Permit 4 CITY OF TIGARD MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00365
c '.. 13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171 DATE ISSUED: 8/2/2006
PARCEL: 1S134DA-01905
SITE ADDRESS: 11120 SW 108TH AVE ZONING: R -4.5
SUBDIVISION: LOT: 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:
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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JEFF HERBER Description Date Amount
11120 SW 108TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 8/2/2006 $72.50
[TAX] 8% State Surcha 8/2/2006 $5.80
Total $78.30
Phone: 503- 620 -5911
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 261 -9915
FAX 503- 261 -9814
Reg #: LIC 122424
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: Jr .-d - Permittee Signature: _�11Q Q ■ l'N ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business
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.
•
4echanical Permit A00** il�'o
:fly of Tigard Received /} 'Z y� t/, — 00365 - y' 4 �/ /
1 125 SW Hall Blvd., Ti , OR 97223
.548.1960 , i j Plan Review
nonc: 503.639.4171 Fax: 503
398.1960
503.639.4175 t-U``__ V 20�r.. „ '. . . . ` d'; , j l f l pate/By: outer Permit: I
i[emel: www. ci.tigard.or.us
Notlt;ed/hte
. :, -.!� f Date Ready/By: h'^” S u S ee Page 2 roe
�� k A ��„� �} dad' l` is I S l ifit menLl In arms on
t... a , r .l�-
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3 New construction % Addition/alteration/replacement
permit fees* arc based a the value of the work
performed. Indicate the value (round -. to the nearest dollar) of a
] Demolition ❑ Other:
mechanical materials, equipment, lab .r, overhead, and profit.
. €a5r rz•. xSu ?,': "
.br +. ; ' %; ':: 1 , Value S
4,1 and 2 family dwelling ❑ Commercial /industrial 0 Aeeessory building }' �,.t,
For special injormaho , use checklist
] Multi Fami1 t.
y ❑ Master builder 0 Other:
t r `� Description Qty.1 Ea. ` Total
H atingicooIing
ob site address: ' // ' 6t, / O S' a 1 Air conditioning or heat pump
/ (requires aim plan showing ptacemea� 14.00
w it rstatdzlp: �/ —
5 ( � / - / - F urnace 100,000 BTU (duets/vents) - 14.00
l - Furnace 100,000+ BTU (duetalvenas) 17.90
iui to/bldg. /apt. no.: 1 Project name:
Gas heat pump 14.00
:Toss street/directions to job site: Duct work 14
Hydronic hot weter_vstem 14.00 _
Residential boiler (radiator or
ttydronfc) 14.00
Unit beaters (fuel -type, not electric),
in -wall, in -duel suspended, etc. 10.00
iubdivision: Lot Flue/vent for any of above 10.00 .
Fax map /parcel no.:
Other: 10.00
Other fuel appliances
22�:8r�o�ez , Water heater i.
LA/1.31—AA,(, - Gas fireplace 10.00
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
+311 i { t Ir :. , , . Chimney /finer /flue /vent „ 10.00
NI T �} . .:: , . Other: , 10.00 _ _ •
4ddress: 1 ' t) , 1�� + ++ b �[ Range hood /other kitchen and ventlla on
, t �1� equipment 10.00
�ityi$tatdZiP: 4 9 D f ,.
a. 7 a 3 Clothes dryer exhaust 10.00
Phone :. ) / • , 6, 1. Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
:::$105
rls t:is , ;L , . Attic/crawlspacefans 10.00
Business name: 14 4 ee t i Other: 10.00
Fuel piping
Contact name: f ar k De_ co S5.40 for first four; 51.00 f• r each additional
Address: 1312 N i D V! Def.¢4 . Strrg 4426D . Furnace, etc.
city/state/ZIP: P ,, �sk q 1 - O Gas heat pump
"", Wall/auspendecVunit heater
Phone: (5 ) ,/(d l,�t tf 5 I Fax:: ( SIB ) r-? of 9' Water heater
Fireplace
E -mail
a• i�ti , . 4 ' S i me e,
;•.�; "'",� ""�i` I< � � , ` , � � � � Range � '
a ,.kL ito,iir is ......,. ... , era 4y r t � s.:
� (� , •..,t Barbecue
Business name: l-f 4 k . ii es- Clothes dryer (gas)
Address: 131 22 J. r ci e- 5 i i i - 4 fit90 Other
City/State/ZIP: CI Ad ' A,Q 4 1 '7 13 C S .? a ?,
"`� _ Subtotal
Phone: (S) .�„- r �q � I Fax: ('35S J ) / Minimum permit ee ($72.50)
CCS tic.: a� 2 J Plan review (25% 0 permit fee)
_ State surcharge (896 o permit fee)
i IR � x ' r. lC PE . IT FEE
Authorized signature: ,,r Thb permit application eipiru K a p .14 11 cot obtained within 181
Print name: _ ` `F C p /f'Da!4 1/ ^ days after It has been steep d as complete.
• • 1 . • Fee methodology sat by Tri County Bei .'fig Industr Service Dosed
n..: an:... . :.ivar.o...•..�...n... , 'irn.
2-.1 t' T B6 T92 COS 00 1 2u t a.eaH 33I1321 11=13H Wd02 = Z T 900a 20 2nd
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CITY OF TIGARD . .,
BUILDING DIVISION PERMIT #: MEC200 00365
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2/2006
Phone: (503) 639 -4171 int im pt i i i ,
Inspection Requests (24 Hrs.): (503) 639 -4175 i_ .
INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7 :01AM PAGE: 69
SITE ADDRESS: 11120 SW 100TH AVE CLASS OF WORK: ,
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HERBER
DESCRIPTION: Installation of A/C unit.
OWNER: HERBER, JEFF PHONE #: 503.620-5911
CONTRACTOR: HEAT RELIEF CO PHONE #: 503 -261 -9918
. Inspection Request Scheduled For: Date: 10/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 038549-01 503 -261 -9916 Y
?g' 15 2 - ( °
Corrections /Comments /Instructions:
/ " , f` - =- -Tg,e1 kL- i — L.,.c K- lip—bet., # S" /AY 4 y7
el.PA'SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , Date : / -- - d , -6 Phone #: (503) 718-