Permit . `'CITY OF TIGARD MECHANICAL PERMIT
° ' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00234
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/26/2007
PARCEL: 2S 109DA -09700
SITE ADDRESS: 15262 SW OAK VALLEY TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 086 JURISDICTION: TIG
PROJECT: NGUYEN
Project Description: Install A/C
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
. FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
LONG NGUYEN Description Date Amount
15262 SW OAK VALLEY TERR
TIGARD, OR 97224 [MECH] Permit Fee 4/26/200 $72.50
[TAX] 8% State Surcha 4/26/2007 $5.80
Phone: 503- 781 -0374
Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
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..
Permittee Signature: i _ _
V / i
Issued By: (
Call 503.639.4175 by 7:00 a.m. for inspections that business • ay.
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.
FROM 5035570919 FAX NO. :5035570919 Apr. 25 2007 01:33PM P5
tcch anicai Per mit Aica 6 o I m . -.,-
c v N ?,K OFFICE USE ONLY
City of Tigard Received
Date/By; PPernik No. , /
_
13125 SW Hall Blvd., 'Tigard, OR 97223 J11t� o 0.1) °?
Phone: 503.639.4171 Fax: 503,598.1960 APR : /, - Plan Review
Date/By:
2 5 21 : Other Permit:
tns Brien Lane; 503,639,4115 r , +..;,, y
Internet www,ci.tigard.or,us � Tr", - ;ill
I Date Ready/By: Luria; Ea See Page E for
1 Y Ui Notified/Method: Supplemental Information •
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"-�'r • ..E : : .ESEL ` l . "116e � . c E�'a�ae�iea G. �eadLla •,,. . -; i ; • ., -i' kfit j ! °? . S .• . .. 1 . ' - bGI�l�ID J i j� r�= .�FYS�`#L1Ji�CKL'IST' •
• ❑ New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
❑ Demolition ❑ O� , performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and pmrir.
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N , •;,. Y r , ; .;� • . -�., : iH ...a' �;• ; •. �,,F � � ' ro-:�'k�'; % Value: $
El I - and 2 - family dwelling fl Commercial/industrial ❑ Accessory ~� Ai � T
r F t5 F
� essory building �• �' � •' W
Multi - family For special laformation use checklist.
El y ❑ Master builder ❑ Other:
y , , w e � ,• • n: T , -� Description I Qty I Ea, .1 _ Total
5 t e i' r .
�'QM ••'l1f�'mlS' � . . ;- II1,. �:'. "•.' 1.1e__ o ____
Job site address: a u ' ' / _ sir Conditioning or heat pump
/ 1 .. Al 1 � (quires site plan showing placement) l 14.00 i-/I
City /Stet 'ZIP: 4 01.4 ")' r OK- q
Furnace 100,000 BTU duets/vents) 14.00
Furnace 100,000+ BT�ducu/vents) 17.90 y �
Suite/bldg. /apt. no.: Pfoject name: Gas heat pump 14,00
Cross streeddirections to job site: Duct work 14.00
• Hydronic hot water rem 14.00
Residential boiler (radiator or
hydronic) . 14.00
-- Unit heaters (fuel -type, not electric),
ry in - wall, in - duct, suspended. etc. 10.00
Subdivision: Lot no.: Fuue/vent for any of above 10.00
Other: 10.00 _ ..
Tax map
/parcel no.: Other fuel appliances
<iy,� ,
y �, x p,••:
� : 4Pa,. t � t� ,I�TL. •� si '�,!'4 �,.... .,, Water heater 10.00
:,; y, '' uF : itirf` ^'Y • (�l �.- : . rt' � i al �t I'. ,
i�' 'r�: N . ��' ? ' h: t]jl!:.x. � • y .' y - T.�' ~ i�.;•y.: ��t. 1�'i ' '� '
Gas fireplace 1000
' , t1 td f . .4 A - Flue vent for water heater or gus
fireplace 10.00 -
• - '-- - • Log lighter (gas) 10.00
Wood/pellet stove 10.00
-
Wood fuepince/inse rt 10.00 .
