Contact name:
$S.40 for first four; 51.00 for each additional
Address: Furnace, etc,
City/Statc/ZIP:
Gas heat pump
WalVsuspcndedlunit heater
Phone: ( ) Fax :: ( ) Water heater
E -mail: Fireplace
Range
CON'TltA.CrOR Barbecue
Business name: SKY HEATING & AC Clothes dryer (gas)
Address : 1635 SE NEHALEM er
hiEdIANitAL PERMIT VEEP
City/State/ZIP: PORTLAND OR 97202
Subtotal . S.•
Phone: (503) 2359083 I Fax: (503) 2350454 Minimum permit fcc ($72.50) 7 2, sa
Plan review (25% of permit fee)
CCB lie.: 50244
A - Stair surcharge (8% of permit fee) S•,ifD
TOTAL PERMIT FEE - 12. lob
Authorized signature:
perm epphcadon aspires if a permk is nut obtained within 180
days after It has been accepted as eeraptete.
1 Print name: JEAN LOP INZI rDatc: 5/23/06 • Fee methodology set by Tri•Cmmty Building Industry Service Board
is ailtdinswootthamrc -oorre App.dx 1 7)3 4404617T(11 /O2/COM,WEB)
05/23/2006 09:50 5032350454 SKY HEATING PAGE 03
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