Permit •
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00512
eau DATE ISSUED: 8/22/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 CC -04300
SITE ADDRESS: 15925 SW CENTURY OAK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 066 JURISDICTION: TIG
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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 -
HANSEN, ELSA M TRUSTEE Description Date Amount
15925 SW CENTURY OAK CIRCLE [MECH] Permit Fee 8/22/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 8/22/200E $5.80
Phone: 503- 639 -2953 Total $78.30
Contractor:
BEAVERTON HEATING + A/C INC
5400 SW 170TH AVE REQUIRED ITEMS AND REPORTS
ALOHA, OR 97007
•
Phone: 503 649 - 1271
Reg #: LIC 118441
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.
Mechanical Permit A 1 li'` t: r' .
1A i' ' �E FOROFFICE USE ONLY
• City of Tigard Date/By ^ —� jv Permit 4 .5 a'� •
AUG
13125 SW Hall Blvd., Tigard, OR 97223 2005 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / lai r t D Other Permit:
rtU. I y
Inspection Line: 503.639.4175 ' i •I _ I I Date Ready/By: Egil ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGA - Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction [Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEG_ ORY OF CONSTRUCTION Value: $
•
[�I - and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi For special information use checklist.
• y ❑Master builder ❑Other:
Description Qty. Ea. I Total
. JOB SITE INFORMATION AND LOCATION Heat' p4g ng
Air conditionin heat pump j
Job site address: /3 fb✓ eGvrow j� ,9A. /4. Cp2CLf iressnap s owing placement) / 14.00
City /State /ZIP: T /6 /4,o 0,e 97 Z`/ Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) • 17.90
Suite/bldg. /apt. no.: Project name: 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
' DESCRIPTION OF WORK Water heater 10.00
/ AQ Gas fireplace 10.00
0 p . 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 •
'2 OWNER • ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: %14a5G.,v Environmental exhaust and ventilation •
• Range hood/other kitchen
Address: /S S ski/ Gf y 04R Cfifc4-L. equipment 10.00
City /State /ZIP: 7 /64-/J, e2 97 z z y Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (52)3 ) 7 j,® — cp9',0 Fax: ( ) toilet compartments, utility rooms) 6.80
V APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: 4yA✓C/t7 1tATint -4 d 4/C / /,r,C Fuel piping
Contact name: rG „ d pyy / ", y $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: .5 SA,/ /7d ''` c/ Gas heat pump
City /State /ZIP: 4 d 9 7 <',7 Wall/suspended/unit heater
Phone: () L < 4 , /ZZ . / Fax: ( (
g � vi,,,� Water heater
�'3
Fireplace
E-mail: Range
- CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: 5,?.,,,£ 4.7 ,4 r'
Other:
Address: MECHANICAL PERMIT FEES* '
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: ,,1/ / State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7 , 3 el`
Authorized signature: ` % — / This permit application expires if a permit is not obtained hin ISO
• days after it has been accepted as complete.
Print name: ii-"4,,,,,g, "?, 1/ /, Cy Date: / /a5 -- * Fee methodology set by Tri- County Building Industry Service Board
is\ Building \Pennits\MEC- PermitApp.doc 12/03 440 -4617T (1.1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fe • Schedule:
Total Valuation Permit Fee:. f
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.01 $72.50 for the first $2,100.00 and $2.30
for each additional $170.00 or fraction
thereof, to and inclu• ng $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the firs $5,000.00 and
$1.80 for each additional $100.00 or
action thereof, to and including
$'.0,000.00.
$10,001.00 to $50,000.00 $2 .50 for the st $10,000.00 and
$1.3 ' for each .dditional $100.00 or
fractio thereof, to and including
$50,000.:0.
$50,001.00 to $100,000.00 $771.50 fo the first $50,000.00 and
$1.25 for :. c ' additional $100.00 or
fraction tr ereo to and including
$100,00 .00.
$100,000.01 and up $1,396 .0 for the $100,000.00 and
$1.10 or each additi.1al $100.00 or
fraction thereof.
Note: All new commerci . buildings require 2 set i f plans.
•
i:\ Building \Permits\MEC- PermitApp.doc 12/03 2
13H Beaverton Heating & A/C, Inc.
Alikt FULL SERVICE: GAS • NC • ELECTRIC • HEAT PUMP • CONVERSIONS • ADD -ONS TO EXISTING SYSTEMS
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5400 S.W. 170th Avenue • Aloha, Oregon 97007 • (503) 649 -1271 • (503) 649 -6446 fax • CCB# 118441
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006- 006'12
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/221200s
Phone: (503) 639-4171 .„ 10„t
Inspection Requests (24 Hrs.): (503) 639-4175
r INSPECTION WORKSHEET FOR DATE: 1/24/2006 TIME: 6:50AM PAGE: 86
SITE ADDRESS: 16925 SW CENTURY OAK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 066 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: Install NC unit.
OWNER: HANSEN„.1EANNE PHONE #: 50332G -10g) (cell)
CONTRACTOR: BEAVERTON HEATING + A/C INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 026396-01 5t6702 Y
370
Corrections/Comments/Instructions: /*/ r - 0 C) CALl' ( Me5 0 . tcl
. . ,
•
0 ri PASS PARTIAL APPROVAL r] CANCEL 0 NO ACCESS
FAIL /1 I4L FOR INSPECTION I I ADDITIONAL FEES ASSESSED
/ . , Z6-06
Inspector: / , .
Date: / Phone #: (503) 718-
- . - - •
CITY OF TIGARD .-
BUILDING DIVISION PERMIT #: MEC2C)05.00512
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2005
Phone: (503) 639 - 4171' °14
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/141/2005 TIME: 7:12A PAGE: 126
SITE ADDRESS: 15925 SW CENTURY OAK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIEL[) LOT #: 066 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: Install NC unit.
OWNER: HANSEN, ELSA M TRUSTEE, PHONE #: 503 - 320 -8980
CONTRACTOR: BEAVERTON HEATING + NC INC PHONE #: 503 - 649 - 1271
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6!19 V1 Mechanical final 02108402 603-649-1271 Y
Corrections /Comments /Instructions:
I �V b , 0115 �`�, �v ,446
I
1
fi
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: // r Imo,./ .. Date: ., Phone #: (503) 718 -