.Y C ai a o y.• . r.. ti ; :; Chimney/liner /flue/vent 10,00
- .. •, , -- � .. �,�si� � �.,... .' i. � Other: 10.00
Name:
"WWI r1 • / Environmental exhaust and ventilation
Range hood/other kitchen
Address: •
equipment 10.00
City/State/ZIP: • Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone:
`7 , ( - , Pax: ( ) - ...+... . .. to ilet cotnpartrieni utility rooms)
' t -q i, i9 ',.I , . q - a+ _t/ i 5 ` C tawls�aCC fans .....- ...- ..._....... . -. 1000
-
' �� ' Alticl
,w:c., . _ ' -r �XHr'., �1' is ' �' '' u ff :��,d'�u � �,.y�.� ) ` •s�.. �N+.. ,�' :��:: Other: 10.00
Business name: T I . • Q i t_I..Y 1 .
1911
Contact name: $5.40 for first four• 51..00 for each additiona
Address:
[5160 `- a I , ai / K) Furnce, etc, •
/� l" W� , Gas heat pump
City/State/ZIP: V . 11 c R. q 7045 Wall/suspended/unit heater .-, -•,,,, -w -. ., __••••
Phone: () 557-- .2 Fax:: () 557-C16(1 Water heater
Fireplace
E-mail:
��'p "�t �i' � 'A �..[ K 1� ;r -4. 7 -FB . . 7 ,.. • •''', -' ."- L ,q,7 t : r , , yl?gti b C i K, . 1 9 ,4 t?: 4:42 +`4 '''''42.11W4' ' Range tKCYC __ ,,. �.. _ '__'_- ._._...
Business name: To CO Tern? 1110 _. - •- -... • Clothes dryer (gas) "
• Address: ,_�. �, •• ; m r t ,,: .. ,
/ � ': . q r t ,:;, ! i.7d Ctl:. , . .tli% . 6 sky (:' • Ciry f �
/State/Zt1a: ! 4 0 , I L _ k_ V �� • subto
Minimum permit fee ($72.
Phone: ( 53) � ) 55 -2 Fax: (003 65� • -_
Plan review (25% of permit tee) {,
CCB lic.: 7 , State surcharge (8% of permit fee) 0
TOTAL. PERMIT FEE 7 • ' ,
Authorized signature: " °�' "�••' t� This permit application expires If a permit it not obtained within toe
_ days after It has been accepted as complet
Print name: / A44304 Date: J��nil■ - Pee methodoloty set by Tri- County Building Industry Service Board
a 1 . _
a • • CONTRACTOR NC -HEAT PUMP UNIT SITE PLAN
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M _ �.�. ...:r., Qirec -4- n
:.� / cei TO BACK PROPERTY LINE
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TO SIDE PROPERTY LINE .
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CUSTOMER INFORMATION
NAME Loi.vii g (� - "
ADDRESS :
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N �� PLEASE REFAX APPLICATION WITH SITE PLAN.
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l
. CITY OF TIGARD
BUILDING PERMIT #: MEC2007 -00234
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/26/2007
Phone: (503) 639 -4171 T !' I l�
Inspection Requests (24 Hrs.): (503) 639 -4175 . 1 L
INSPECTION WORKSHEET FOR DATE: 5/4/2007 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 15262 SW OAK VALLEY TERR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 086 TYPE OF USE:
PROJECT NAME: NGUYEN
DESCRIPTION: Install NC
OWNER: NGUYEN, LONG PHONE #: 503- 781 -0374
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 5/4 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047633 -01 503-557 -2220 N
Corrections /Comments /Instructions:
PASS M PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL rd ' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ■ Date: 5- y d7 Phone #: (503) 718 -
11