Permit y 9 t
f
CITY OF TIGARD MECHANICAL PERMIT
*et DEVELOPMENT SERVICES PERMIT #: MEC2006 -00414
c DATE ISSUED: 8/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CD - 12700
SITE ADDRESS: 07704 SW CYPRESS LN ZONING: R -
SUBDIVISION: HAMBACH GROVE LOT: 025 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:
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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MELIA ARTHUR Description Date Amount
7704 SW CYPRESS LANE
TIGARD, OR 97224 [MECH] Permit Fee 8/22/200€ $72.50
[TAX] 8% State Surcha 8/22/200€ $5.80
Total $78.30
Phone: 503 -515 -3671
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 266 -3478
PRI 503- 266 -1249
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 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.
08/21/2006 08:41 15032632513 ROTH MECHANICAL PAGE 02
1l1vsb - K K
' � [ ' ehanica1 Permit A u -I, P ' I/OR OFFICE J�: I.lsi: ONLY q a yl� v - - Received
City of Tigard Dare/ay: Ole ■ Q.i effil yr >i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
e \ Other Permit
Phone: 503,639,4171 Fax: 503.598.1960 AUG _ 20 �'`Dq " ' 'ukpty r h Date/By:
Inspection Line: 503.639.4175 1 > ` 1 I Date Ready /lily; Mill El See Page 2 for
Internet: www,ci,tlgard.nr.us , ylt OF jIkJ $ Notified /Method; Supplemental Information
QyPE OF" W ORK COMMERCIAL .FEE! SCHEDULE. - USE CHECKLIST
Mechanical permit fees* aro based on the value of the work
❑ New construction Ei Additinn/altcrittiotl /repla • - performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other r mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCT! ME ylJ 91 Value: $
-- - maw RESIDENTIAL EQUIPMENT /:SYSTEMS FECS*
1- and 2 - family dwelling ❑ Commercial /industrial 0 Accessory building -
For special information use checklist.
❑ Multi - family 111 _ Master builder ❑ Other: Description P [ Oty, Ea, I Total
:.. ... JOB SITE INFORMATION AND LOCATION 1•
Air conditioning or heat pump
Job site address: 7p 5W t * re 6 4, I., v3.e____ (requires site plan showing pinoement) 1 14.00 I N. oU
Furnace 100,000 BTU (ducts /vent.) 14.00
ry a O R 7 2 Furnace 100.000+ BTU (ducts /ver,t:1 17.90
Suite/bldg. /apt. no.: 1 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
hydmnic) 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: I Lot no.:
Other,, 10,00
Tax map /parcel no.: Other fuel appliances
,
...., : :: !. .:
. . : : y , , : � . .:... • ....L.. � . , : ; : ... DESCRIP'`l"ION.Ci~F WORK .. r ; , . : : . ,... '' 10.00
. . . . . . . . .W a t e r heater
Gas fireplace 10,00
. f - r4d 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
- nn r /flue /vent
PItOPER'I;Y .OWNER . :: ... :.: 0' T. ENANT .. ..
Itnney 1 c 10 nn
H:: Other.' 10.00
Name: m 1i 0 , 1/4. . Environmental exhaust and ventilation
Address; Range hood /other kitchen
__
T equipment 1 0.00
City /State /ZIP: fM
5 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, �.
Phone: ( 503) 5 i 5 - 3 &,7 ( Fax: ( ) toilet compartments, utility rooms) 6.80
r crawlspacc fans 10.00
y+
APPLICANT Q . P ERSON Att
Y Other: 10.00
Business name:, M Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
- F rnace etc, -� -- ^
u
Address:
— - -- Gas heat pump
City /State /ZIP: Wall/suspended /unit heater
Phone: ( ) Fax:: ( ) Water heater .
mm Fireplace
E.. nail: Range
L, :' :: :.. ' , :;. is ;. . . Barbecue
:. .:.. � . CONTRALTO$.. :: , .
Business name: f�5 � �? / �Q Y - % Clothes dryer (gas)
I r O ther:
Address: - / `_�i� -- ;; ?•.`':'. : :... 1 MECHANICA :.I,;
t! �
City /State /ZIP: a 1 t✓. „ OK / 7U// : Subtotal
Minimum permit fee ($72.50) ' , 5 p
(5
Phone: j) L(069 -( 2 f _ 4 1 Fax: ( 5 � ) 2 6 Z . , • - 7 j � � � , plan review (2S %of pennil fee)
CCB lie.: L1 DO .' • - State surcharge (8% of permit fee) 5j 0
TOTAL PERMIT FE'R -7g , 3 0
` � , p t , (9 Thta permit application expires if a permit Is not obtained within I Rd
Authorised signature:
6/ days finer it has been accepted as cnmptctc.
•' Fee methodology set by Tri -Count Building Indust Service nuur i
_� /
[ Print name: / _ __ Dale; Y Y Y 8 h'
0812112006 08:41 15032632513 ROTH MECHANICAL PAGE 03
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CITY OF- GARD
BUILDING DIVISION PERMIT #: ME.C2008- 004414
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2212006
Phone: (503) 639 - 4171 "A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/14/2006 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 07704 SW CYPRESS LN CLASS OF WORK:
SUBDIVISION: HAMDACH GROVE LOT #: 025 TYPE OF USE:
PROJECT NAME: ARTHUR
DESCRIPTION: AC install
OWNER: ARTHUR, MELIA PHONE #: 503 - 616-3671
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 803-26E0249
Inspection Request Scheduled For: Date: 9/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036514 -01 503 -515 -3671 Y
Corrections/Comments/Instructions:
I!� PASS I 1 PARTIAL APPROVAL fI CANCEL ❑ NO ACCESS
FAIL CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9 14-- 6 c 2 Phone #: (503) 718-