Permit iw.
T- {}l,
C ITY OF TIGARD MECHANICAL PERMIT
� � DEVELOPMENT SERVICES PERMIT #: MEC2005 -00127
All 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/23/2005
PARCEL: 2S111DB-14800
SITE ADDRESS: 09303 SW HOME ST ZONING: R -4.5
SUBDIVISION: KESSLER ESTATES LOT: 005 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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
FROOM, ROB Description Date Amount
9303 SW HOME ST.
TIGARD, OR 97224 [MECH] Permit Fee 3/23/200E $72.50
[TAX] 8% State Surcha 3/23/200E $5.80
Total $78.30
Phone: 503 -525 -3615
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Phone: 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: R3 ,c
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.
Mar 23 ►1,5 07:19a 503- 537 -2172 p.2
e
Mechanical Permit �® FOR OFFICE USE ONLY •
City of Tigard Date /By: 2. 7 IP =II,- Permit No.1 , , ,5"Qd , ^ 7
13125 SW Hall Blvd., Tigard, OR 9724 A' :1-', 2005 Plan Review
Phone: 503.639.4171 Fax: 503.598.1 /4s I'' Date /By: Other Permit:
Line:
Inspection 503.639.4175 4 y, Date [lead B Q See Pa e 2 for
Internet: ine: .ti ard.or.us "" ' �" y y >
www.ci.tigard.or.us Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE. OF .WORK_ :. .: COMMERCIAL FEE* SCHEDULE .- USE CHECKLIST
❑ New construction [✓]"Addition /alteration /replacement Mechanical permit fees* are based on the value of the work I
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
•
( dwelling o RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2-family g ❑ Commercial /industrial ❑ Accessory buildin
For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description
1 Qty. I Ea. Total
. JOB SITE. INFORMATION. AND.. LOCATION. . • . Heating/cooling
Job site address: Q I
Q �' Air conditioning or heat pump
\
(requires site plan showing placement) 14.00 ! (e"--_
City /State /ZIP: 1-0 0 } 7 2 Furnace 100,000 BTU (ducts' vents) 14.00
! 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
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other. 10.00
Tax map /parcel no.: Other fuel appliances
' . DESCRIPTION OF WORK Water heater 10.00
A� �� ` / ( Gas fireplace 10.00
V � ( ten m/ � L_Iii.-� 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
' • PROPERTY OWNER - .: E❑ TENANT y mer ue vent
tmne / 10.00
1^ Other: 10.00
Name: rJ v ('y Environmental exhaust and ventilation
/� � r _-- , 5 Range hood /other kitchen
Address: 'ter � w 'r - U, 1'l.Il
equipment 10.00
City/State /ZIP: u6( a or 2 _ Clothes dryer exhaust 10.00
Phone: c1 ) - - - - - - ) ') 1 7 Fax:
Single-duct compartments, rtment (u tility
( ) toilet compartments, utility moms) 6.80
APPLICANT ... . ❑ CONTACT PERSON Attic /crawlspace fans 10.00
I ,- Other 10.00
Ole' 1.
Business name:O - �4) 4- �'( Fuel p iping
J
Contact name: llll ell """/- Ti"`""""' $5.40 for first four; $1.00 for each additional
Address: ^I fi
, 3 Furnace, etc.
Y � j'V
Gas heat pump
City/State /ZIP: L111ebit ( 012 0 Wall /suspended/unit heater
Phoned .3 f� I Fax 3) 63 - 7 2/-3 2_ Water heater
s� Fireplace
E -mail: Range
NTRACTOR • • Barbecue
Business name:) `/' i .7 I ..01 ! 4. 6� Clothes dryer (gas)
Other:
Address: 2v / ``•)(. 3q1 MECHANICAL PERMIT FEW..
City /State /ZIIP: et ` !J� C C � � Subtotal I1..� -
Phone 2. 5 3 FaxCS.v -3) S /_ 7 , Minimum pennit fee ($72.50)
[ Plan review (25% of permit fee)
CCB lie.: ' t State surcharge (8% of permit fee) h go
TOTAL PERMIT FEE c ->t)
This permit application expires if a permit is not obtained within 180
Authorized a
' nature r j i /i l days after it has been accepted as complete.
Print nam BP n j e/ I 1 a eA-, Dater ( 23/ 0 " " Fee methodology set by Tri -County Building Industry Service Board
ir Building .Permits',MEC- Pcrmiblpp.doc 17 440 - 4617T (t 1:031C0M /WttB)
Mar 23 'S507:19a 503- 537 -2172 p.3
p.
Site plan for _ FROOM
OCT back
g
art
9303 SW F14N E ST
1