Permit q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00551
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/19/2007
PARCEL: 1 S134BD - 04100
SITE ADDRESS: 11760 SW HAZELWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.2 LOT: 129 JURISDICTION: TIG
PROJECT: HOLTON
Project Description: Install heat pump and furnace.
CLASS OF WORK: ALT 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
HOLTON, JAMES FRANKLIN + HELEN E Description Date Amount
11760 SW HAZELWOOD LP
TIGARD, OR 97223 [MECH] Permit Fee 9/19/2007 $72.50
[TAX] 8% State Surcha 9/19/2007 $5.80
Phone: Total $78.30
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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
//tic Permittee Signature: \ �____ fip,
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.
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Sep 1907 10:58a Oregon Heating & A/C 503 - 537 -2172 p.1
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard
' E 3125 S \'V Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1460 S E P 1 9 2007 Date By: Other Permit:
TIGARD_ Inspection ®
Line: 503.639.4175 a o Date Ready /By: H See Page 2 for
Internet: www.ti ,�N! `� gard- or.gov �u i U b �'�� +° Notified /Method: Supplemental information
BUILDING DWISIOI
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction i Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials equipment, labor, overhead, and profit.
:
CATEGORY„ OF CONSTRUCTION Value $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
1 C Air conditioning or heat pump
Job site address: t4' �N! `-- kQz.clWcic�c L (requires siteplanshowingplacement) 14.00 � f.00
City /State /ZIP: �oiy -- C1 o��3 1_ Furnace 100,000 BTU (ducts/vents) 14.00 L -o
J Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: Gas heatpurnp 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' VI'ORK :, .
Wat heate
Gas fireplace 10.00
HVAC- in s {Q 1' hPfli\ V171 f l lr1 ' ll C tj Flue vent for water heater or gas
fireplace I0.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner/Rue%vent 10.00 _
PROPERTY'QV4'lYER .. ❑. TENANT Othe 10.00
- r.
Name: c JnlY1P Nn1�bn Environmental exhaust and ventilation
r � Range hood/other kitchen
Address: ' S A , \17J L OC � (� equipment 10.00
City /State /ZIP: ' T a c fl a.3 T Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: k_A_L Z' 1 .16 — Fax: ( ) toilet compartments, utility rooms) 6.80
tticicrawlspace fans 10.00 -
.. , ® .APPLICANT _ . ... , . ❑ CONTACT PERSON 10 00
Other:
Business name: Oregon Heating & A/C Fuel piping
Contact name: for first four: $1.00 for each additional
Furnace, etc.
Address: PO BOX 297
Gas heat pump
City /State /ZIP: Dundee OR 97115 WalUsuspended/unitheater
Phone: (503) 538 -2953 Fax:: (503) 537 -2172 V\'ater heater
Fireplace
E -mail: Range -
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Oregon Heating & A/C
Other:
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City/State /ZIP: Dundee OR 97115 Subtotal
Minimum pennit fee ($72.50) 7'
Phone: (503) 538 -2953 Fax: (503) 537 -2172 Plan review (25 %ofpennit fee)
CCB lie.: 172126 State surcharge (8% of permit fee) 5, $
TOTAL PERMIT FEE 7, Q
� This permit application expires if a permit is not obtained within ISO
Authorized signature: � �� , * days after i[ has been accepted as complete.
' 1'7 - 1 . t� J J— t c ^ n Fe0 methodology set by Tr
7 * i- County Building Industry Service Board
Print name: 1 -L P�1 t l l }�" Date. ( ` J /
1tBuilding 'iPermits•.MEC- PermitApp.doc 01/06/06 440- 4617T(t1t0VC0M 'EB)
Sep 19 07 10:58a Oregon Heating & A/C 503 - 537 -2172 p.2
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Level 1
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5' +
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5 , + 5'+
II
Main ,`r.use
208 cfrn 1:21. 1039 cfm
•
•
208 di
Garage
SW Hazelwood Loop •
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Job #: Oregon Heating & Air Conditioning Scale: 1 : 100
Performed for: Page 1
James Holton PO Box 397 / 922 Hwy 99W Right -Suite Residential
11760 SW Hazelwood Loo Dundee, OR 97115 6,0.101 RSR39325
Tigard, OR 97223 Phone: 503-538-2953 Fax: 503 537 -2172 2007 Sep - 07:41:42
one: -
Phone: 503 -453 -7714 C: \My Documents\Wrightsoft HVA...
larry@oregonheating.com
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -005 a1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: c9119/2007
Phone: (503) 639 -4171 41441101Ii
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,,_.1
INSPECTION WORKSHEET FOR DATE: 9/2B/2007 TIME: 7 00 1 PAGE: 38
SITE ADDRESS: 11760 ,W HAZELWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO .2 LOT #: 129 TYPE OF USE:
PROJECT NAME: HOLTON
DESCRIPTION: Install heat pump and furnace.
OWNER: HOLTON, ,JAMES FRANKLIN + HELEN E, PHONE #:
CONTRACTOR: OREGON HEATING & AC PHONE #: 503 - x3f3•7953
1
Inspection Request Scheduled For: Date: 9/28t• 007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 056556-01 503.538-2953 Y
Corrections /Comments /Instructions: .
6. -
/PASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
q / 8/ 7Phone Inspector: Date: #: (503) 718-