Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -10061
1 � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/15/2006
PARCEL: 2S103BD -05600
SITE ADDRESS: 12681 SW 116TH AVE ZONING: R -4.5
SUBDIVISION: HUNTER'S GLEN LOT: 012 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
KELLY & WY MIX Description Date Amount
12681 SW 116TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 6/15/200€ $72.50
[TAX] 8% State Surcha 6/15/200€ $5.80
Total $78.30
Phone: 503- 705 -6700
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -0611
FAX 503- 234 -0439
Reg #: LIC 161085
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: _ '1 \
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.
Jun 15 06 07:47a p.2
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Meet Permit A . s Received , 1.
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City of Tigard " --07--„ bl Ed Vt.: ,.., _ a
-
. , . Date/By: a Permit No. \ 2g
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
T OJUII 1 r
JUN Date/By: Other Permit:
Inspection Line: 503.639.4175 i 2, l '''.
Date Ready/By: la See Page 2 for
Internet: www.ci ci F TIGARD
.tigard.orus Notified/Method: Supplemental Information
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Mechanical permit fees* are based on the value of the work
Ei New construction (g3 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition El Other: mechanical materials, equipment, labor, overhead, and profit.
.
- ....„,,,,,,„ •4 Nt '7 .t. , .1' - - ,,L. 0 ara ,::: .., -..;-4* , :L:...-. Value: S
.•`,4:1'7Vftt*Jit , 14444 ''' .4 \.'kle . `• • • ' ='''' 4 44 "" , . " '" .'° ' VA
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'',' ' ' '''',"' ''''''''''''''""' ' ''"'''''''""""'" "". " ''.. - '' .°'" ' ' ' ' '''' ' ' /. '
and 2-family dwelling 0 Commercial/industrial Ci Accessory building
,_.... For special information use checklist.
Dill Multi-family 0 Master builder El Other: Description Qty. Ea. Total
-....;,,,,,,, , ...teg V. - .., ..:. ,,,, r ,,,, ''''
V 44;;17:C.
4b: -.*: :81#44SA , VIOSEVOM t0:14 ,! 1 i: lateitlfaMMV, Heating/cooling
Air conditioning or heat pump
Job site address: 2.(L'/ s 1 ‘ WO pm, (requires site plan showing placement) 'i 14.00 pl.
City/State/ZIP: -- 11 S/ al 7 7 `;'% Furnace 100,000 BTU (ducts/vents) 14.00
9 • 1
_j .. ■ ` Furnace 100,000+ BM (ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name: An \ )(
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
Flue/vent for any of above • 10.00
Subdivision: Lot no.:
Other: _ 10.00
Tax map/parcel no.: Other fuel appliances
'' '''' Water heater
titsiiii-b**OlitgagtgOtivt 10.00
. . ..• •• • :.;:, *.'''''. r., ' '''. L' i ,'.' ' ',,...,' :',,; ' TA , -1 ,, *'1 , .' 4 6 .','"-'," ,',..., V...*.i , r4 , ..:N.V.`,.....: M..-..,..•;',10.4:4',,,r,14..';.01,1-1Vt,,Khe,,,,,,4..p.,:.,, : Gas fireplace
10.00
I 'iV.:31 (A....f. 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
'''' ' '''''' '''''' '.• ' '''''.'"'"' '' '''''''''''-''''''''''''''''e"41N,"40,:=e,;,10,--.,A.--,,,,,,,,,.,-----'.,4,,,A0v,w,F;vh-,,,q, Chimney/liner/flue/vent 10.00
. .
Name: V- 1 (' 1 k.!- 0-iY CA/W----Mt)(
, , ) I Environmental exhaust and ventilation
Range hood/other kitchen
Address: i ttp '6'1 `6\ii,, ‘ 'Os ' Ag.z.,' , equipment 10.00
City/State/ZIP: • rr 1 ::1
-AL.- --, Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
.,.
Phone: ( ..--7 - 1C.', 4- 5 -- Fax: ( ) toilet compartments, utility rooms) 6.80
::' otil,..10,2 :,4,riitv 'OMi...04;tivir,apretrowirdietitasityx-------6{-Ra*LIA=1; Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: SS.40 for first four; 51.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E-mail: Range . .
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, , , :;:.; , : , .,41-Ii;i0W.-tiftf: - 20VI'VeMiiig0e , aggir:yi i'•''''''''''i: ,.',W4, „„
V ..•p., , i,....4-,d` ,, -4..,...' . . - 4-1' ;,
Business name: Sunset Heating and Cooling Clothes dryer (gas)
Other:
Address: 0607 SW Idaho Street
City/State/ZIP: Portland, OR 97239 Subtotal •Iu
Minimum permit fee (572.50) 1 -•,,,?:, `:,--_,,,t
Phone: (503) 234-0611 Fax: (503) 234-0439
Plan review (25% of permit fee)
CCB lie.: 161085 State surcharge (8% of permit fee) 4- :/- WO
... ,, i ...
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',,/\, 'N-kri" TOTAL PERMIT FEE 19:0
This permit application expires if a permit is not obtained within ISO
Authorized signature: i' '''',----- - A''' - - '
s 1 (....----' days after it has been accepted as complete.
'........,
Date: (1,2,..'6. 14,-,.. \.,.,,
Print name: Shauna D'Amb • Fee methodology set by Tri-County Building Industry Service Board
i
i .113u i Id i ngTermit AME C- Pcnnit App dm 12/03 440-461 Tr (11/02/COWWEB)
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Name: ftz,1.\..1 rt ."
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Address: 12,Log( :ct. wom Pot() Itki\
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CITY OF TIGARD
BUILDING DIVISION . ^ -, - PERMIT #: MEC2006- 10051
13125 SW Hall Blvd., Tigard, OR 97223 _ DATE ISSUED: 6115'2005
Phone: (503) 639 -4171 aio \
( �
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: 7/3/2006 TIME: 7.03AM PAGE: ?8
SITE ADDRESS: 12681 SW 116TH AVE CLASS OF WORK:
SUBDIVISION: HUNTER'S GLEN LOT #: 012 TYPE OF USE:
PROJECT NAME: MIX
DESCRIPTION: Installation of NC unit,
OWNER: MIX, KELLY & WYNONA PHONE #: 503 - 705.6700
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503 -234 -0611
Inspection Request Scheduled For: Date: 7/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 032583 -01 503 -234-0611 N
Corrections /Comments /Instructions:
C , 1 •
'ASS ❑ PARTIAL APPROVAL ❑ CANCEL f] NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e. r Date: F. ?' 3 . 0 G Phone #: (503) 718- 7_4,