Permit CITY OF TIGARD
MECHANICAL PERMIT
46, DEVELOPMENT SERVICES PERMIT #: MEC2005 -00176
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/19(2005
PARCEL: 25111 CB -01723
SITE ADDRESS: 10350 SW KABLE ST ZONING: R -3.5
SUBDIVISION: HOOD VIEW NO.2 LOT: 022 JURISDICTION: TIG
Project Description: Installation of heat pump, furnace & air cleaner.
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.
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
ARNOLD, ROBERT J + VIRGINIA L TR Description Date Amount
10350 SW KABLE ST
TIGARD, OR 97224 [MECH] Permit Fee 4/19/200E $72.50
[TAX] 8% State Surcha 4/19/200E $5.80
Total $78.30
Phone:
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: 0 51.r_."2 Permittee Signature:
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.
i Apr• 1 05 07:48a 503 - 537 -2172 p.3
Mechanical Permit Appllca d ' FOR OFFICE USE ONLY
_
Cit Tigard -- Permit No.:
`J g Date /By: y -/q _ $ s ;� �2ay.c WO 76
13125 SW Hall Blvd., Tigard, OR 97 . ' vj e�t�o R ecei ved Plan Review
Phone: 503.639.4171 Fax: 503.5 • : J1i it 1� � e Date /By: Other Permit:
Line: 503.639.4175 * J�,, e•' f� Date Ready /By: WM 0 See Page 2 for
Internet: www.ci.tigard.or.us V•13% . C.111*'5\O Notified/Method: Supplemental Information
TYPE 64 w� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
El New construction dditio � ation /replacement Mechanical permit fees* are based on the value of the work
performed. lndicate the value (rounded to the nearest dollaar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • Value: S
`L'l 1 -and 2-family dwelling • • • RESIDENTIAL EQUIPMENT I SYSTEMS FEES* •
y g ❑ Commercial /industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. I Total
•
:TOIi SITE INFORMAT AND LOCATION Heating/cooling
Job site address: �� 1 Air conditioning or heat pump
� tJ (J (requires site plan showing placement) 14.00 ! `
City/State /ZIP: � t! , ( 1 -7 2 7 -L i Furnace 100.000 BTU ( ducts.vents ) I f L4.00 "
'� -/ Furnace 100,000+ BTU (ducts vents) 17.90
Suite/bld /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.: 10.00
Other: ■
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
' Flue vent for water heater or gas
• fireplace 10.00
I 0 ` • �� ' '� L �f U - Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /lineriflue /vent 10.00
PROPERTY OWNER.. ' ❑ TENANT
Other: 10.00
Name: /� hi _,�, �4,' ,ul Environmental exhaust and ventilation
Address: G (92) S J���/ � �" Range hood/other kitchen
i equipment 10.00
City/State/ZIP: 10' CS i 7 ?f Zvf Clothes dryer exhaust 10.00
Phone: Si 7
Single-duct compartments, bully rooms) Q .Z Fax: ( ) toilet compartments, utility rooms) 6.80
LICAN"I .. , ❑ CONTACT PERSON Attic /crawlspace fans 10.00
1 ���� l ( i "Jf '� Other: 10.00
Business name: �_! /t/1 A 9 e `t'1 1� +jt 1-- 1 . Fuel r Lblfl piping
Contact name: / Ir t' Y I �� ttbbb $5.40 for first four; $1.00 for each additional
Address: 0 ) lit-- 3, 6'� Furnace, etc.
J / Gas heat pump
City/State/ZIP: e/ZIP: C j1 J ; Wall /suspended /unit heater
Phone: bb J 6 3 C� r9 b i 5 I Fax: 3 s . -'- 7,0--2,- Water heater
��//''�� Fireplace
E -mail: Range
/ � C TRACTOR Barbecue
! 1jc A � j : / I Clothes d ( gas)
Business name: �� i j „
ro . Oth er: Address: /�� )9 MECH PERMIT FEE s
Phone:
.q1.75 / l W 0111 `� � 1 �j �/ (872:50) Subtotal t
J 318 ,2,4 �'7,�` Fax�f(�53 / �J ! '] j/ �Z� Minimum pennit fee permit
fee)
�l / t UJ Plan review (25% of permit fee)
CCB lie.: [ L. I 4 State surcharge (8% of permit fee)
i t TOTAL PERMIT FEE MIE '
Authorized sy /� 1 Vr/ 1 ? // ) /� %}�/t r n � This permit application expires if a permit is not obtained within 180
r tt, 111 _ . v (/r 1 ✓ (rte r 1 ` days after it has been accepted as complete.
Print name: V h 1,1,.. ( j , " " Date: { � // / i) / (J l`7 * Fee methodoloer set by Tri- County Building Industry Service Board
i:' eitsMEC- Pennitnpp.doc 12103 440 II 7T ( t 11 /COMMED)
Apr? 19 05 07:47a 503- 537 -2172 p.2
' , FP pr 10 05 03:42p Specialty Heating 503 598 0718 p.3
Apr 18 05 x :03: 30p
503 p,2
•
JOB ____ .._ - __ .
OREGON HEATING & AIR CONDITIONING, INC. C..• CCB #125815 sNO. °�
P.O. BOX 397 GLCULATEDer DATE __ _ _ -
DUNDEE, OREGON 97115 a � -
G ,CCKCD 6Y DATE _ -. r . .
(503) 538-2953 Fax ( 537 -2172 — _ "5
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CITY OF TIGARD
A
BUILDING DIVISION PERMIT #: MEC2005-00176
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4119!2005
Phone: (503) 639 -4171 , m ili���m li,,,,. il
In spection Requests (24 Hrs.): (503) 639 -4175 '1.1—
INSPECTION WORKSHEET FOR DATE: 5/12/2005 TIME: 7 PAGE: 92
SITE ADDRESS: 10350 SW KABLE ST CLASS OF WORK:
SUBDIVISION: HOOD VIEW NO.2 LOT #: 022 TYPE OF USE:
PROJECT NAME: ARNOLD
DESCRIPTION: Installation of heat pump, furnace & air cleaner.
OWNER: ARNOLD, ROBERT .1+ VIRGINIA L TR, PHONE #:
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503-538-2953
Inspection Request Scheduled For: Date: 5/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006665 -01 503-538-2953 N
Corrections /Comments /Instructions:
('/ -- { -fiL!( / -. /‹.//1 421�- CA -1'1 5 __— - .9 S
•
ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: S �1 --d- Phone #: (503) 718-