Permit CITY TIGARD MECHANICAL PERMIT
14 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00124
°= --� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/21/2005
PARCEL: 2S112BA -01100
SITE ADDRESS: 14360 SW 80TH PL ZONING: R -7
SUBDIVISION: WAVERLY MEADOWS LOT: 041 JURISDICTION: TIG
Project Description: New 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
HELFENSTEIN, HARVEY A + MARY E Description Date Amount
14360 SW 80TH PL
TIGARD, OR 97224 [MECH] Permit Fee 3/21/200` $72.50
[TAX] 8% State Surcha 3/21/200E $5.80
Total $78.30
Phone: 503- 639 -9331
Contractor:
A -1 AIR CONDITIONING CO INC
2038 NW ALOCLEK DR # 225
HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS
Phone: 503- 645 -5900
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: � �1„<� Permittee Signature: jj-cf--,
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.
03/21/2005 12:14 5036907435 Al -AIR PAGE 01
Mechanical Permit Ap l rr• >- FOR OFFICE USE ONLY .
City of T i g a r d i v ' Received
- -- ^ G
Date/13y; Y�� Permit No.: 1' J _ ea o / 2V
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 / a'n' " y , . r • \ Date/B : Other permit
Inspection Line; 503.639.4175 + I y
Internet www.ci.tigard.Or.us AR 21 10 .,,_ ..•I l� bate Ready/By: lid See page 2 for
Notified/Method Supplethentat informauon
CITY
:::. , � tJ� . .a.: : :r til�I�lGFtG` 'FEE' SCALDIJLF - USE CHECKLIST
❑ New construction tgj Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) alai!
❑ Demolition ❑ Other: mech mate
_ risk, equipmen labo Overh and Pro fit
1 7 : IOIV::: ty ";.:',./ value: 5
lin 1 and 2- (stall dwellirt R,ESiIDENTIAL EQUIPMENT / SYSTEMS FEES'
Y g ❑ Commercial/industrial ❑ Accessory building
0 Multi _ For special information use checklist.
Y builder ❑ Other:
: ;'•. o Description
' ..:..:.4 ; '�'4' to '§ F ' bN - F Total
� * oliot; .
Job site address: 1 3 / WV :04' ' - Air conditioning or heat pump en, (requires site plan showier placement) L 14.0Q l�'
City/State/ZIP: tea( 9 Z �. Furnace 100;000 BTU (ducts/vents) 1 4.00 '
Suite/bldg. /apt, no.: / Project name! Furnace 100,000+ )3T(J (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: a rtNd _feefC V r. Duct work 14.00
W dronic hot waters stem t 4.00
Residential boiler (radiator or
dronic) 14.00
Unit heaters (fuel -type, not electric),
_in -wall, in -duct, suspended, etc. I0,00
Subdivision; Lot oo.: Flue /vent for any of above 10.00
Other: 10.00
Tax map/parcel too.:
other fuel appliances
?::!`'4: '`^;'t: A0 • It,Q� ,a . V b', "'�•, ;. Pit"l �, ,p','; Water, heater 10.00
AA 1 4 Gas fireplace 10.00
i - 1Z/ .4 r c.,14", ► I . Flue vent for water heater or gag
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00 •
i' r' :1'?Pltb f' Af ('�`'t.v'•' ( 3:t t a'l' j• • ; Chimney/liner/flue/vent 10.00
h'y:' : 1`l, ,",:..;f' a' '.'A7�1Qa4i . 1`'?` , ?4 �;
Other: 10.00
Name; V � Environmental exhaust and ventilation
�� i 1 �Y15 • h
Address: 1 �( sw 80 *1. • Range hood /other kitchen
e u me at 10.
City /State/ZIP: • , , ok C'k et 7-7-it Clothes dryer exhaust 10.00 W
Phone (�'3 ,-1,1 et '3 N+ Fax: ( ) Single -duct exhaust (bathrooms,
toilet Compartments, utility rooms) 6.80
'.: :10 . . 711 1}It„ ,.; , 4 = r :1; rTt., fy,ti : :: ,il[`i`0. ,ij,,i •. : a. Attic /crawlspace fans 10.00
Business name:
Other: 10.00
Fuel piping
Contact name: • W d ER 55.40 for first four; 51.00 for each additional
Address: Furnace, etc, �
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater _
Phone: ( ) Fax :: ( ) Water heater
E-mail: Fireplace
.�1t :. ', t r� � 3 huge
,��' ' i
�.n(a i R i 1��. w f I fti . f 1
�1.. :.1101 Barbecue
Clothes dryer (gas)
Other:
Address: 2,038 A. t. A to c - K ■ r. 4' 2-7-5 r'F ,- r .. it U Meat PERMrF,i tts*
a
City /State/ZIP: a ', lk o. • A t 2 Subtotal (c{�
Minimum permit fee (572.50) _ Q-
Phone: (�a3) boos- 5' 60 Fax: ($aj) (pep 74( Plan review (25% of permit fee)
CC13 tic.: 614 02 State surcharge (8% of fee) y $'
TOTAL PERMIT FEE 78.30
- Authorized signature: lads permit Application expires it a permit 1s not Obtained within 180
days after It has been accepted as Complete.
Print name: ') uU » s a ".01. 4 5 f Date: /7 f /& S • Fee methodology set by TO- County Buildhtg industry Service board
oaWilding\Partnits∎toxC- PemtltADp doc 12/01 440-4617T ( tt ll02 /COM/WE
03/21/2005 12:14 5036907435 Al -AIR PAGE 02
Air Conditioning Site Plan
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(tf 310 O .50 80 k PL.
Job Address
CITY OF TIGAFD
BUILDING DIVISION PERMIT #: MEC2005 00124
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2005
Phone: (503) 639 -4171 H1 " �I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5f2312006 TIME: 7 :08AM PAGE: 'i07
SITE ADDRESS: 14360 SW 80TH PL CLASS OF WORK:
SUBDIVISION: WAVERLY MEADOWS LOT #: 041 TYPE OF USE:
PROJECT NAME: HELFENSTEIN
DESCRIPTION: New NC unit.
OWNER: HELFENSTEIN, HARVEY A + MARY E, • PHONE #: 503.639 -9331
CONTRACTOR: A -1 AIR CONDITIONING CO INC PHONE #: 803.648.5800
Inspection Request Scheduled For: Date: 5123f2005 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007446 -01 603-639-9331 N
Corrections /Comments /Instructions:
,
ezt , r‘/G :5 S
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
■
Inspector: Date: Phone #: (503) 718-