Permit CITY TIGARD MECHANICAL PERMIT
Azt On DEVELOPMENT SERVICES PERMIT #: MEC2006 -00377
I DATE ISSUED: 8/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 DA -05900
SITE ADDRESS: 08813 SW BELLFLOWER ST ZONING: R -7
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT: 054 JURISDICTION: TIG
Project Description: AC install.
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:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TERRI CLIFFORD Description Date Amount
8813 SW BELLFLOWER LN
TIGARD, OR 97224 [MECI - I] Permit Fee 8/7/2006 $72.50
[TAX] 8% State Surcha 8/7/2006 $5.80
Total $78.30
Phone: 503 - NA
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 -2952 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 281 -0752
FAX 503- 282 -5722
Reg #: LIC 8897
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:
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.
iviechankcal Yerlmat . '
Applrca i ') i :. , , ,- ..... , .:FOR Oi+l +'d 'E S • ,1 .• , - ,
' . •t
tc City of Tigard j�." 1\ A R! t, D d �t 7 I'cnnitNo.:�' �j7C�&j�� 7
13125 SW Hall Blvd„ Tigard, OR 97223 \.l �l vl 1ri� i' y
Plan Movie Other Perm:
Phone: 503,639.4171 Fax: 503.598,1960 A.vmplo4i a Date/Ry:
Inspectioat Line: 503.639.4175 AUG o 1 a�1. . 'el I bolt luady/liy: -- Jeri 50 See Page 2 for
Internet: www.ci.tigard-or.us ' G NetiffodMlcthod: Supplemental information
' Ira rtw= tom►
x'. ,YT "•••7, ^ •'r, ^ t1'�r „�Mf�('9 M1, .k Mr,.y� �A�y " vb u �4 .,y .. •1 . � ..- � ryr,{p� ..P4 , , .t.,. s , . g r �. • � ; -- 1 . '.. .i�ar ^- , ntir.i ,� � Mu ^ +' - 'r +.w �.r,, : :T�r,: ��
3:I + L Sti; 4 } "1' '� � SA Id S/ 6 ;' xF" • Qi� ` n e i, i� � ,.�. ti iW' , �4J.. Rv� n, A , , :. 0 l l 'f `•f tie {41.t }1:1r: ; e 1'�)d R ' t 1 ,� `f7 g,Ot +.jug, '
..,LxY�c to a ,iip, , s l : wed x• A , .. , L.>bm; 16C . 2le. d +' ri41 k,4 {�hil. h� a ^ ta i, • ,,.,.,
i `‘ ' to ` ` Mechanical permit fees* are based on the value of the work
New construction
Q ® b t . i /rllteri>ttton /replaeernent performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead and profit.
r, +,!RT '++OC §: y a DAJ•1 L 1 MP SEW .,'
a _ r ' SrSr } EV C kl, a1 �c s "�,Ir" �`y,.�t iU t's , �� i L ' 1 t t, d ,',,: tt,'4 ,,, Value: $
it fu, �- ks1.��iA.r. :,, r t w a Y- a „ ,m, w -: , .
7 t a <'1 t 3 • ,} � tiyW;w, n r .ar^r .� y . r t ,r � n4 r, ry '•�KU, �'� e +; .�.�
® I- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building � ' �' I � "'Jy
Multi Master builder For special information use checklist.
❑ y ❑ ❑ Other maw, Description Qty. 1 Ea. � Total
i ' r . `r r i . �it ill ' t 1 t pd 7N v 47 i lr ' ., A r'^ Beating /cooling I
Job site add ress: 1 '3 !} f� Air conditioning or heat pump i
7Llti� 7 (requires site plan showing placement) ) 14.00 . /IA .(t 1
City /State/ZIP: Furnace 100,000 BTU (ducts/vents) 14,00
�� � �� { >� / n Furnace 100,000+ BTU jduets /vents) 17.90
Suite/bldg. /apt - no - : Project name: \e C
v 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) t4.00
Unit heaters (fuel -type, not electric),
in - wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: I Lot no.: Other: 10.00
Tax map/parcel no.: Other fuel appliances
y� • �, p�y
"E, "),4 '. , f ,4 p �`�L'k tU;d S: 9li , ' r S �' y �d � 4 ', .,"�A'd �r , r � ti.'whSU a tPS�S y ^ I i Water heater 10.00
Gas ere lace _ 10.00
/ ./ ) 1\ ]\ O, \\ N \, i . *\ 4 ,S. Flue vent for water heater or gas
fireplace 10.00
--- Loj lighter {was} 10.00
•
_�� wood /pellet stove 10.00
Wood fireplace/insert 10.00
�� A A : . 4 r' r, chimney/liner/flue/vent /liner /flue /vent 10.00 4
i,g / +:'a ,; + " •',� �rt ppa �t 'r� M yy �� RR .r. ' , ` r , pp� 1 '/i R i, t• ' 9 x !
