Permit C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2005 -00299
I� I �I DEVELOPMENT Tigard, -639 -4171 DATE ISSUED: 6/6/2005 13125 PARCEL: 2S1 12 BA -09400
SITE ADDRESS: 14450 SW PENNYWORT TERR ZONING: R -12
SUBDIVISION: BONITA TOWNHOMES LOT: 030 JURISDICTION: TIG
Project Description: AC install.
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
VICKI BALLARD Description Date Amount
14450 SW BALLARD [MECH] Permit Fee 6/6/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 6/6/2005 $5.80
Phone: 503 624 - 0865 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 - 557 - 2220
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.
Issued By: ', f Permittee Signature: A 'T " L C —
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.
Jun 01 05 03: 51p Tr i County Temp 5035570919 p.1
,....,
' • •
. Permit Application ... .
FOR OFFICE USE ONLY
SW Ha
City of Tigard' . Received ,,,,,
,
Phone: 8. 466 Permit isloink 0(27,51.-e64:2_V
13125 ll Blvd., Tigard, OR •ria 3 c E I Allikt, Plan Review
503.639.4171 Fax: 503.5°, l!
Other Permit:
Inspection Line: 503.639.4175 V E Date/By: : ..„:„...„.,_,,,,,,, ,,,,
.,..- Oa 1. Date Ready/By:
Internet: w
Notified/method: jur — i Tup t
:Jr] 0 3 2005 1
,
yrEr`Cik,..Wopic '.: :; - '''':. '''''. ''.; "-'!'..:" -.:.:-' 1;-: :COtoitiectiit...ki.s6:iin.iirE.,-,-138E-CHECKLIST
1:3 New construction . A ' Alid l i T tic/n)tei l atkrt4/4AWment Mechanical permit fees* are based on the value of the work '
lition • : r■J 6.•1 INTG DIVISI01\1 . performed. Indicate the value (rounded to the nearest dollar) of all
o Demo
mechanical materials, equipment, labor. overhead, and profit. ,
0 , -,:.:.:.; ..i.:, ... ._. Value: $
..,
- X —
• . . .-_::--.**,$05004.E-1•
1 - and 2 dwelling p Commercialmidustrial 0 Accessory bullding E,4 1.01PMENT/BY.STEYIS•FEES
For special information use checklist.
0 Multi 0 Master builder 0 Other:
Description 1 Qty. 1 al. 1 Tocai
• • -.. .• -- • -,-- --,,-..- -• ,-".--,-- - • ..,-.- - • ,:- • , • •.- • .....:. ---• . ,, • - ---. - . • ., _.. .
...:7; 1NE:Oft.IVIATIO6 2 : ' - ,_: :: :. Heatin /cooling
Job site address: 14450 ow pennvwci+-rerr. 1 Air conditioning or heat pump
, (requires site plan showing placement) 1 14.00
City/Statea)P: Ileand 97224 1 ' Furnace 100,000 BTU (duets/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) ' 17.90 •
Suite/bldg./apt no.: I Project name: .
Gas heat pump 14.00
Cross street/directions to job site: ..
Duct work 14.00 1
Hydronic hot water system 1 14.00 :
•
' Residential boiler (radiator or
hydronic) ; 14.00
Unit heaters (fuel-type, nor electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot Lot no.:
Other: 10.00 ,
Tax map/parcel no.:
Other fuel appliances
I - .• .? - -, ..--',••-• ''''i'••: '•,----'• .”..,-.,-,,,,l-DESCRIPTION,z0E.-WORK.,,,l'^i.'.-.!,-)'!;21 10.00 1 . ;:7,; ;„- ,:,„,,. ,: . , .: il : 1
Gas fireplace 10.00 :
(ntal 1 c Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 1 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
i:'F. 11i34:::;;;*"144.7..-::.:'.:4..ii.li!4g,141- f _. :r1 : :‘; ;;' . • S ' ]: :',..: : ',. - L ' ;:• .1; ---
1 10.00
Name: vi s 1 cerri Other.
