Permit C ITY OF TIGARE) MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00245
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/17/2005 PARCEL: 2S103CA -00601
SITE ADDRESS: 13465 SW HOWARD DR ZONING: R -4.5
. SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Installation of heat pump, furnace & duct work.
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
STOCKAMP, MIKE Description Date Amount
13465 SW HOWARD
TIGARD, OR 97223 [MECH] Permit Fee 5/17/200: $72.50
[TAX] 8% State Surcha 5/17/200f $5.80
Total $78.30
Phone: 503- 709 -7033
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
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: 2 r Permittee Signature: j - Z, f\K
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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May.18 05 11:48a 503 - 537 -2172 p.2
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Mechanical Permit A:111' ` `M £1 ' / ' !w FOR OFFICE USE ONLY
P.eceved r
City of Tigard ) /�{
Date /By: / �L'' ✓ �l // Permit No.M ,, . /' 2/j+� (� /tJ� 7C��
13125 SW Hall Blvd., Tigard, OR 97223 /AY 1 C 2005 ' \�J� �t� eZ / [/�t/�
Phone: 503.639.4171 Fax; 503.598.196P l V �oO Plan Review Permit•
���� ( Date By:
Inspection Line: 503.639.4175 J . e A Date Ready /By: JIM / H Sec Page 2 for
Internet www.ci.tigard.or.us CITY OF TIGARD NotifiedtMethod: ) / r Supplemental Information
BUILDING nnnsIOA. V
. . - .:.TY OF WORN, EE* SCHEDULE : . O COM1tifERCIAL F REDUCE = :.T1SE CHECKLIST
Mechanical permit fees are based on the value of the work
❑ New construction 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 I SYST FEES*
1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
111 Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. 1 Total
JOB SITE INFORMATI AND LOCATION.
Heating/cooling
Job site address: �tn�I '�` y % Air conditioning or heat pump
/ ` I V v 6 t o Limit (requires site plan showing placement) t. 14.00
City/State/ZIP: - 4 0' /• �� 3 1 'Z 7 ' ? Furnace 100,000 BTU (ducts/vents) 1 14.00
t 1 t� 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 1 14.00
Hydmnic hot water system L 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
' r t..! :.. :..: ...::: ;.:.... : :::.. •DE CRIP TIOPf :Ol ..*6*:.;,.,; : : -s` .. Water heater 10.00
S
t I (' pu.Avt / I Gas fireplace 10.00
L'� ). ) ( t F -fi t o ' ^� fCV l �i% ( � Fle vent for water heater or gas
a o-- 1, ) (; n/ fireplace 10.00
j Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
. ...
- ROPERTY OWNER :: c` ::'. :: . .. . ❑ _TENAN'G';'.::'- ..�;. : ; ; "'.
` Other, 10.00
Name: ( it /_mi l , 1 j� 0 Environmental exhaust and ventilation
Address: ,) 1� ,n Cc- �t Range hood/otherkitchen
f�/ y �: lam• equipment 10.00
City/State, /ZIP: \ x•71 j,.- O Gov 5)- Clothes dryer exhaust 10.00
! 1 y J! Single -duct exhaust (bathrooms,
Phone: �- A) ) ,,i j - ' r - 1.-\ --7 -� . Fax: ( toilet compartments, utility rooms) _ 6.80
,; "i; ' APPLICANT_: ;°i•. J ONT• ..._ ACT PER S ON *'.. '..''.; Atticicrawlspacefans 10.00
' , ❑C
/j� Other. 10.00
Business name�vlre/yl 1 i , J piping
` - Cwv �. J poem
�6 C� n
Contact name: 1 }�,O 1.� $5.40 for first four; $1.00 for each additional
1 „
Address: S'i V) Furnace, etc.
J 1 Gas heat pump _
City /State /ZIP: Alibi- 0 V- G1 i t t S WalL'suspended /unit heater
Phone`( 2) 5 6S1, Fax :613) S 3- 1 �--2 Water beater
E -mail:
Fireplace
Range
• ` : C • CTOR Barbecue _
Business name: • I n 0 i ' / 0 Clothes dryer (gas)
Address: ♦t Other:
t 7� 4 / A
.m.kc ANICL PER.yIIT FEES*.:.
- City /State /ZIP: Subtotal
n Minimum permit fee ($72.50)
Phone:
63' Fa £ 7 Z 17 Z
�J . Plan review (25% ofpetmit fee)
CCB lie.: 1 i) �� State surcharge (8% of permit fee) �. -')
1 j
TOTAL PERMIT FEE ) 6 - d '
Authorized s a ture: ( x This permit application expires if a permit is not obtained within 180
1 :raw) � j ,/y ' ) LJ d ' ..c Q J Print name: . /)n ry,� /^ Date: •, 1I=L_ * Fee methodology set by T -County Building Industry Service Board
ii Build 'mg \Pernits'MEC- PermitApp.doc 12/03 ���'(LL� 1. V t t 11 ► 440 -4617T (1 l /02/COM.WEB)
Ma,16 05 11:48a 503-537-2172 P - 3
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00246
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17/2005
Phone: (503) 639 -4171 to grail lll��
Inspection Requests (24 Hrs.): (503) 639 -4175 .... -W '_-
INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 79
1 Z/
SITE ADDRESS: 13465 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STOCKAMP
DESCRIPTION: Installation of heat pump, furnace & duct work.
OWNER: STOCKAMP, MIKE, PHONE #: 503 709-7033
CONTRACTOR: OREGON HEATING + A/C INC PHONE #: 503- 538.2953
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010580.01 503 - 538.2953 V I :o ° -- // : m0
Corrections /Comments /Instructions:
--- l e.',/ 6. q oc (Ks) :i_ssoc-56)
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74,Ass M PARTIAL APPROVAL LI CANCEL ❑ NO ACCESS
❑ FAIL % M ALL FOR INSPECTION [I] ADDITIONAL FEES ASSESSED
Inspector Date: Phone #: (503) 718-