Permit CITY OF TIGARD •
MECHANICAL PERMIT
T ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00423
T I G n k D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/13/2008
PARCEL: 1 S125DA - 01900
SITE ADDRESS: 09130 SW 69TH AVE ZONING: R
SUBDIVISION: KINGS VIEW LOT: 004 JURISDICTION: TIG
PROJECT: WEAVER
Project Description: Installing heat pump and electric furnace.
CLASS OF WORK: ALT 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:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
ROBERT WEAVER Description Date Amount
9130 SW 69TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 8/13/200E $72.50
[TAX] 12% State Surch 8/13/200E $8.70
Phone: Total $81.20
Contractor:
PREMIER HEATING & AIR CONDITIONING
PO BOX 86295
PORTLAND, OR 97286 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -6566
FAX 503- 239 -4998
Reg #: LIC 96473
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: Permittee Signature: 717A07361/
Call `x.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.
AU' -11 -2008 22:38 FROM:P 5032394998 TO:5035981960 P.3
Mechanical Permit Appli .- .
I , • GeV � ® l O R U l i 1(1 1 ' r O \ I.1
City of Tigard r- 18 Reo a p ; ,:,.
13125 SW Hall Blvd., Tigard, OR Y: p I d g. Permit No.: t � / �� Y 1p
: . Phone: 503.639.4171 Fax: 503.598.1960 Au G 1 226 u 3 ` Other Permit: �J
1 i i ; \ k 1, Inspection Line: 503.639.4175 Date Ready/By: � Mir Sec Page 2 for
Internet www.tigard- or.gov �= TiGAR Notified/method: T. I B Sup�clInformatloa
CITY G�y
TYPE OI�V PN -?. � ® � COMMERCIAL FEE' SCHEDULE- USEcRECKLIST
lacemeni Mechanical permit fees* are based on the value of the work
❑ New construction brAddition/alteration/rep
El Demolition El Other performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor,_ overhead, and profit
CATEGORY OF CONSTRUCTION Values
- and 2-family dwelling CommerciaUmdtrstrial RFSIDENTIAL EQUIPMENT / SYSTEMS FEES*
Y g ❑ ❑ Accessory building For special ikon use checklist
0 Multi - family ❑ Master builder ❑ Other:
Description 1 Qty• I Ea- I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: qi3 0 dVV tpq! r " Ave Mr conditioning or heat pump j,
(requires eke plan showing placement) ) 14.00
City/State/ZIP: -77M 0 � g/ '7 Furnace 100,000 BTU (duces/vents) / 14.00 j .
/
I Furnace 100,00&i- BTU (duds/nab) 17.90
Suite/bldgJapt Project name ll/�A no.: Gras heat Pimp 14.00
Cross street /directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (lbel -type, not electric),
in -wall. in -duct, suspended, eta 14.00
Subdivision: 1 Lot no Fluelvatrt for any of above 6.80
Other. 10:00
Tax map/parcel no.: Other fuel appliances
r� DESCRIPTION OF WORK Water heater 10.00
3 '�N r[ i t Q , /She/ � T/
/ / el (, � v�ent water heater or gas 10.00 i £/t 5/ r E �' i v fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood frsvjaoe/inscrt 10.00
PROPERTY OWNER 1 �±7� I ❑ TENANT Chimney/liner/flue/vent 10.00
Other 1t• i eel- ' A16011 J 10.00
Name: M/ t��'C. / Environmental exhaust and ventilation
Address: f Q f A l / li yt Av g. �C Range hood /other kitchen
if Ai t r �1/ �i equipment 10.00
City/StatePZlP: --176--A.40 Q K L�i7'7 . Clothes dryer exhaust 10.00
j J 'r J Sin e-duct exhaust
BI (bathrooms, ) 6 - i Fax ( ) toilet compartments, utility roans) 6.80
❑ APPLICANT ��YYVV ❑ CONTACT PERSON Attic/crawlspace fans
10.00
Business name: . Other 10.00
Fuel piping
Contact name' S5.40 for first four 51.00 for each additional
Adds : ll..t ����L G's:-'! Address:
Gas heat pump
CIty/StateIZIP: Wall/suspended/unit heater
Phone: ( I Fax:. ' -)) Water heater IV
F 4. lace
&mail' Ran: ,
CONTRACTOR By -
Business name: / /IAA tr. .e :�11i :/ L . _ Clothes dryer ( s)
Q,{ /l / Other.
Address: i‘)4 ��� MECHANICAL PERMIT PEES*
City/State/ZIP: i liertitA in aq '/-22sg / n p Subtotal OF d
Phone: ( 563 3 - ( let I Fax: 041'3 / -- / l l ' ° Minimum Permit fee (* )
7.2 . j d
CCB lie.: q �� 7. state s
✓` �� J ' T -, / ' ( of permit fee)
(12% of permit fee) 7
TOTAL PERMIT FEE
Authorized signature: 1 This permit a ntes
_ _ . � 4 I � I� r p po expires u s permit o O not owithin 180
m/� days after It has bees maned m complete
Print name: i �� �? � Date: / Hum • Fee metbadology set by Tri•Camty Braiding Industry Service Board
r:nua aloe 01/19/07 . •17T(I1/01/CQId/WE8)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/13/2_00f0
Phone: (503) 639 -4171 41W4 „ >:
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/17/2008 TIME: 7:00AM PAGE: 31
SITE ADDRESS: 09130 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 004 TYPE OF USE:
PROJECT NAME: WEAVER
DESCRIPTION: Installing heat pump and electric furnace.
OWNER: WEAVER, ROBERT PHONE #:
CONTRACTOR: PREMIER HEATING & AIR CONDITIONING PHONE #: 503- 233 -6566
Inspection Request Scheduled For: Date: 9/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 075542 -01 503 - 233 -6566 Y
Corrections /Comments/ Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: S Date: /- v Phone #: (503) 718 - g9,23
AUg-11 -2008 22:39 FROM:P 5032394998 T0:5035981960 P.4
L 1i1 7L 7L a P.O. Box 86295
Portl and, Oregon 97286 CCM 96473
(NEAT /NO AND AIR CONDITIONING, INC" Ph.: (503) 233 -6566 Fax: (503) 239 -4998
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