Permit CITY TIGARD MECHANICAL PERMIT
�� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00325
n�� 1 3125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/20/2006
PARCEL: 2S112CD -13300
SITE ADDRESS: 07764 SW CYPRESS LN ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 031 JURISDICTION: TIG
Project Description: Installation of 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:
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
ALEX PALADIOS Description Date Amount
7764 SW CYPRESS LN
TIGARD, OR 97224 [MECH] Permit Fee 7/20/200E $72.50
[TAX] 8% State Surcha 7/20/200E $5.80
Total $78.30
Phone: 503- 430 -8478
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: a�
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 �u li c� a IOl OFFICE: I.l w_ ()NI .Y .
Received �_ e _
City of Tigard Date/By: '
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639-4171 Fax: 503.598.19 �®� � r li .), ls Plan Review
:‘,44i,, Date /By: Other Penni[:
Inspection Line: 503.639.4175 ' I . � . • Date Ready/By: LB See Peer : for
Internet: Www,ci,ugard.or.us �� !� Q .1 Notified /Method: Supplementut lnturm+itiun
1 D 1
;PE 0 - t\0 • 174,16M-Z4 I MER
1 COMMERCIAL FEE* SCHEDULE 7 USE,Cf L(CKLIST
r a " 7:7 '--- echaniCal permit' fees` are based on the value of the work
❑ New construction EA i sf( t l ration / reh l acettl T 7 i e � p , •
performed. Indicate the value (rounded to the nearest dollar) of all
0 [� (�}FCerr mechanical materials, e ui•merit, labor, overhead, and .tn fit,
• • CATEGORY OF CONSTR UCTION.. . , . •
.. Yatue $
l'1 and 2- family dwelling ❑ Comtthercial /indu3trial 0 Accessory building RESIDENTIAL EQUIP.NJEJyT /:SYSTEMS FEES*
For special Information use checklist,
❑ Multi - feebly ❑ Master builder ❑ Other:
_ Description Qty. > u. Total
JOB SITE INFORMATION' AND .LOCATION lieating/conling
Air conditioning or heat pump
Job site address:
Svnl ac. vt{ -„_ _ (requires site plan showing placement) I 14.111) iy _00
City/State/ZIP: -1' - Gt _� Furnace 100,(100 BTU (ducts /vents) 14.00
, R. r A a — " -9 Furnace 100,000+ BTU (ducts /vents) 17,90
Suite/bldg. /apt. no.: I Project name: T Gus heat pump 14.00
Cross street/directions to job site: Duct work 14.00
hl drone hot water systetm 14.00
Residential boiler (radiator or
hydrvnic) 14.00 _
Unit heaters (fuckype, not electric),
in -wall, in -duct. suspended, _etc, _ 1001
Flue /vent for any of above 10.00
Subdivision: _ Lot no,: Other •
10.0(1
Tax map /parcel no.; Other fuel appliances
1: :.: ..:. . : ',: .... : N t� Water heater
� ,' . AESCRII!T 4 :OF.'�VORi� .. 10,00
Cas fireplace 10,00
Ai A fi d 0 Flue vent for water heater Or gas
fireplace 10.00
— ----- Log lighter (gus) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
T —
" Chimney /liner /flue /vent 10.00
'' .. :. :PRO ?ERTV 'ON'NE4Z '': 7 : 0 TENANT
Other: 10.00
Name: a I d ; Environmental exhaust and ventilation
Address:
Runge hood /other kitchen
e ui.ment 10.00
City /State/ZIP: 5 i� & Clothes dryer exhaust 10.00
Single -duet exhaust (bathrooms,
Phone: (565) s-1 f 3t,_ 4 1 g Fax: ( ) toilet compartments, utility rooms) 6.E;0
. .... '. ' ''rEit APPLICANT ': ❑ CONTACT • PERSON _ Attic /crawls acp a taus , 10,00
Other. 10.00
Business name:. Fuel piping
Contact name: $5.40 fur first four; SI.OU for each additiona
Address: f um see, etc. r _
Gas heat um
City /State /ZIP: WalUsuspendcd /unit heater
Phone: ( ) INII fax:: ( )
Water heater
Illr Fireplace
E- mail: Range
• :;:'. :: t::... 1!. Q .
, :: .. . ... ;'. C0 . RACE'.. ht . • .:'.: ;:. .. Barbecue
Business name: ! ! I �Li ., Clothes dryer (Ras) •
�� �— Other;
•
Address: / / 2.6 , '•``` :M CF 2JJC :
ea ' ' � � AJa �!~�MI'T FIDEt►
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City/State /Z1P: e t - v V 1 9 / (,)/ . 3 Subtotal
Phone: ( G�j) Z �� - 2.� Fax: ( 5) // ' Minimhutn permit fee ($72.50) 1 2 , 5 D
1 ' ... 4 Plan review (25% of perm fee)
CCB lie,: / v0
--- State surcharge (8% of pent1it fee) 5 , Cr 4
���� TOTAL PERMIT FEE 7 . 3 Q _ �
This p ermit ap plication expires If a permit is not obtained within 18 ;t
At
Authorized signature: days after it has been accepted as complete.
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07/18/2006 16:18 15032632513 ROTH MECHANICAL PAGE 03
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CITY OF'TIGARD
BUILDING ®IVISION PERMIT #: MEC700 -00325
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 /20 /2006
Phone: (503) 639 -4171 !° 0 04iiil"�l��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: i140007 TIME: 7: 00AM PAGE: 'IJ
SITE ADDRESS: 07764 SW CYPRESS 1.11, CLASS OF WORK:
SUBDIVISION: I- IAMBACHGROVE LOT #: 031 TYPE OF USE:
PROJECT NAME: PALA(3I0S
DESCRIPTION: Installation of NC unit.
OWNER: PALADIOS, ALEX PHONE #: 503 - 43043478
CONTRACTOR: ROTH HEATING ,& COOLING PHONE #: 503 - 266.249
Inspection Request Scheduled For: Date: 1 432C}07 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 041796 -01 50328 &1249 N
Corrections/Comments/Instructions: ,�i
S O a 772, c2 4I 1.44., uaRr /,,&.bc —c. 4# - 5 q4-5 3G. .. .. cz•71 c e —a,.., t `G
I
•
ASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL , CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
A i, Inspector: Date: / —_4 —lam Phone #: (503) 718 -S