Permit 4 CITY OF TIGARD MECHANICAL PERMIT
��� DEVELOPMENT SERVICES PERMIT #: MEC2005-00827
= --� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/16/2005
PARCEL: 25111 DA -04200
SITE ADDRESS: 15224 SW CRITERION TERR ZONING: R -7
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT: 037 JURISDICTION: TIG
Project Description: Install heat pump.
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MICHAEL THAYER Description Date Amount
15224 SW CRITERION TERR
TIGARD, OR 97224 [MECH] Permit Fee 12/16/200 $72.50
[TAX] 8% State Surcha 12/16/200 $5.80
Total $78.30
Phone: 503 -598 -9983
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 640 -3607
FAX 503 -681 -0793
Reg #: LIC 66578
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: Z(1 " -- =� Permittee Signature: s p}\
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business a s .
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 Application ' FOR OFFICE USE. ONLY
City of Tigard Iteceived
Date/Ely. , 16 65" , - Permll Nal h.6—)Cd /6 1 7
13125 SW Rail Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax 503,598,1960 ,. ,,,,
4,4■ Ityal I ii" Dale/By ' Othet Permit;
Inspection Line: 503.639.4175 .1.0J■ ' ..I.. Date Ready/By, IZ See Page 1 for
Internet: www.oi.tigard.or.us
Notified/Method: ' MI Supplemental Intorrnarlon
• • , , , ' ;' . 1 1 , 7 ':;,7 . :: . s i : ' .,,,„ , e . '14 1 '3,0' ,, `: : ' : ,E CW,OR1C7' , ' 1.••- , :',,'' l ';. " ' , '!i',L' '• . ..,' .1'01V61.0-CIAI.,, It:.E • SCkEDULE - USE CHECKLIST
C] New construction 111 Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of at]
fl Demolition 0 Other
mechanical mace equipment. labor, overhead. and omit t
Value: $
- i', : . • 7Y,r'd'i.,,; • :;. cAitOeik • CONSTHP,CTION ;',....l I'' ' . ' • „ , .:: '., . . ,.
, , , ' RESIDENTFAL FOrr-PMENT / SYMMS FEES*
IP - and 2-family dwelling 0 Commercial/industrial 0 Accessory building
F 37:NW:al inOnnation use checklist.
0 /viuld D Master builder C Other:
Description Qty [--.. E. ' I Total
1' ,;. " ...e.;.;leiii sritiNE jANti LOCATION .:. . , I ' ' ,- Heating/cooling
Job site address: T
ir. A t conditioning or heat pump
r-2a_ 6171--1-c4.1 frequires MO pion showine placement) 1 14,00
—
City/Srate/ZIP: 773 5 2:4,"( Furnace 100,000 BTU (ducts/vents) 14.00 i
Furnace l 00,000+ STU (ducts/vencs) 17 00
Suitc/bldg./apt. no.: Project name.
Gas heat pump I 00
Cross street/directions to job site: Duct work 14.00
ydrome hot water system . 1400
Residential boiler (radiator or
hydronic) 14.00
—_______.
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. etc. 10 00
Fluc/vent for any of above 10.00 1
Subdivision: Lot no,: .
