Permit - " r CITY OF Tt GARD
el
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00458
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/24/2007
PARCEL: 1 S134DB -10100
SITE ADDRESS: 11279 SW 110TH PL ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 003 JURISDICTION: TIG
PROJECT: SHEIKHLY
Project Description: Install 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:
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
ABBAS A. SHEIKHLY Description Date Amount
11279 SW 110TH PL
TIGARD, OR 97223 [MECH] Permit Fee 7/24/2007 $72.50
[TAX] 8% State Surcha 7/24/20W $5.80
Total $78.30
Phone: 503 -524 -3449
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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 B ,/l0/7/4/ 1_,Oei Permittee Signature://, /9p,i1C.40071
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 23 07 01:41p Oregon Heating & A/C 503 - 537 -2172 p.
Mechanical Permit Arriplieltiitin/jErn FOR OFFICE USE ONLY
II ft., - e .7.i.' .. ` � R eceived
Date By: I i"t ! .Ll��
_ Dat c, %By: Review
City of Tigard ✓ 7 f 1 P No.: f � f t - � /09 -45'
R 922
13125 SW.Hall Blvd., Tigard,lO 2007
Phone: 503.639.4171 Fax: 503.598.1 Other Permit
at
TIGARD Inspection Line: 503.639. :' '9'7,uA9D Date Ready/By: larks: 0 See Page 2 for
Internet: www.tigari - oetni air at;1810 K 1 Notified /Method: 11 /ti Supplemental Information
TYPE OF WORK • COMMERCIAL FEE* ( SCHEDULE - USE CHECKLIST
•
Mechanical permit fecs* are based on the value of the work
❑ New construction ®Addition %alteration /replacement
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 •
® 1- and 2-family dwelling ❑ Commercial /industrial o RESIDENTIAL EQUIPMENT / SYSTEMS FEES* •
❑ Accessory buildin
❑ Multi- family ❑ Master builder For special information use checklist.
❑ Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: l r Air conditioning or heat pump I
I I V�] .' Q I S , x I ll /� lth 1" (� l (requires site plan showing placement) V 14.00 14.00
City /State /ZIP: joar'd G i a "`a-+ 2 Furnace 100,000 BTU (ducts/vents) 14.00
'�". Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite /bldg. /apt. no.: 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:
Flue/vent for any of above 10.00
Lot no.:
Other. 10.00 _
Tax map /parcel no.: Other fuel appliances
.. • Water heater 10.00
• - • • DESCRIPTION OF WORK
HVAC- Gas fireplace 10.00
1nS C 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 Chimney/linerifueivent 10.00
❑ TENANT
- Other. 10.00
Name: C\V S p1 5'V..)Pi1,( Environmental exhaust and ventilation
Address: ' alq �\N I 1101 h r `I Range hood/other kitchen
I equipment 10.00
City/State/ZIP: Cl othes d
y � g ard � laa3 dryer exhaust 10.00
( Single -duct exhaust (bathrooms,
Phone:
5--(a3) 5 a q - 3 4 try Fax: 6 ) toilet compartments, utility rooms) 6.80
• • ® APPLICANT . - ❑ CONTACT PERSON Attic!crawlspace fans 10.00
Other: 10.00
Business name: Oregon Heating & A/C
Fuel piping pip
mg
t
Contact name: Ra.6hel1f . S5.40 for first four; $1.00 for each additional
Address: PO BOX 297 Furnace, etc.
Gas heat pump
City /State /ZIP: Dundee OR 97115 Wall/suspended/unit heater
Phone: (503) 538 -2953 Fax: : (503) 537 -2172 Water heater
E -mail:
Fireplace
Range
CONTRACTOR Barbecue
Business name: Oregon Heating & A/C Clothes dryer (gas)
Other.
Address: PO BOX 397 MECHANICAL PERMIT FEES" • :
City.%State /ZIP: Dundee OR 97115 Subtotal r It. (V)
Phone: (503) 538 -2953 Minimum pennit fee ($72.50) Z. co
Fax: (503) 537 -2172 Plan review (25% of pennit fee)
CCB lie.: 172126 State surcharge (8% of permit fee) °5, go
0 TOTAL PERMIT FEE 7a Si')
Authorized signature: "P V " — Q - __ . This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: R/y i e Date: 7 ' Fcc methodology set by Sri- County Building industry Service Board
t il��?� 1 e v t I _1'� J �]
IaBuilding',Perm its'.MEC- PcrmitApp.doc 04061 440-- 1617T(11 %021CO.WWEB)
503-537-2172 p. 2
Oregon Heating & A/C
Jul 23 07 01:42p
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00458
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 8/17/2007 TIME: 7:01AM PAGE: 51
SITE ADDRESS: 11279 SW 110TH PL CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 003 TYPE OF USE:
PROJECT NAME: SHEIKHLY
DESCRIPTION: Install alc unit.
OWNER: SHEIKHLY, ABBAS PHONE #: 503 - 524.3449
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 -53t8 -2953
Inspection Request Scheduled For: Date: 8/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 054210 -01 503 - 538 -2953 Y
Corrections /Comments /Instructions:
CC
PASS l I PARTIAL APPROVAL I I CANCEL n NO ACCESS
I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector - Date: 0 e #: 3 718 -
p D e Phone (50 )