Permit CI TY OF TI GARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00280
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/20/2006
PARCEL: 1 S134AD -05100
SITE ADDRESS: 10800 SW 108TH CT ZONING: R -4.5
SUBDIVISION: BLACK BULL PARK LOT: 028 JURISDICTION: TIG
Project Description: Replace existing heat pump.
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: DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
BRIAN BAILEY Description Date Amount
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10800 SW 108TH CT
TIGARD, OR 97223 [MECH] Permit Fee 6/20/200€ $72.50
[TAX] 8% State Surcha 6/20/200€ $5.80
Total $78.30
Phone: 503- 443 -2479
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815
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: J�i Permittee Signature: ,.. 5,4 3 -c, c)
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.
Jun 20 06 06:52a MS Rentals, Inc. 503- 537 -2172 p. 2
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Mechanical Permit Application . . FOR OFFICE USE ONLY , /'
City of Tigard oY �� Itl �oOf Received • , l i /'�j, PermitNo.V\ , /0( UOc2/
13125 SW Hall Blvd., Tigard, OR 97223 JU Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 '' r Date/By. Other Permit • Inspection Line' 503.639.4175 y (j �I f�! D ate Reads /By: / lens: Q See Page 2 for
Internet: www.ci.tigard.or.es � � 1Ly — Norined /Methad: / / (cr Supplemental Information
AT TIT 1IT1\ir ;' 11STOis, EE.x ;se b i> :.: sip chic .
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iEiier.�, � '1
Mechanical permit fees' are based on the value of the work
❑ New construction 4d ditiortialteration /replacement
performd. Indicate the value (sounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
:,, .:...... ... ::... ....:.:< .:-: ; ,. ; -.:.CaTE•G01271':OF': 3iUC`rloI'i; a. :;',`.::` >:= ';;.:':: :.:c.: ,�' • r „RE NF:t :S� TEM SFLES *' ..:-:
Value:
- CON5x RESIDENTIAL- E S
E and 2 family dwelling ❑ Commerciallindustrial ❑ Accessory building For speciel intonnation use checklist.
❑ Multi family ❑ Master builder ❑ Other. Desc_iption I Qty. Ea. Total I
", : J`.OB SITE tINFOBM4T1ON °AND, 1..00ATIOI\ jt;. . a .;. ;=.,' Heating/cooling
" i 0 r U 6 _ �( 1 0 Of.-- conditioning or heat pimp
Job site address: V �� ' (requires site plan showing placement) 14.00
/ Furnace 100,000 BTU (ducts/vents) 14.00
City /State /ZIP: 0. �a3
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt. no.; 1 Project name: - ....=-.-
Gas heat pump 1 14.00 ILL,
Cross stree.t/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 I 10.00
Subdivision: 1 Lot no.: Other i 10.00
Tax map /parcel no.: Other fuel . :.. , appliances
..:...•,,.. ._; . . -h r ,-� - Water p
Gas fireplace I 10.00
;Fr C t L � t i q h t ---1 Flue vent for water heater or gas
` . S '...1 fireplace P fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
:_ .:.ex,,,, ::... ....:::. i,i %_` .' = Chimney/liner/flue/vent ent .
,.,
Name: cbinme � 10 oa
¶ V f /, _ ' _ i Environmental exhaust and ventilation
ilation
Y Cit /G ��t �nnr nn ` /+� Range hood/other kitchen
Address: ! V 0 0 Co .A..) ) U ~ (. ^ , equipment 10.00
City /State /ZIP: ' ,( y J C 9-�;�3 Clothes dryer exhaust 10.00
`' ' Single -duct exhaust (bathrooms,
Phone: ( t -i . .-(--i e1 Fax: ( ) c en utility rooms) 6.80 I
,. .:.:,, ......: .. . . . ..:.;:.;.., :'::.::; tccra,v p cefans
[P I CANT.. - ?d;.:f._,..:,•,.. ..
toilet
Att' � is a 0 00
.:., , ..,::,:.-.. .. _,:.;._., _ ,:... I 10.00
L
Business name / P./ . _/ . r�.G1 -- 1 �/�1n Other.
, Fuel
piping
Contact name: ' a1 }(1-4-k--•P2 S5.40 for first four; $1.00 for each additional
r) - Furnace, etc.
Address: 1 l 6,- 341'0 / Gas heat pump
City' /State /ZIP: J2 I O- L11, 1 1 �T Wall suspendedlunit beat.o
.r
Water heater •
Phone. ) a .. Fax:: — ) l j 1 �� Fireplace
E -mail: e
ue
C e es dryer gas)
Business name: `,1,4,/i / 0 i :
�` _� t � Other.
Address: .. i ' S - - :NLECFtAtti'ICAL PERyITT `:i' ,''
��' . :. ... . ..... Subtotal - �_..` . .
n Minimum permit fee ($72.50) �
Phone: . Fax _ _ 2,1
CCB lit.: Plan review. v (25% of permit ut fee) I
Fax
State surcharge (8% of permit fee) J J tJ
(7�; 5 1
./� TOTAL PERMIT FEE ` 7K --jiI
Authorized signature: t tiei l n� t ) I (� , �/1 d ' This permit application expires if a permit is not obtained within 180
! O1 lY J �,r i !(i days after it has been accepted as complete.
Print name: .�. •�, " ' i i . f ' ( - 1 60 fl 1 Date: ` Fee methodolog set by Tri- County Building Industry Service Board
. . . _ . -- nnrt n41- 0 r Imirnr tnvra)
Jun 20 06 06:52a MS Rentals, Inc. 503-537-2172 p.3
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CITY OF TIGARD
BUILDING DIVISION J PERMIT #: MEc200C� 00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: C'2(f /2006
Phone: (503) 639 -4171 av �'�1
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' v.
INSPECTION WORKSHEET FOR DATE: 7/14/2006 TIME: 7:16AM PAGE: 58
s r f..) ,� v 6z _ ( � 1L4" r,;�I1
SITE ADDRESS: 1081 0 SW 108TH CT CLASS OF WORK:
SUBDIVISION: BLACK BULL PARK LOT #: 028 TYPE OF USE:
PROJECT NAME: BAILEY
DESCRIPTION: Replace existing heat pump.
OWNER: BAILEY BRIAN PHONE #: 503 -443 -2479
CONTRACTOR: OREGON HEATING . 4 - NC INC PHONE #: 503 -538 -2953
Inspection Request Scheduled For: Date: 7/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # -ssag -
689 Mechanical final 033077 -01 503 - 5382953 Y
Corrections /Comments /Instructions:
' POST — /41'b K -a - . n! ., , 1z j p/ /4 hk/ L/ u S I''7 (.v -
o t ''- j Z_.Z /•/
4- SAP ISIC,k e PAu��
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a PASS U PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C--111r) Date: 171/1/06 06 Phone #: (503) 718- 0-6
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