Permit CITY TIGARD MECHANICAL PERMIT
14 DEVELOPMENT SERVICES PERMIT #: MEC2005-00222
c• I DATE ISSUED: 5/9/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111DB
SITE ADDRESS: 09337 SW HOME ST ZONING: R - 4.5
SUBDIVISION: KESSLER ESTATES LOT: 008 JURISDICTION: TIG
Project Description: AC install
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
MARTINEZ, ROBERT Description Date Amount
9337 SW HOME ST. [MECH] Permit Fee 5/9/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State SurcharE 5/9/2005 $5.80
Phone: 503- 620 -1611 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: ( �.G�� =%�9 Permittee Signature: n� ��� C
Call 503-639-4175 by 7:00 a.m. for inspections that business d ay.
J
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 OI 05 12:40p 503 - 537 -2172 p.2 • Mechanical Permit A'# i FOR OFFICE USE ONLY
City of Tigard
Received :3 9 D� /6 Permit No.: iv\6c- v5
13125 SW Hall Blvd., Tigard, OR 97223 MAY 0 9 2005 J -cam
Phone: 503.639.4171 Fax: 503.598.1960 � Other Permit:
Inspection Line: 503.639.4175 ,u. �l�
Date Ready/By: CITY OF TICI - Notified/Method: Supplemental Pen for
Internet: www.ci.0 aid.0i.us Notified,'bicdtod: loformation
. BUILDING '- DIVISION
TYPE OF WORK • . COMMERCIAL: FEE *" SCHEDULE `TJSE CHECKLIST''
Mechanical permit fees* are based on the value of the work
El New construction E4tion/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
ATEGORY• OF CONSTRUCTION . ` Value: $ • C
1=4 a nd 2- family dwelling ❑ Commercial /industrial ❑ Accessory budding SIDENTIAL EQUIPNXEI�'i. /SYSTEMS FEES* '
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. Ea. Total
' JOB. AND ND'LOCATION' tng/cooling
Job site address:
c.-1,- 11 y \ Yak - it co .-- - - tkng heat pump , {
✓� ( 4rea7t n showing placement) 14.00 `t'
City/State/ZIP: I v r � Furnace 100,000 BTU (ducts /vents) 14.00
L � � �
1 Furnace 100,000+ BTU (ducts /vents). 17.90
Suiteibldg./apt. no.: Project name: Gas beat 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
. s ..::._-:: .... .. .. ..: ..; :DESCRI:PT[ON:OR WORKn " .: t ;: . .,:. ; , heater
��
f � / �q � / a Water eate
1 �� f " - V ��,/I iry 4 y f n ..., Gas fireplace 10.00
t (� L+� (, r / P�Q 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
..:: :- P PERTY •O.WNER•• : .. 1. , • ❑ TENANT :::i. Othe mer /clue vent
Chimney/1' ' 10 00
Other. 10.00
Name: ,° ' ,1/ !) • :. )(_j i . i ° - Environmental exhaust and ventilation
Range hood/other kitchen
Address: / 0 , T) 1 ' ; 'rte' 7.-- equipment 10.00
City /State /ZIP: �� 1 of_ t i - VI Clothes dryer exhaust 10.00
Phone: i ") -7-, 4 D I
Single-duct compartments, exhaust (bathrooms,
�, Fa
c artm utility rooms)
APPLICAN .' ' ' ❑ )CONTA PERSON t cwPspace fans 10.00
- toilet n nts u' i ro rrts 6 80
. ...:......:.. Att '�
Business namei r
)/�e „, � Other. 10.00
l� C �- Fuel piping
Contact name: 1 ' }/LS i $5.40 for first four; 51.00 for each additional
Address: f K �ja Furnace, etc.
c1 / Gas heat pump
City/State /ZIP: V G `L S Wall/suspended/unit heater
PhoneC( 3) t✓ j { � 4 . ; 3 Fax:\��) 3) Gj 37 2- -3- Water heater
�'� tl Fireplace
E -mail:
Range
;..
C ll TRACTOR Barbecue
Business name: • • , ,/ / " l i - .) / r Other.
dryer (gas)
. ' `� 1111 (gy't4 r.
Address: / : ........ . ...
' / -. MECHANICAL PER IIT FEES
City /State /ZIP: &
11 { 0 LI
r. i� J L Subtotal f ( ' .�
Phone: J23 C 3 Ids Fax_ 3 �� 247 Minimum permit fee ($7250)
CC�� :f ' // t Pl an review (25% ofpennit fee)
CCB lie.: ■ t < State surcharge (8% of permit fee) -KC)
1 TOTAL PERMIT FEE ��!r30
Authorized s ture: G ' ' I1 J1 This permit application expires if a permit is not obtained within 180
Il J • I ) 'i'
� �
O - ..� V days after it has been accepted as complete.
Print name: a ' r P A ' a • Date: f , o p1 • Fee methodology set by Tri- County Building Industry Service Board
i :\BuildingV Permits N. MEC- Penn 0App.doc 12/03 440 -461 Tr (I I /02 /COM'WEB)
503-537-2172 P - 3
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OREGON HEATING HEATING & MR CONDITIONING, INC.
SHEET NO.
OF
CCB #125815
P.O. BOX 397 CALCULATED BY
DATE
DUNDEE, OREGON 97115
(503) 538-2953 Fax (503) 537-2172 CHECKED BY
DATE
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CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2005 -00222
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/9/2005
Phone: (503) 639 -4171 i# i a l ipul��l�� 1
Inspection Requests (24 Hrs.): (503) 639 -4175 _ . :_..
INSPECTION WORKSHEET FOR DATE: 5/26/2005 TIME: 9 :23AM PAGE: 14
SITE ADDRESS: 09337 SW HOME ST CLASS OF WORK:
SUBDIVISION: KESSLER ESTATES LOT #: 008 TYPE OF USE:
PROJECT NAME: MARTINEZ
DESCRIPTION: AC install
I
OWNER: MARTINEZ, ROBERT, PHONE #: 503- 620.1611
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 - 538 -2953
°F V' SY)*
Inspection Request Scheduled For: Date: 5/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007847-01 503-538 -2953 Y
Co ections /Comments /Instructions:
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' ❑ PARTIAL APPROVAL ❑ CANCEL i:_4 0 ACCESS
/fib FAILfr ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: w -- 1 4A9 -- ~/ Date 7 �7 Phone #: (503) 718 -