Permit r,
fiGA C ITY O F'RD MECHANICAL PERMIT
4 4 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00302
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/6/2005
PARCEL: 2S 110DD -05400
SITE ADDRESS: 10600 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 154 JURISDICTION: TIG
Project Description: AC and furnace replacement.
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:
LPG 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
DAY, DAVID A + MARTHA KAY Description Date Amount
10600 SW HIGHLAND DR [MECH] Permit Fee 6/6/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 6/6/2005 $5.80
Phone: 503 670 - 4092 Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Phone: 503 - 538 - 2953
Reg #: LIC 125815
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: (9 a—z a. re.7,–
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.
Jun 03 05 08:27a 503 -537 -2172 p. 3
t
.: 4 -)1 .
Mechanical Permi i _plication r i FOR OFFICE USE ONLY
Received // 5/ / tNo.0 0..M� { .../ 6
City of Tigard Date. �J � /36 Pemu36. ....--Al l ✓
13125 SW Hall Blvd., Tigard, OR 9722 _ Plan Revie / p�/
Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 !Q Ey I \
JUN Date /By:
Inspection Line: 503.639.4175 ��� �' Date Ready /By: .1 0 See Page 2 for
rn
Inteet: www.ci.tigard.or.us 03 3 200 Notified/Method: ,J .zj�j Supplemental Information •
' O . COMMERCIAL FEE* SCHEDULE -. CJSE CHECKLIST
BUT • T7% o 1 Mechanical permit fees* are based on the value of the work
fim
❑ New construction �T2N1i eat
1 performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
1 and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑Master builder 0 Other: For special information use checklist.
Description Qty. Ea. I Total
' .. JOB SITE INFORMATION LOCATION Heating/cooling 10 it v` r rte. 6.) 1. Air conditioning or heat pump )
Job site address: t J � !; I + • L,',� /t'1( re (requires site plan showing placement) 14. R -
p .
9 P P ) I. 1 -
,
City /State /ZIP: .:17-4,./A r ' - i Furnace 100,000 BTU (ducts /vents) ( L4.00 0 '-1 � .r t 1; 4t �1 a me: v y Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: . 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
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 map /parcel no.: Other fuel appliances
DES.IPT[ON, F O WORK:.: •
f CR ' Gas fireplace 10.00 •
\ , I, s . /, s � l � I " q i r I ' "' i 0 L- (; i � ' v Y -4 Flue vent for water heater or gas
1 _ fireplace 10.00
li :✓ . ./ ,± i 'tii I/ 1 L-i� Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
..
Chimney/liner/flue/vent
GJ . PE RTY O
RO .. WINER : : ::: GJ .: `TENANT`
Other: 10.00
Name: �('.1 1
i . .1 L t N Environmental exhaust and ventilation
�l 61 - l - . n ` f I / � Range hood/other kitchen
Address: (
J e l . !- ( /, � (� C-
i.� (. r equipment 10.00
CitvlState /ZTP: t, ' 1 4 ./ i .,,--d / V) 7 .7 ' . Clothes dryer exhaust I 10.00
1 Single -duct exhaust (bathrooms,
Phone: t i,� f/ 1 9- u� ; { ) Fax: ( ) toilet compartments, utility moms) 6.80
: !'APPLICANT. , : 0 ' CONTACT PERSON ...
. Attic/ crawlspace fans 10.00
Business nameDirp 4I T _ / ► , i/ f ' /'(\, :20 J Fuel piping
10.00
� l.Lt/Y vv t w' Fuel
Contact name: ( 1 n . $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: r .G {�� Gas heat pump
City/State /ZIP: nu, c heater
Phone`( 3) 63g a � Fax:
6j3 S ' 3 zj + - Water ter
Fireplace
E -mail:
Range
. C II tITRACTOR ' .. Barbecue
• Business name: • ), / / ;• � Clothes dryer (gas)
Other:
Address: , %..... /) ✓ ✓✓ .. MECRANICAL.PERMI'T F EES*
City /State/ZIP: L%1 i' t CO J LS Subtotal . -
Phone:_ �,3 03 J �L pax G, �� 2,172_,. Minimum permit fee ($72.50)
i��C t 1 t J Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee) ~ , (✓
�; l5
TOTAL PERMIT FEE ' R j� ,48
1 n , M This permit application expires if a permit is not obtained within i8D
Authorized s' ature: �; �! 1V /I J la � `!� � � �' 4 days after it has been accepted as complete.
I Print name:: t _ 1 A Date:.i I * Fee methodology set by Tri -County Building Industry Service Board
a.ru -,,,,,,, ,, ,,02rCOMr,m.)
Jun 03 05 08:27a
. , 503-537-2172 p.2
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Site plan for : c_014_t1 .
back
h 3
a A; S I -
front
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CVIZA1 O a ti A; 1 ZfeeG`,
15
CITY OF TIGAR
BUILDING DIVISION PERMIT #: MEC2005 -00302
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2005
Phone: (503) 639 -4171 /48 // qp „
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7:07AM PAGE: 91
SITE ADDRESS: 10600 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.4 LOT, #: 154 TYPE OF USE:
PROJECT NAME: DAY
DESCRIPTION: AC and furnace replacement.
OWNER: DAY, DAVID A + MARTHA KAY, PHONE #: 503- 670 -4092
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 - 538 -2953
Inspection Request Scheduled For: / Date: 7/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 011065 -01 503.538 -2953 Y
Corrections /Comments /Instructions:
P Yk�0 1 Dc 1 c �� 0
•
.7„, .
____.
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
H FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I - Jam/
Inspector: ��r Date : — I V D Phone #: (503) 718-