Permit , 4 At �T I ® MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00315
P.. DATE ISSUED: 7/12/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S135CD -13300
SITE ADDRESS: 09670 SW PIHAS ST ZONING: R - 4.5
SUBDIVISION: GREENBURG PINES LOT: 004 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:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
DAVID LONG Description Date Amount
9670 SW PIHAS
TIGARD, OR 97223 [MECH] Permit Fee 7/12/200E $72.50
[TAX] 8% State Surcha 7/12/200E $5.80
Total $78.30
Phone: 503- 890 -2221
Contractor:
MILWAUKIE HEATING & COOLING
PO BOX 220216
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -5562
FAX 503 -557 -0790
Reg #: LIC 104102
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: Q, K3j\`cQ
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.
Jul 11 06 02:36p Milwaukie Htg & Clg 503- 557 -0790 p.l
■
1 I'h 1 4 1, .0 , T 1 a I l i , la . '.I I i 7 �
Mechanical Permit Application 1 , ` I-1 i -0 R i1 01 . F1(F 151 0\(1 y f , a r 1�
City of Tigard
tear , r" Permit No.:I "� t ' ajg' 1
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/ y Other Permit:
Inspection Line: 503.639.4175 AM.' .'� Date R d,%le% S Storage r
Internet: www.ci.tigatdor.us � � � Notified/Methoo Storage d: Suppkmet►tai Information
OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
El New construction Addition/alteration/replacement Mechanical permit fees* are based an 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: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES°
1- and 2- family dwelling ❑ Colnmercial/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
Job site address: ) J Air conditioning or heat pump
� 7 ( /" . r �f -S (requires site plan showing placement) I 14.00
City/State/ZIP: - 4 L „ z 4 6C, G `7 -1.,2.3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (duets/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
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
Subdivision: f Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Add Gas fireplace 10.00
LI �, Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER 1 ❑ TENANT �ey/lincr /flue/vent 10.00
Other. 10.00
Name: DAV I CI L iA Environmental exhaust and ventilation
Range hood/other kitchen
Address:
{ 6 ft ‘ Vl ({ S equipment 10.00
City /State/ZIP: 1 a rj 2 �J f ? 3 Clothes dryer exhaust 10.00
-
s [ Single -duct exhaust (bathrooms,
Phone: (c63 c 22 2. / Fax: ( ) , toilet compartments, utility rooms) 6.80
0 PLICANT L-7 a.ONTACT PERSON _ Attic/crawlspace fans 10.00
Business name: ` / t . ` Other. 10.00
Mf 1�Q�� Q a'�r!ny 4— t / ad / ! G7 r 1 Fuel piping
Contact name: , e • t( / t y k . /_ .1 $ for first four; $1.00 for each a dditional
Address: / .. u
t- - 2? Furnace, etc.
._ _. ° ; - - Gras heat pump
City/Statc/Zl,'': J C.. 4 � G 7Q f 5 WalVsuspended/unit heater
Phone: (S-6 3) 5 5-5-4 a Fax: : (3 ) 5-5-7_ 7 9 6 Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
i_ Clothes dryer (Ras)
t�
Business name: / wa ci x I .. Wee.--1- -.- 69 1 (H9 Other:
Address: r 4 le11 „ t' MECHANICAL PERMIT FEES"
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee (S72.50)
Plan review (25% of permit fee)
CCB lic.: / Ql /6 Z State surcharge (8% of permit fee)
TOTAL PERMIT FEE n; 3 0
Thi
Authorized signature: s permit application expires ifs permit is not obtained within 180
days after it has been accepted as complete.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00315
13125 SW Hall Blvd., Tigard, OR 97223 '-'-- DATE ISSUED: 7/12/2005
Phone: (503) 639-4171 111°V
Inspection Requests (24 Hrs.): (503) 639-4175 ,„ 110- --... riCe A006 -0o3/s
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: 106
SITE ADDRESS: 09670 SW PI HAS ST CLASS OF WORK:
SUBDIVISION: GREENBURG PINES LOT #: 004 TYPE OF USE:
PROJECT NAME: LONG
DESCRIPTION: Installation of A/C unit.
OWNER: LONG, DAVID PHONE #: 503-890-222i
CONTRACTOR: MILWAUKIE HEATING 8, COOLING PHONE #: 503-557-5562
(
Inspection Request Scheduled For: Date: 7/27/2006 Pour *--e: ito e.
Code # Inspection Description Confirm # Contact # 'es ag -
699 Mechanical final 033739-01 503-657-5562 le
Corrections/Comments/Instructions:
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0 PASS 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
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Date: — 07/ 6 ( ?..,Y±<_(_
Inspector: A._/ Phone #: (503) 718-
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A/C - Heat Pump -- Unit Site Plan
C Contractor Info:
Q_ Name: V' t 0
Phone: I 5
Back Property Line.
Customer Info:
Name: D v, a Lirrt r
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Addr: 6I?) iw, P h 4 t^
o Phone: 8 ci 0_ 21,2, 1
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