Permit e
CITY O F��rTI GARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00309
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/29/2007
PARCEL: 2S112CD -13200
SITE ADDRESS: 07750 SW CYPRESS LN ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 030 JURISDICTION: TIG
PROJECT: MILLER
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
ROGER MILLER Description Date Amount
7750 SW CYPRESS
TIGARD, OR 97224 [MECH] Permit Fee 5/29/2007 $72.50
[TAX] 8% State Surcha 5/29/2007 $5.80
Total $78.30
Phone: 503- 310 -2553
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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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.
Issue• ;y: �� ��� j // Permittee Signature: n, AO
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.
May 29 07 12:06p p.2
j7_Lp `- 1 ` r...-M
M Permit Application FOR OFFICE USE ONLY
City of Tigard Receives
:' c s r 5 s 61. Permit No.: 1
- � A �
�`� P .--- 4 - % r 1 a , ! j • Date/By: ♦ y „'` 1
13125 S W Hall Blvd., Tigard, OR1•,97223 J i _
Plan Review • � - j
J
Phone: 503.639.4171 Fax: 503 :595 1960. I : >,,� s n6 n v,� "
,�, � ,, Date/By: Other Permit:
Inspection Line: 503.639.4175 �.j;. Date Re /13
„ y y' iwis: I RI See Page 2 for
Internet: www.ci.tigard.or.us MAY Noticed /Method: Il Supplemental Information
TH 9 2001 Y 2 9 l«VJJJ
iy p
,: • .E' OF WOm .:::.. R COMMERCIAL FEE *: SCHEDULE .- .USECAECIaIST
❑ New construction �
/ alter a ti.Qn /r r. Mechanical permit fees* are based on the value of the work
y �] Addi�ionep a - �
'. " r 1 T j % / , , P -'1 X E performed. Indic the value (rounded to the nearest dollar) of all
❑ Demolition - ❑ Othe } �-' - " ° rm
mechanical materials, equipment, labor, overhead, and profit.
- .CAT'EGOR'Y OF CONSTRU - I.N --
Value: $
- RESIDENTIAL EQUIPMENTa:SYSTEMS FEES* . .
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: J
Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION .- .:
. Heating/ cooling
Job site address: 50 6 Air conditioning or heat pump I cc
JLV i P �� V (requires site plan showing placement) I 14.00 14 '
C ity/State /ZIP: - Ti cCu cl 1 O. �J G j ---i 2 Li_ I_ Furnace 100,000 BTU (ducts /vents) 14.00
.. ■ Furnace 100,000+ BTU (ducts'ventsl 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 1 -0.00
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
Subdivision: Lot no.:
Flue /vent for any of above 10.00
Other. 10.00
Tax rnap /parcel no.: Other fuel appliances
• ' -
r . Water heater 10.00
' :' DESCRIPTIQIY OF VL ORK
H Gas fireplace 10.00
{ 1 f 0I . 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 _
• Chimney /liner/flue /vent 10.00
01 PROPERTY OWNER :. ❑ TENANT
Other. 10.00
Name: 1209 c f " ,� ` I t �+ I Environmental exhaust and ventilation
f Range hood /other kitchen
Address: 1 7 SD &A) 0 Li p't& S equipment 10.00
City/State/ZIP: `-5 a (�-f ( q 7 22_q Clothes exhaust 10.00
Single -duct exhaust (bathrooms,
■
Phone: (i)3) 3 I 0-1:. •25 S 3 Fax: ( ) ; toilet compartments, utility moms) 6.130
". , _ APPLICANT • :.. :, .: ❑ .CONTACT PERSON ctawlsp fans . ... ttt 10.00
Business name: Other. 10.00
Fuel piping
Contact name: $5.40 for first four; $1.141 for each additional
Address:
Furnace, etc.
Gas heat pump
CityiSta to /ZIP: Wall. /suspended/unit heater
Phone: ( ) Fax:: ( ) _ Water heater
Fireplace
E -mail:
Range
,F �..:. ,. . C ON?
• :,;,"•1; - .1; ): : -' . :';: = .r 'RACTQR::_•_,, .. ;, Barbecue
Business name: D*h 1 „,,fi' Clothes dryer (gas)
Other.
' i 2(0 J r. ..
Address: , .M EC EIANICAL PERMIT FEES *:
City /State /ZIP: _ ,-t 6,/� ` ? �, 3 Subtotal 1 L • CC
( f f/ 7 Minimum permit fee (572.50) - 7 . L -5 �:
Phone: 5 ) z �ia • -( 2. 9 Fax: (5 ) 26Z, - � 7/ Plan review (25 "/0 of permit fee)
CCB lie.: / t tom{/ � State surcharge (8% of permit fee) S .
TOTAL PERMIT FEE ' 750
Authorized signature: �4 t\ This permit application expires if a permit is not obtain within 180
ge (fy ' C l days after It has been accepted as complete.
Print name: / / J� n't6A- Date; ... .5 , /2' / " Fee methodology set by Tri- County Building industry Service Beard
1'B6ICiu5\ic,iiN iI, pp doe 12tD3 4.4 0,-;6 i ri'111'02:COM,WEl3)
May 29 07 12:06p P3
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,ADR.1-77
CITY OF TIGARD
BUILDING DIVISION ,, PERMIT #: MEC2007 -00309
13125 SW Hall -Blvd., Tigard, OR 97223 D ATE ISSUED: 512912007
/
Phone: (503) 639 -4171 �NA(l
Inspe Requests (24 Hrs.): (503) 639 -4175 ...„„All
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 67
SITE ADDRESS: 07750 SW CYPRESS LN CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 030 TYPE OF USE:
PROJECT NAME: MILLER
• DESCRIPTION: Install a/c unit.
OWNER: MILLER, ROGER PHONE #: 503 - 310.2553
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266 -1249
•
' Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 050136 -01 503- 266.1249 Y
Corrections /Comments/ Instructions:
4-i. y. ,,./(9-/e i4 - 5-'2, 66 v' -A- Cce ':,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL SS
❑ FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: % Date: - /.f — 7 Phone #: (503) 718 - -(5-'