,�� 1H �5 �� ^^�yrx,���- `dr .M�y Jiy, ���� � � � �� : '.. A � .W r + ^ 7 �ti tr (�kS!M Y /,
�'.$ ' a� S�1Y �`Y1Y / / VA•J4 r I 1 �, 1 ,T -p. At pi A .^ t, Other: 1V.o4
Name: _ C c C j\k • 'kb ' Environmental exhaust and ventilation
Address: ` r• Range hood /other kitchen
� ) � c\ � �� � LP equipment 10.00
City/State/ZIP: /1 (� ()Q (171 a t( Clothes dryer exhaust 10.00
S Single - duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
^: r� r4, . P){., .� v w{� • mt + U�" t. U Q {, rrs� 11'., r s v ,YH vl`vn ar Anic/crawlspace fans 10.00
:•*.,r;.`a,,iM1tr,F pr i zt . !.4 ''tQrYEffir,4•pc q , t'� " P '/4 °Y.r „ - _ r a l i, ti
Other: 10.00
Business name: �; (�� {,l` \�(, 0,a) \v - -
F ue l piping
Contact name: %'��%i ` e% 'd l • $5.40 for first four; S1.00 for each additional
Address: Furnace, etc.
•- -.-- -- Gas heat pump
City /State/ZIP: Walllsuspcndcd /unit heater `
•
_
Phone; ( ) [ Fax: : ( ) Water heater
111 Fireplace
E -mail r, N h it C? ' ,. ,' % 1 'r , L) , Range r
1,:i ..1.t;tr ,.. F '''''',11,b71':',' r�+�+ a t''' { � � C r' ,' v'ir s ��. � L � �� . rob
- : n. .. + ` . G ;'t'A . 1!• . � 1�" „? .• rp „ i Nu �tLW.d., i _ (�i :,'••i h" 4, t ,..r ' + r k �Yl :, A ,t 1 N' Barbecue
Clothes dryer (gas)
Business name:
a(\(''A \\ \* - )( 0, }- C, ,1 \ ,(\C Other:
Address: �� ( y: Y ,4.P :,r, ,nrwa ^ :�s :. ^vsn, e . ; �,, , al.
:.,,QC) k (A t .Y ' \.7 i t;' : r :i
�� � , • :(,- '�i' 1 ,A� Yal': ]11:f1`:TE S :
:� =
City/State/ZIP: f�
iP: 11 C ( Cti • `( ` _.._. - Subtotal )t{, CC)
Pho ne: (4 : ) lt< + Fax: (.. 2 k
Minimum permit fee ($72,50) - ,�'
l ` i (;.1..:::c.,;)__ -�� ! 1 3 t 'I Plan review (25% of permit fee)
CCH tic.: "?R•9 1 State surchnr e (8% of permit tee) Ac , () i
TOTAL PERMIT FEE '7-1-'3 „--C
_
Authorized si8uanire- l ' A� / -` � This permit application aspires i1' n permit is nor oetaincu within 180
1 meter it has been accepted as complete.
Pt•iat na1111.. r ' 0( ) �k 1 \' _. `�Q; , ''' f Date: • r (1 - . D.../ • Fee methodology yet by 1'ii- Ctninsy Building tudusiry Service Hoard
, Uiv , id , +!.Ucrndis\MEC- PianiiApp.doe 12/03 440.1617T (I OW /COM /WE:1i)
Id WdET :E0 900E b0 '6n0 EELS 20S : 'ON DNOHd but Ioo3 'g 6utl:eaH 1I19Nd : woad
H
\\:
. •
RI .
a_
CONTRACTOR A/C-HAT PUMP -- MR SiTE PLAN
r •
A ,
r\i'•
Direciri) in
eei TO SACK ROPERTYLINE
cs) U
cv
,i. .
6 _
. . ._ .. .. . _ .
a
l't.. et'
TO SJIJE PROPERTY LINE
N
N
N
N
co
•
N
n
o
•
_ .._ .. .. sfteio PMferi Lit\e-
.. ._..... ...__ . . _ .. ... _ .
0
z
w
z
0
I
o_ •
TO SIRE ET
. .
. 5L \
cr,
- 5 . CUSTOMER INFORMATION
u
o NAME •
cz
cr, ADDREss • 1 P''f C j
...,
S \
w3 su3 5_,\■c,\(),J3( .,- .
,
E
0
U-
CITY OF TIGARD - "
BUILDING DIVISION PERMIT #: MIEC2006M03
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/7/2006
Phone: (503) 639 -4171 /adi X19"
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8h8/2006 TIME: 7:03AM PAGE: 86
SITE ADDRESS: 08813 SW BELLFLOWER ST CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT #: 054 TYPE OF USE:
PROJECT NAME: CLIFFORD
DESCRIPTION: AC install.
OWNER: CLIFFORD, TERRI PHONE #: 503- NA
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503. 201.0762
Inspection Request Scheduled For: Date: 8/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 035149.02 603-438494 N
Corrections /Comments /Instructions:
""1-6C- Lila , ,.-c.r, W4.6 - ,5L #' s '?Y 641 6 . u
`PASS ❑ PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
I I FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: 6- /I -alv Phone #: (503) 718 - L.44S—