Environmental exhaust and ventilation
Range hood/other kitchen
Address: Same
equipment 10.00 1 ,
City/State/ZIP:
Clothes dryer exhaust , 10.00 1
Phone: 6)3 td4-4sq(25 Fax: ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
:::-;....,..7•;:":7:;.1..":3;.•/...'asii.::-:70:tg-eyiiit.p7,ysi,7,,t7r...,.."?.::::v..::3-.;,,,i.,.b....650/7,..-.7,./,Eti,§614,-,;:::..:- ::::.; Amecrawtspace fans 10.00
Other:
BusIness name. in Calanp Confrol
Fuel piping 10.00
c Contact name: 'ur i
55.40 for first four; $1.00 for each additional
_
Fumace, etc.
Address: 0 iaD S. etackctillCILS Ri Vrir ff1
Gas heat pump
City/State/2D: CrCgCn 0 -/A1 e t Q q 704r5
Wall/suspended/unit heater : •
' .
Phone: (tato) 557•- 222.) Fax:: (503) 557-0q 1 q Water heater 1
Fireplace
E-mail:
, Range
Z., k' . ",'.• -...:..-.-:i Barbecue
Business name: H-1 cour T (o Clothes dryer (gas)
Other: .
1 l•
Address: t?)IF70 • mos RI kfct 6P .,..7 - •
City/State/ZIP: °Weer) L_i CR_ cl71+5 subtotal
1
Phone: ( a3 ) 55-r-2 7 2 (a) Fax: (jQ) 657 - 6 ( 1 111 - permit fee (S72.50)
Flan review (25% of permit fee)
CCB lic.: 721,23
State surcharge (8% of perrnn fee) iligl 1-1:
,. _
TOTAL PERMIT FEE t L1
/7 0 C7./....._____.
Authorized sig natur, .54erce2 -7 / This permit a ftiteornitex.hpaisr bee s e i f c per c e p it t m eh p t i :i t n e e
Print name: ia_ A0A1 i Date: ti2ig /OS
1 • Fee methodology se: by Tri Building Industry Service Board
ABuilding\?errnits‘hEC-PermitApp.doc 12/03 440 (11/02/COM/WEE)
N � Y-
Q 'A r.
I • Corn RAC1-OR .NC -I IiAT PUMP --- UNIT" SITE PLAN
m . 2c1 /5r
Q.__, za j ---- ?
cn
o
r
In
tn
m
0
. /.........—.........—
lo
1
n
C
7
° TO STREET -
U
_____ _____... .:._ ?2,-,v:/:14Z.CA.ORT--- -----i-
1._
- , CUSTOMER INFORMATIOIJ
NAME .
Q
in • ADDRESS
m •
o .
In PLE ASE REPAX APPLICATI0� 11 ill I Sf[T PLAN. t,r,
0
cri
T 0
`L
n `
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00299
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/612006
Phone: (503) 639 -4171 �� "ijji
Inspection Requests (24 Hrs.): (503) 639 -4175 ��_:
INSPECTION WORKSHEET FOR DATE: 6/17/2005 TIME: 7:11AM PAGE: 83
SITE ADDRESS: 14450 SW PENNYWORT TERR CLASS OF WORK:
SUBDIVISION: BONITA TOWNHOMES LOT #: 030 TYPE OF USE:
PROJECT NAME: BALLARD
DESCRIPTION: AC install.
OWNER: BALLARD, VICKI PHONE #: 503-624 -0865
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-557 -2220
Inspection Request Scheduled For: Date: 6/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009506 -01 503- 557 - Y
Corrections /Comments /Instructions: \lcCk4` Q7 (� 9 �( 11\ (0 hI I 1
4.1 .........
_el.: re
1 (J. .- C rg 4
Ci\1I, 11,x- - l I'S*StU
`y: PASS ❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
❑ FAIL • CALL FA INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r Date: b q2:j Phone #: (503) 718 -
z