Permit C ITY OF TIGARD ` "' MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00336
DATE ISSUED: 7/21/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135CD-13500
SITE ADDRESS: 09720 SW NACIRA LN ZONING: R -4.5
SUBDIVISION: GREENBURG PINES LOT: 006 JURISDICTION: TIG
Project Description: Heat pump 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:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KEVIN BLACKMAN Description Date Amount
9720 SW NACIRA LN
TIGARD, OR 97223 [MECH] Permit Fee 7/21/200E $72.50
[TAX] 8% State Surcha 7/21/200E $5.80
Total $78.30
Phone: 503- 439 -6868
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
•
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: s- 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.
•
r _
Mechanical Permit Ap O FOR OFFICE USE ONLY .
City of Tigard 1 I Y ` DA Recei
Date /By ( V&. u PermitNo.: i j . ',& DP $'
13125
13125 SW Hall Blvd., Tigard, OR 97223 3 Plan Revi : Other Permit:: `
Phone: 503.639.4171 Fax: 503.591.1960 I U L 2 1 200',W Date/By: Inspection Line: 503.639.4175 Dare Rcady /By: tom: 17 See Page 2 for
s
Su Supplemental lnforma
Internet: w•ww.ci.tigard.or . us CITY OF TIGARD NotifieGlterhod: PP
UILDING ply
IS , •
::.:•,..: _._.. .... .... . • • ,, ... ... . .. : .. •:COMivTERCIAL , :FEE "'.;$CHEDCLFE.r ;,'CIS _
Mechanical permit fees' are based on the value of the work
❑ New construction Addition(altationrreplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit.
...:..;::. _ . r ::: -' •: + : ::CATEGOR O-.t N� RU
dCtisiSi '� : -:,: e:.. - - :: `r-=: i
••; �KESIDEi�LtI EQU IPI F�IVT`J�ST '`
1- and 2- family dwelling ❑ Comrnerciaiiindustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total
k Ol` : 4ND '': _ r
_ l, O Heating /cooling
J B: : S1TE:�IIPN�C)Filvi- . - �? .. . -x' . - . -. �', .. .., ..,. : .
Job site address: / /i� r(i�- Air conditioning or heat pump 9 4 (requires site plan snowing placement) 14.00
City / State/ZIP: " e "' (1 a U(3. Furnace 100,000 BTU (ductvvenis) 14.00
Furnace 100.000+ BTU (ducts/vents) y 17.90 i , /
Suite/bldg. /apt no.: Project name: Qi eatpump ` 14.00 1 1 1
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 I
Subdivision: Lot no.:
Other. .00
r.
Tax map /parcel no.: Other fuel appliances
;Aa': c`;iS "' n�"�� %`- 'o-,;l S -, .r.,=- - - ' =' `..� _ ..y ?i:;��s:, r; - y:it "'�. r2`-i Water heater 10.00
�,gq R rt _ 5 y ( E: 3 ::, �.�,y�, ....`' ..;"-± li �. r,... , i r.S i .11 y i. -
, a"z 7 aic i - J4� Wes` --,0 `4 -`lc - i - -- ,c,..,, -". !T.;d.I''' -' - +E'w;. P i ' ? r t:"
, '.ir .ti.rx:i!IG- 1'v ::phi lC: d', - � %.. �'- _ �=,,: ufC:_ �=: .,....r!......_-_-• °- -d5s -:3'_ Gas "1: ` �,_:, -SN _�1Y.iSr
` fireplace 10.00
�j ,',l am. V` 1' � - Pt/41'W Flue vent for water heater or gas ! vvv fireplace I 10.00
Log lighter (gas) { 10.00
Wood/pellet stove 10.00
Wood fire_olace/insert 10.00
:.• , ,.,. : .�...... �.,.,, ..,.,.,,,_;: r ... : ...a- .. - u; , lner/flut:ven.
