Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00345
���I DATE ISSUED: 7/26/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 104 D D -02 700
SITE ADDRESS: 12859 SW RIDGEFIELD LN ZONING: R -4.5
SUBDIVISION: MOUNTAIN HIGHLANDS NO. 2 LOT: 024 JURISDICTION: TIG
Project Description: Installation of 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:
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
JASON MOCK Description Date Amount
12859 SW RIDGEFIELD LN
TIGARD, OR 97223 [TAX] 8% State Surcha 7/26/200E $5.80
[MECH] Permit Fee 7/26/200E $72.50
Total $78.30
Phone: 503- 799 -3675
Contractor:
A -1 AIR CONDITIONING CO INC
2038 NW ALOCLEK DR # 225
HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 645 -5900
FAX 503- 648 -9824
Reg #: LIC 62102
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 / �'D i o� Permittee Signature: -e Q \c), e
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.
-ROM :A -1 AIR FAX NO. :5032572607 Jul. 26 2006 07:37AM P1
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Mechanical Permit Application v 7 , 1 , i � i.,, > i i l,,t ; . i t > , i ■_a. � _,5 __ _ :,, ti
Received ive i
City of Tigard Receive ._ . I — i
13125 SW Flail Blvd„ Tigard, OR 97223 plait Seview •
Phone: 503.639.4171 Fax: 503.598.1960 \\J ® , „ , ; ; D g Other Permit-
Inspection Lint: 503.639.4175 fkeC 1,1..2't , i;'1 ( I3ffie RcaQylBy
Internet: www.ci.tigard.or.us Nom; lifilli32!!!!!111
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Demolition Pam fees' are baud on the value of the work
0 Ncw construct
Q _ Vtll 0 ` 1L• performed_ Indicate the vah>,e (rounded to the nearest dollar) of all
mechanical materials, equipmen overhead, .
and profit
W 4,,, ft '7, r 1 t n i ; vF ` : � C - >.. i ,,, ,, value: $ ■ ® I- and 2 - fam dwelling ❑ Commet•cilti mdushiel ❑ Accessory building
❑ Multi- family ❑Master builder ❑Other Far special information use checld st.
Description , 1 Qty. J Ea. L Total
Job site address 12859 SW Ridgefield La. Air conditioning or heat pump 1 ( raQaiirssite DltmaLowiaflplacement) 14,00 ili --
City/&atetZIP: Tigard, O.R 97223 Furnace 100,00013TO (duerx/veat6) 14.00
Suite/bldg./apt. no_ 1 Project [tame: Furnaoc 100,000+ BTU (duets/vents) 17.90
Gas heat pump 14.00
Cross street/ ons to job site: Duct work 14.00
FI tbunic hot wafer , - 14.00
- - Residential bailer (radiator or
drone) 14.00
Unit heaters (fuel - type, not electric),
in -wall induct, suspended, etc. 10.00
Stibdivi�tcm Flue/vent for any of above 10.00
Other. 10.00
Tax map/parcel no.: Other fuel appliances
. -. ' . a r f • $, i u ° i r r En , o-; - Water heater 10.00
W 1 .
Add-on Air Conditio Gas tf 10.00
� Floc vent for r water heater or gas
fireplace 10.00
10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
/ r Cltimruey/loced8wheat 10.00
o' '. 1. , " .. .1� . 10.00
Name: Jason Mock Environmental exhaust and ventilation _
Range hood/other kitchen
Addness: SW Ridgefield Le. cruiPincrd 10.00
City/State/ZIP: Tigard 97223 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooltts,
Phone: (503)799-3675 Fax: ( ) mild compartments, utility rooms) - 6.80
a ti ''a nr 1
r Athc%taw f ans 10.00
Business name Fuel phi
Contact name: owner 55.40 for first four 51.00 for each additional
Furnace, etc_
Address
Gas heat pump_
City /State/23P: Walvsuspeude d/intit heater
Fax:: ( ) Water heater
Phone ( ) Fireplace II
E-mail; Ran:
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I r' - Aw l a^ p��
A1 e.Wlw
usineas r A 1 Air conditioning r,4 Clothes deter (,ens)
li
Other.
Address: 2038 NW Aioclek Dr. #225 ',,,`[.;Y.,
r .
.n: �. ,.. .,. _ __: n. [ �,':,.-<,-, • „,� i.�l ., r. , ... , � f a a s:.v. roat
City/State/71P: Hillsboro, Or 97124 Subtotal /14 °-=
Minimum permit fee ($72.50) 7 Z. Si)
-
Phone: (503) 645 - 5900 Fax: (503) 257.2607 Plan review (25 %ofpermit fee)
CCB lic.: 62102 State surcharge (8% of permit fee)
J ,,r • TOTAL PERMIT FEE
J j � , T6ia permit applkatioe expaci if s permit is net obtmined within 180
Authorized signature: 9 jt days after it bas beet Accepted as complete.
Print name: Doug Landis Date: 7/26/06 * Fee methodology set by Tri- Coemty Badding Industry Service hoard
i:M&n76ratWeralicA IDGPermarWp•doo 11/05 440.4617T (ii/oz/C0t.t'w'.9)
RO,M 4 A -1 AIR FAX N0. :5032572607 Jul. 26 2006 07 : 38AM P2
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Job Address