Permit I 1
C1TY TIGARD • MECHANICAL PERMIT
� o , DEVELOPMENT SERVICES PERMIT #: MEC2005 -00189
cII 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/21/2005
PARCEL: 2S1 04 BA -11900
SITE ADDRESS: 13503 SW LIDEN DR ZONING: R -12
SUBDIVISION: CASTLE HILL NO. 3 LOT: 149 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:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SILVER, TIMOTHY + CHAN FU Description Date Amount
13503 SW LIDEN DR [MECH] Permit Fee 4/21/200: $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 4/21/200: $5.80
Phone: . 503 - 372 - 5784 Total $78.30
Contractor:
OREGON HEATING + NC 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: )'t- 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.
Apr 29 05 11:14a 503- 537 -2172 p.2
•,. ' b r' L
Mechanical Permit Ap lie FOR OFFICE USE ONLY
City Tigard Received R
of Ti and E D ate/By: f 0 1 1' 1...) Sig— ? ,
13125 SW Hall Blvd., Ti Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 A Other Permit:
�,�y Date/By: Inspection Line: 503.639.4175 0 2o0J � I _ Date Ready /By: ® See Page 2 for
Internet: www.ci.tigard.or.us AP ■ . Notified/Method: , Supplemental Information
1 OF TIGARD .
COMMERCIAL FEE* SCHEDULE :: = USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction EA 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:
' •RESIDENT1AL: EQUIPMENT/ SYSTEMS FEES* •
• - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building - -
El Multi-family El Master builder ❑ Other For special information use checklist.
Description Qty. I Ea. I Total
• - • JOB SITE INFORMATION. AND LOCATION .:. . . ' • Heating/cooling
Job site address: C 3 nil-i/o Air conditioning or heat pump 1 �'
(requires site plan showing placement) 14.00
City/State /ZIP: rerd. L ' 1v -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: I Lot no.: 10.00
Tax map /parcel no.: Other fuel appliances
. • - .. . - DESCRIPTION OF WORK..: • .:. • .: .. Water heater 10.00
(in ce3-zbu } � � f r� ,per Gas fireplace 10.00
lA/t/ r i/G t 1. 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
• Chi /flue/vent 10.00 • ROPERTY OWNE I .. • • ❑ TENT' . . Other. 10.00
Name: � / � � q ' . 2 > ' v Environmental exhaust and ventilation
Address:
•
3 t Rangehood/otherlcitchen
y LGC 1 �� equipm 10.00
City/State/ZIP: / , / (31') 7,7-3 Clothes dryer exhaust 10.00
_ _ s, 3 3 ` � ' 1 x I Lt� to
ilet filet compartments, (bathrooms,
Phonet Fax: ( ) toilet artmentsrtments , utility lity rooms) 6.80
• .. . PPLICANT. • 0 • : . : . 0 CONTACT PERSON Attic/crawlspace furs 10.00
Other. 10.00
Business name: A ` .-� p p g
1J' �", ` Fuel pi pin
Contact name: $5.40 for first four; $1.00 for each additional
Address: SIM i Furnace, etc.
n' /� Gas heat pump
City/State/ZIP: II i .r .LL. 1 0 li J j l Wall/suspended/unit heater
Phone: t( ?U3 1E5 3c; 9 _C / ; Fax: : l f3-1 21 Water heater
E- mail: ✓ `�`�� Fireplace
Range
C NTRACTOR Barbecue
Business name: M Clothes dryer (gas) • ` Other: Address: — r� 1 • • MECHANICAL PERMIT FEES*
City/State /ZIP: gt,ti V°, On +L/ Subtotal ILI
Phone: [ l
(g33 I �5 tiS3 V ° Fax: 3 J 111 Vh 3) , 37 Minimum permit fee (S72.50)
Plan review (25% of permit fee)
CCB lic.: l rt5 State surcharge (8% of permit tee)
TOTAL PERMIT FEE r
/1 This permit appticadon expires if a permit is not obtained within 180
Authorized signal! ` I,
_ ±2A,4 - t days after it has been accepted as complete.
Print name: ( 1 'It� , L e (S\ Date:� 10 • Fee methodology set by Tri-County Building Industry Service Board
i Buildine•Pe,mius.MEC- PermiWpp.dx 12/03 440- 461rr(11/021COM /WE13)
1 05 11:14a
pilit
503-537-2172 P - 3
•
JOB < \\le-t
OREGON HEATING & AIR CONDITIONING, INC. SHEET NO OF
CCB #125815
P.O. BOX 397 CALCULATED BY DATE
DUNDEE, OREGON 97115 CHECKED BY DATE
(503) 538-2953 Fax (503) 537-2172
SCALE
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CITY OF TIGARD - • -
BUILDING DIVISION PERMIT #: MEG200500169
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/21/2005
Phone: (503) 639 -4171
Ali "'' 4P4� j�i'�
Inspection Requests (24 Hrs.): (503) 639 -4175 "__
INSPECTION WORKSHEET FOR DATE: PAGE:
5/10/2005 TIME: 7:16AM 87
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 13503 SW LIDEN DR LOT #: TYPE OF USE:
PROJECT NAME: CASTLE HILL NO. 3 149
DESCRIPTION: SILVER
AC install.
OWNER: SILVER, TIMOTHY + CHAN FU, PHONE #: 50372 -5784
CONTRACTOR: PHONE #:
OREGON HEATING + NC INC 503-538-2953
Inspection Request Scheduled For: Date: 511012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006424 -01 503-538 -2953 N
Corrections /Comments /Instructions:
('= Lr Am__ 124 „./4 le h L 4-1 1 - 7 5 1 -7-174 - i , vcd CO,Qec_,Z 7
ASS ❑ PARTIAL APPROVAL - ❑ CANCEL -- - -❑ -NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: �` /O - -� ----- Phone #: (503) 718-