�, - Chimneys' / 10.00
E , ,,.r_�µ:� r :_}ii 'R EERi0 ai - _.:.a•t . g; i:r_i . �i'E (1 ' 3 }
„�'!.;- cii r.- •••rh_:.:: :.. .:�� `�a .,:",tI .•.;,v'_ ,.'s ...• r<it.... .. :. a ,'1 Other 10.00
Name: tf 1 L J, Environmental exhaust and ventilation
1 1 „�� � �� '
equipment hood/other kitchen I
Address: bb / ' v L ui p meat 10.00 .
Clothes dryer exhaust i 10.00
Phon City/ State/ZIP: r - ! ' / ,� ,et.,..- Single -duct exhaust (bathrooms,
e . {�i;�q �p V toilet compartments, utility rooms) J Fax: ( ) t o till ro msl 6 80
z; �-. Atticicmwlspace fans 10.00 _
:; -: " Pi' G '.' 5 +.,: t . 3 " ^.COlYFi CT'PERS . :g -,.f `,.
__,.,.. .�� �1
.: ..., ...._ , r._ .. . ..:... r ...:. ._ .,. "..,:....,,..., ... . .: ...... Other. 10.00 1
10
SusinessnaveiQ�( c - ' L'�,, I Fuel piping •
Contact name: lI ` �J 4J•'1 )11-S/+-e-3 $5.40 for first four; S1.00 for each additional
• Furnace, etc.
Address: 1 f- ,, P Gas heat pump
City/State/ZIP: J� y , U 0 CM U-5- Wall/suspended/unit heater
•
Phone, , 3) £j a,2 , Fax: l ,3) `/ 3-i 1' - -z
Water h j
E -mail: / I ��� Range
are ...,...:,,..... -•...:. � t _ Barbecue
:. . .. .:..:
n '. J J Clothes (gas)
^
Business name: yA O ` ' ' r ✓`�' . , i t l U ' at es dryer Ras
0') % ?1 ' `� t Other. � .
Address: I) , r) ;.,; ',1 NLECEi41�ZCALP •_ .:, :.:::
' r` �/� F- I r ERTy IIT' E. , ,.
City' / State/ZIP / : /4 W q - /_ L ii I /� 1 I L `. ;' Subtotal 1 . 7
7 lfJ V Minimum permit fee (572.50) 1 v�� 0
: Phone :o0 S,� 15 011._1•4,6.3 ` F- V: (3 � 2 7 Plan review (25° 0 of permit fee)
CCB lic.: I .. t S' State surcharge (8% of permit fee) f3'• : vU
111 TOTAL PERMIT FEE '7K. } )
'• This permit application cr[pires if a permit is not obtained within 180
Authorized s',gn tune: � 1 ` 1 days afte it ba been accepted as complete.
I Print name:
It ��,'� [i_>,. • Fee methodology set by Tri County Building Industry' Service Board
it ' r r 1 �!1 . 1 Date: ("!?
—_M
E ' al 2L'E- LES -EDS '3 `sTeluad SW dGi =i0 90 is inf.
Jul 21 06 01:17p MS Rentals, Inc. 503 -537 -2172 p.2
i
o _ — ,i
i
�'
I
J I /'
J
I
i
{
2
I J
•
cL
14
E
l9 Z
U
J \
�"- 4
n i .
v —Q
t
1
e ______________________ ___---(‘
I
i
,.y) .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006 00336
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/7/2006 TIME: 7:02AM PAGE: 49
SITE ADDRESS: 09720 SW NACIRA LN CLASS OF WORK:
SUBDIVISION: GREENBURG PINES LOT #: 006 TYPE OF USE:
PROJECT NAME: BLACKMAN
DESCRIPTION: Heat pump install.
OWNER: BLACKMAN, KEVIN PHONE #: 503.430.6868
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 03-53B -2953
Inspection Request Scheduled For: Date: 9/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036125 -01 503 - 538.2953 Y
Corrections/Comments/Instructions:
2) 6.-Gar-4-724 "Ad- WI, ASO,e. L .A. 6 �sL S 9¢ 2.6 9 ,fdcd G'a1 2<s S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: - Date: 9— Phone #: (503) 718- ?A-4-S--