Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00275
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 2S 110AA -92921
SITE ADDRESS: 10825 SW CANTERBURY LN 102 ZONING: R - 12
SUBDIVISION: CANTERBURY CREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: CUMMINS
Project Description: Install a /c.
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
JOHN CUMMINS Description Date Amount
10825 SW CANTERBURY LN 102
TIGARD, OR 97224 [MECH] Permit Fee 5/15/200i $72.50
[TAX] 8% State Surcha 5/15/200i $5.80
Total $78.30
Phone: 503- 352 -5294
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 By: _ a d o , j / / " Permittee Signature: / &n
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.
Maj 15 07 08:09a Oregon Heating & Fl /C 503 - 537 -2172 p.1
Mechanical Permit Application . FOR OFFICE USE ONLY ; .
Fril City of Tigard Date /B : I AL. PermitNo.: H I , ^ 002
' 1 3125 SW Hall Blvd -, Tigard; O2YSI .A"i r Da le/'B R 97223 y G 1 5 200 Plan Ryiew
' Phone: 503.639.4171 Fax: 503.5 0 Other Permit:
TIGARD Inspection Line: 503.639.4175 Date ReadyiBy: KM ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD NotitiediMethod: Supplemental Information
Rlll1_glWG DIVisi®N • TYPE OF WORK COMMERCIAL PEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /al teration;replaeemen[
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. •
CATEG ORY OF CONSTRUCTION Value: S
® 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
' For special information use checklist.
❑ Multi-family ❑ M aster builder ❑ Other:
Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
^ g c � VI� (' ' Air conditioning or heat pump
Job site address: • l J � ,1 Q
5 c ) -� ��C }r LL''\ I 0 (requires site plan showing placement) 1 14.00 I 4.0()
City/State /ZIP: Ticaar ] 11aD/ 1 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: Project name: r J'^' t t yti�in1AS 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
hydronie) 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 OF WORK Water heater 10.00
•
HVAC Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
•
lfl5t(:\ K. Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER • 1:2 TENANT Chimney/liner/flue/vent 10.00
Other. 10.00
Name: ��,�� (J ,rn1 h C Environmental exhaust and ventilation
Address: ��(0t , � cQr ) e ,� b. # e� Range hood/other kitchen
r J .3 equipment 10.00
City/State /ZIP :i`crd 9i /4 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (9:y) a -59cty Fax: ( ) toilet compartments, utility rooms) 6.80
Ei APPLICANT ❑ CONTACT PERSON . Attic /crawlspace fans 10.00
Business name: Oregon Heating & A/C
Other 10.00
Fuel piping _
Contact name: .aS $5.40 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
Minimum permit fee (572.50) 7 a . 50
Phone: (503) 538 -2953 Fax: (503) 537 -2172 Plan review (25% of permit fee)
CCB lie.: 172126 State surcharge (8% of pennit fee) . g
TOTAL PERMIT FEE 7g.
Authorized signature , t This permit application expires if a permit is not obtained within 180
' days after it has been accepted as complete.
;^�
Print name: f 26.)(1 t� bee, e, Date: 5 — 5 —/7 t Fee methodology set by Tri- County Building Industry Service Board
Ii. Buildint; ln
Paits '• P 04 /0 l 440 -4611 (ii '02 /COM%WEB)
N
1 10
1 V
INJ , 6 .c•'
r...
.
Ct.I
1
r--
CO E i
. c 1
i
CO
0 i
I1)
1 I
!
i • ,,..)
U
cc 1
C (", r L 1
..-1
.I-) I ;
(13 I .
a) _
r Y
c
ha
to
L
o .
to t) Cark4TtrbUi'l LO - if
1
co /04b'
o
cm
o
E
0 ...
in
--, .
n
to
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007- 00275 .
13125 SW Hall Blvd., Tigard, OR 97223 0 DATE ISSUED: 5/15/2007
Phone: (503) 639 -4171 a� 1 1
Inspection Requests (24 Hrs.): (503) 639-4175 _..
INSPECTION WORKSHEET FOR DATE: 7/11/2007 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 10825 SW CANTERBURY LN 102 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CUMMINS
DESCRIPTION: Install a/c.
OWNER: CUMMINS, JOHN PHONE #: 503 - 3515294
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 - 538 -2953
Inspection Request Scheduled For: Date: 7/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 051775 -01 503 - 538 -2953 Y
Corrections /Comments /Instructions:
fp-
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 471 i /1/ Date: 7 // v Phone #: (503) 718 -