Permit CITY TIGARD MECHANICAL PERMIT
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�4 DEVELOPMENT SERVICES PERMIT #: MEC2006 -00318
DATE ISSUED: 7/12/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104AA -11600
SITE ADDRESS: 12435 SW 129TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 135 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DAN & MART MORGAN Description Date Amount
12435 SW 129TH AVE
TIGARD, OR 97223 [TAX] 8% State Surcha 7/12/200€ $5.80
[MECH] Permit Fee 7/12/200€ $72.50
Total $78.30
Phone: 503 - 590 -4158
Contractor:
EASTSIDE HEATING + AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 774 -3281
FAX 503- 774 -3057
Reg #: LIC 3258
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: _ 0
Call 503-639-4175 by 7:00 a.m. for inspections that business da
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 12 06 11:39a Fax Server 503 - 774 -3057 p.2
Mechanical Permit A _pliP I n FOR OFFICE LSE ONLY 0
City of Tigard �,;/ Date/By; _ / 8 Parfait No.. A 72/` 5 1!
13125 SW Hall Blvd., Tigard, OR t 7 - `i` _ vt c t� i
g Plan Review
Phone: 503.639.4171 Fax: 503.598.7 960 TO _AU,' 'k 1..1 'k, , Date /By: Other Permit:
Inspection Line: 501639.4175 �1'l ^•/ Date Ready /By: B See Page 2 for
Internet: tYww. ci.tigard.Or.uS 1 j 1 c t f, Notified /Method: EIRI Supplemental Information
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liO 1 ,\1 S1O ' COMiMERCIAL FEE' SCHEDULE - USE CHECKLIST
t l�tt/BIteration/replacement Mechanical permit fees are based on the value of the work
❑ New construction performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQU[PAIENT / SYSTEMS FEES'
j' I- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi-family For special information use checklist.
❑ y ❑ Master builder ❑ Other:
Description / Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump +•)
Job Site address: 'pi 3 i 1 q I �v7� (requires site plan showing placement) j 14.00 I `�
City /State/ZIP: - r ^ Furnace 100,000 BTU(duets/vents) 14.00
/ ~� 0 �`� _ Furnace 1 00,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no_: I Project name: Q s Lid - t ra(:),V) Gas heat pump 14.00
Cross street/directions to job site: J 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
I Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORE: Water heater 10.00 _
f }} II Gas fireplace 10.00
, '_ [ f- ! 1r ( l: t-1 ,4t L �t�t (-'S I'll ✓? ev Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00 j
Wood fireplace/insert 10.00 1
Chimney /liner /flue/vent 10.00 j
PROPERTY OWNER ❑ TENANT
Other: 10.00
• Name: b C ,-.- M.r a 1'-- (D v -- 1 a _ ,.- Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (g ) ) _14 / Q_c Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT V CONTACT PERSON Attiderawispace fans 10.00 ,
; Other 10.00
Business name:
G F " � G�--1 r^ ./ `r r,... < �� r.1 , Fuel piping
Contact name: t?�.,1 3 „,... 7 . 7 ,... d $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. .
Gas heat pump _
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) ) 7 - 7 ;-( --.--7 j 1 Fax: : ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name: v ' , l r ,, d Clothes dryer (gas)
(?e �� vim ri ✓ 7 �/t r r'1 r'�� Other:
Address: .7 - -) E r 6 h o _s l5r-7 C,'e e K P f V d MECHANICAL PERMIT FEES"
City /State/ZIP: PO ( r^ A I i q 7 (O Subtotal
Minimum permit fee ($72.50) i 2. s
Phone: (5D 7 7 4 _ / I Fax: (5) 7 7 -3 U..s- 7 Plan review (25% of permit fee)
CCB 1ic.: 3 r g - S t a t e surcharge (8% of permit f e e ) 5-, :t )
TOTAL PERMIT FEE
Authorized si ature /� ,, This permit application expires if a permit is not obtained within 180
�i�' r� days after it has been accepted as complete.
I Print name: [ �� + I nnte• -7 _to _ t I = Fee ntethodolosy set by Tri- County Building Industry Service Board
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INSTALLATION ADDRESS:
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PROPERTY LINE
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CITY OF TIGARD .. ..., MEt�20(I6 00310
BUILDING DIVISION PERMIT #: 7/12/2006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 °`'' !..
7/21/2006 7: 01 AM 81
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
12435 SW 129TH AVE .
SITE ADDRESS: BELLWOOD NO. 3 135 CLASS OF WORK:
SUBDIVISION: MORGAN LOT #: TYPE OF USE:
PROJECT NAME: Installation of NC unit.
DESCRIPTION: •
MORGAN, DAN & MARTHA 503- 690 -416t1
OWNER: EASTSIDE HEATING + AIR CONDITIONING PHONE #: 503- 774 -3281
CONTRACTOR: PHONE #:
7/21/2006
Inspection Request Scheduled For: Date: Pour Time:
Cc 1 . # I imat9Ocipapmgri ption 99997 g9919 # 28 Mes
Corrections/Comments/Instructions:
'L — ii . , - .1 S 2 S i4 C, - —
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ' .� Date: -Z Phone #: (503) 718- C-.5'