Other' 10,00
- _
Tax map/parcel no.;
Other fuel appliances
-.. ,..0 ; ,., ,. '1,)ESCRIPTION, OF.: WORK r;i,' ' -;,t, , , ,„ , , Water hcai;r
I i 10 00
Gas fireplace _ 10.00
Flue vent for water heater or gas 1
lircplace 10 .00
(Y.-l 1- - 1 A ki IA.9-c.vt rLA-1,- _
Log lighter (gas) 10,00
, Wood/pellet stove I 10,00
Wood fireplace/insert 10,00 1
—..„
Chitnnev/Iiner/flue/ven r 10.00
! TIdlIP 120i..# ,ckwog*:0; -,..,' I. -',!•,:‘,:'„„ , ,:r
. 114 .c'
'.' Ocher 1 I 0 OQ
r
Name:
••• i' : Environmental exhaust and ventilation
Range hood/other kitchen
Address:
I
equipment , 10 00
City/State/ZIP:
Clothes dryer exhaust 1 10.00
— Single-duct exhaust (bathrooms,
Phone: ( ) rCted-,- c qd y Fax; ( ) toilet compartments. utility rooms) 6.80
0 r 4.P ,,;:'''' . - .CONTACT, PEpSON, - Attic/orawlance fans 1 10.00
Other: 1000 J
Business name: :. , ^ c -:_( - k_..) /4 t - t l / - \ LT_ . - •
Fuel piping
Contact name: / (Net P (- C s _ ( ' / c t.' c. -‘ _ Furnace. $
et 5 c ..
.... 40 for first four: $1.00 for each additional
_
' I
Address: - > 7 .- S 6. c ("' -frt .._ I
I- ,......., -i ,. c C i.- f - rD t 2. ,...., Gas heat pump
City/State/ZEN 7 (. ei c, c(,_ , C ie 9 )- 2_ -. 3 Wall/suspended/unit hearer
Phone; ( c ) 6 c.( e. , - /- L 6 ?., Fax. : ( . )
Fireplace
E-mail:
line
1101 (..',;,:,.,ii.q.c'4',.:.. s'';',,'4;',;/?I'''""..I''-,- Barbecue
Bu .P' ;
siness name: • ,- ... . •
SI.--(. ....-...k.- .--1‹...-..,.:•.-..C• ..J-- , Clothes dryer (gas)
Other
Address:
:lA
; Ill,. I , .,rCia.A4NICAT:.,P4RIVEET. VEES'•
City/State/ZrP:
Subtotal
Phone: ( ) . I Fax. ( ) . minimum permit fee ($72.50)
-----. .. Plan review (25% of permit fee)
CCB tic.: 6 ( r 9. S'''' .
State surcharge (8% of permit fee)
TOTAL PERMIT FEE I - y.j X)
,
Authorized signature: C.-.1 \L.f.. c •-k.._..._. Thls permit uppileetion expires If permit 12 100 t obtained within 150
day, after it bail been 2 ccgp red ue complete.
Print %lame: A t.t,_-, e - I CC..., \ Date: / I • Fes methodology SCE by Td-Ccurity Building Industry Service Board
6.13211ding1PerrnaMMEC-PerrnicApp,doc QM 4410-1217T (1 I /07./C0 NUMMI)
XVJ Z0 . 171 g 0 OZ/9 1. /3 I.
C00/3 0 0 21
SITE PLC
IP I
PL
PL
I I j
PL
K V � w Lri c>y \.
STREET
Specialty Heatina & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax 503.598.0718
1zllsboro Phone 503.64 -0 -3607 Fax 503.
61.0 793
COO /CO0 Z4 bl 4002 ?9L ?Zl
CITY OF TIGARD
BUILDING DIVISION - - PERMIT #: MFC2005_O027
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/16/7OO6
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 ._..
INSPECTION WORKSHEET FOR DATE: 1/18/2006 TIME: 7.01AM PAGE: (;,
SITE ADDRESS: 15224 SW CRITERION TERR CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 2 LOT #: 037 TYPE OF USE:
PROJECT NAME: • ll~HAYER
DESCRIPTION: lnslall heat pump.
OWNER: THAYER, MICHAEL PHONE #: 603- 69B - Y933
CONTRACTOR: SPECIALTY HEAL iNG & COOLING PHONE #: 503.,640-3607
Inspection Request Scheduled For: Date: 1 /10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 025165-01 503 Y
Corrections /Comments /Instructions:
OFF WC eie
f'\
PASS n• PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL • CA F. - SPECTION ❑ ADDITIONAL FEES ASSESSED
-
Fr
Inspector: Date: j t,C f ( hone #: (503) 718-