Permit CITY OFTIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00292
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/21/2007
PARCEL: 2 S 115AA -10300
SITE ADDRESS: 10978 SW BRETTON CT ZONING: R -4.5
SUBDIVISION: BRETTON WOODS LOT: 008 JURISDICTION: TIG
PROJECT: LEE
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
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
ROBIN & CAROL LEE Description Date Amount
10978 SW BRETTON CT
TIGARD, OR 97223 [MECH] Permit Fee 5/21/2007 $72.50
[TAX] 8% State Surcha 5/21/2007 $5.80
Total $78.30
Phone: 503 -789 -6795
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478 •
Reg #: LIC 14008
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 1/ MI ' L .. 1. /2 Permittee Signature: Qp q/yl ; `th-cr1
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.
May 18 07 07:OOp p.2
1Vl ec h la n ica [ P ermit App�l�, atlJo - , i I ,, • FOR OFFICE use O NLY
City of Tigard Reeerved , a 1
Date./By 5 I �- ) Petmit No.: A E ,
13125 SW Hall Blvd., Tigard, OR 97223 Y` t ' 7 ` n 02
Phone: 503.639.4171 Fax: 503.598.1960 tq n i I Flan Review
L,ttift, 1 v Date 3y: Other Permit: � _ �3�
Inspection Line: 503.639.4175 �' IN ` ,.,i, (I ;1' N Date Read /t3 Juris: ' El Paa
Internet: www.ci.tigard . Notified(Method:
Y � r "' . ' S1 . i l �r 1 k -t" Supplemental information
-a ': " VI
CO hfERC1AI . EEE *. SCHEDULE = .US1 CHECKLIST
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❑ New construction .. Addition /alteration. /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
:::',. =CATEGORY OF CONSTRUCTION , `: ue: $
Value:
2-family dwelling : °AES1DENTIAI ;:EQUIPMENT /`SYSTE[NS *i
1 -and 2- fa
y g ❑ Commercial/industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description 1 Qty. I Ea j Total
..:: JOB SITE INFORMATION AND .LOCATION
rip •
_...... Heating/cooling
Job site address: ( 0° Air conditioning or heat pump
1 g�� --11 _ (requires site plan showing placement) ( 14.00
City/State /ZIP: ' -C- ( . Li `s;/ Furnace 100,000 BTU (ducts/veins) _ 14.00
Furnace 100,000+ BTU(ductsisenis) 17.90
Suite/bldg./apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydmnic 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
: ` - . - DESCRIPTION op ;WORK Water heater 10.00
Gas fireplace 10.00
. Flue vent for water heater or gas
Q' . 13-1/-) 10.00
1 Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
.::.:: PROPERTY OWNER. .. .:.. G. TENANT • : mer /(lee /vent 10.00
Chimney/l
,`� Other. 10.00
Name: `01 Environmental exhaust and ventilation
F I ' Range hoodiother kitchen
Address: I ��L equipment 10.00
City/State/ZIP: V _ ,I�`b 4 1 7 b35. Clothes dryer exhaust 10.00
t! `G'- Single -duct exhaust (bathrooms,
Phone: ( ) ib 3$ - �f Fax. ( ) toilet compartments, utility moms) 6.80
:11 ICANT : - : CONTACT PERSON crawlspace fans 10.00
0 Attic/
Business name.:
Other 10.00
_Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wallisuspendediunit heater
Phone: ( ) I Fax: : ( ) Waterheater
Fireplace
E -mail: Range
, :- .r.:!. . CO ..... _ : IyTRA '; •: ' :::. :;... - - Barbecue
Business name: g h cry Clothes dryer (gas)
p & , / 2 ( O� O t h er: _
Address: • ;;-1, _ , . - MECHANICAL' PERMIT FEES* 1
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City /State /ZIP: ea.vi' � 9 7D,. Subtotal
( J�) Z _ Y / 7 / / — Minimum permit fee (572.50) `7 '2_,,,c j
Phone: 5 65i . - - t 2..L/ 6
Fax: (5 ,f9 2 7 /1 7e
� Plan review (25% of permit fee)
CCB lie.: / ()Of State surcharge (8% of permit fee) 5, !O
/�j� ^�, TOTAL PERMIT FEE ` 3
Authorized signature: / (f/YY , V 6 ` This permit application expires if n permit k not ohtatne • wi within ISO
• �t days after it has been accepted as complete.
I Print name: / 1 J� V u f /I (0,L Date: / Y l - I ' Pee methodology set by Tri County Building Industry Service Sward
ir1Buildinb'Pe„ica>MMEC-Permit A pp. doe itfOS 44u- 4517rt I iio2•Y:OM1Vwtiai
May 18 07 07:OOp p.3
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• CITY OF TIGARD
BUILDING DIVISION ' " PERMIT #: MEC2007 -00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/21/2007
Phone: (503) 639 -4171 �i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/23/2007 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 10978 SW BRETrON CT CLASS OF WORK:
SUBDIVISION: BRETTON WOODS LOT #: 008 TYPE OF USE:
PROJECT NAME: LEE
DESCRIPTION: Install a/c unit.
OWNER: LEE, ROBIN & CAROL PHONE #: 503789.66795
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266 - 1249
• Inspection Request Scheduled For: Date: 5/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 048884 -01 503 - 849.8595 V
Corrections /Comments/ Instructions:
PASS l PARTIAL APPROVAL n CANCEL I NO ACCESS
FAIL G? FOR INSPECTION ADDITIONAL FEES ASSESSED
.Inspector: — Date: Phone #: (503) 718- 1