Permit a CITY OF TI CARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00478
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/1/2007
PARCEL: 2S 112AB -00600
SITE ADDRESS: 14101 SW 72ND AVE ZONING: I -H
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WESTSIDE MAYFLOWER
Project Description: Replace 7.5 ton system, like for like. Value: $7498
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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
TUFFORD, PHYLLIS J TRUSTEE Description Date Amount
BY VERN TUFFORD
EASTSIDE VAN + STORAGE CO [MECH] Permit Fee 8/1/2007 $186.50
PORTLAND, OR 97206 [TAX] 8% State Surcha 8/1/2007 $14.92
Total $201.42
Phone:
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
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: i d;Z: ---
4L,L. Permittee Signature. / /_LL.
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.
' Mechanical Permit Application �o I OR OrFI( Iisli O:. I.,'
City of Tigard ii r:: d `', r x Received D � it • t , �00 i --�y7
1114 ' r= ; ay Date/By: 1 3125 SW Hall Blvd., Tigard, af' : 2223' "` `' Plan Revie
Phone: 503.639.4171 Fax: 503.598.,1 ,60 1 2007 Date/By: OtherPenttit.
.1 i i ; A K 1 Inspection Line: 503.639.4175 � ® Date Ready/By: ® See Page 2 for
Internet: www.tigard or.gov 1 Notified/Method: Supplemental Information
TYPE Or WORK J a COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction tfo Addition/alteratio - Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 'y 99.
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling NI Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
r Air conditioning or heat pump
Job site address: / y e/ 5&.7 72 "1 (requires site plan showing placement) 14.00
City/State/ZIP: �`s 9 t/ Furnace 100,000 BTU (ducts/vents)
�' p Furnace 100,000+ BTU (ducts/vents) / 17.90
Suite/bldgJapt. no.: Project name: teef'Si..e �01 170wro -, 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
Flue /vent for any of above 10.00
Subdivision: Lot no.: 10.00
Other:
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Yowl Gas fireplace 10.00
/Pat li a {_ b k e -a - 1 k.' 2.C" Yo Flue vent for water heater or gas
/ ./ � �� fireplace 10.00
Q �/ 5� �,,yj • O / /7 k iTS /ter P r Log lighter (gas) 10.00
��11 Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
❑ PROPERTY OWNER ' ❑ TENANT Other: _ 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
,�1 Other: 10.00
��
Business name: i { $ m
! is .. 4 +•, D . V Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: Gas heat pump
City/State/ZIP: WaWsuspended/unit heater
Fax: : (J 3) - / _ 5 / O Water heater
Phone: Hp 3 ) 8' ti _ e� 6-5--- Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: N /
n i ~ l_ "� �en '� /f �� a� Other:
Address: /.7/5--.0 s 6 rK,.. / A... ,e, MECHANICAL PERMIT FEES*
C ity /State/ZIP: G ��a�l L ", L- 7 , 8 4 5 Subtotal At
y _ Minunum permit fee ($72.50)
Phone: (93) c5 7.220 / Fax: (59 S$ 7— ef/f Plan review(25 %ofpermitfee)
CCB lic.: 7� &' Z_ 3 State surcharge (8% of permit fee) H
6 7 / ]
TOTAL PERMIT FEE , yy
Authorized signs ( � �/� This permit da a f ter it has been accepted pted as complete.
within 180
Print name: 1 [� 1 Q . a r(chi I Date: $ - //b 7 • Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Pumits \NEC- PermitApp.doc 04/06/06 44046171' (11 COM/WEB)
1
- CITY OF TIGARD 0 .
0
BUILDING DIVISION PERMIT #: MEC2007 -00478
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1/2007
Phone: (503) 639 -4171 4.�
Inspection Requests (24 Hrs.): (503) 639 -4175 " 'II�
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:OOAM PAGE: 28
SITE ADDRESS: 14101 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTSIDE MAYFLOWER
DESCRIPTION: Replace 7.5 ton system, like for like. Value: $7490
OWNER: TUFFORD, PHYLLIS J TRUSTEE, PHONE #:
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503.557 -2220
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes . =
699 Mechanical final 053942 -01 503-557 -2220 �—
Corrections /Comments/ Instructions:
' -ASS /4 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL LL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
ir
Inspector:
Date: e h O 7 Phone #: (503) 718- C.--C-r