Permit . .
, ,. .
A CITY OF TIGARD MECHANICAL PERMIT
r� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00734
Ail 13125 SW Hall Blvd., Tigar O R 97223 503 - 639 -4171 DATE ISSUED: 11/3/2005
PARCEL: 2 S 102 B D -01503
SITE ADDRESS: 12750 SW PACIFIC HWY 123 ZONING: C -G
SUBDIVISION: VILLAGE SQUARE LOT: 001 JURISDICTION: TIG
Project Description: NO HEAT 1 furnace and gas line. Value: $4345.00
•
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm:. OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
GOSPODINOVIC, ROSE Description Date Amount
12770 SW PACIFIC HWY [MECH] Permit Fee 11/3/200f. $127.70
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11/3/200f. $10.22
Phone: Total $137.92
Contractor:
SKY HEATING + AIR CONDITIONING
1635 SE NEHALEM REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Phone: 503 235 - 9083
Reg #: LIC 50244
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: 1 $9L( ��,� t_ ' `
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11/03/2005 10: 41 5032350454 .0r.■ ...._.-......-
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dlechanica I Perm' it A '&1141 • linil Permit No- / / _007- JI
L'ity of Tigard Received
1125 SW Hall Bivd., Tigard, OR 9RECawlim4 '0' . Date/By:
Pion Review
hone: 503.639.4171 F ;f
F. 503,598.1960 Otha Permit:
',i.*..-itils Date/By:
nspection Line: 503.639.4175 --4,W- '' ' Date Ready/By. 10111 Ft See Page 2 for
nternet: wYrwei.tigard.rmus CON Ob. Tig, --- Notifi.omothod; , Suppletnestel Information
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.'tiftittigebagittV VelitinSzt .. ,` -
- / co, I Mechanical permit fete are based on the value of the work
0 New construction 1531 Addition/aJteration/replaoement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demoliticm. 0 Other: tnecltatdouumgoaijithxiliater Tibor, overhead. and .m
:r: : :.i . ../:. : -! : : :: !.. '!'Y.'" ;:11.V.ttiOg.ttOeg.,..::-:1'..6'.....:::..:.::..f. S..'!..::';'',':
graggrilligotttpmmv.z4miswarr.,... ':. ...
til 1- raid 2.4kt:roily dwelling Eg Commerciallindustr ial 0 ACCeSSOly building For special information sae checklist.
0 Multi-fantily 0 Master builder CI Other: Description QtY. Mil T
10$;$11140,111141rOcgOrAt#.10100,0611014Sil;!....;'‘;;;;.....''. Meath l: coolln:.
Job site address: 12750 SW PACIFIC HWY Air conditioning or heat pump 1111
IC . . ir0 site • Ian shown)._ Atomment 14.00
City/State/Z1P: TIGARD OR 97223 Pomace 100 000 BTU dues/vents IIIII 14.00 1111111
FnmaCimi004. TU duem/vents MI 17.90 .11111
Suite/bIdgJapt. no.: let z 10 Project name: 1111111 14.00
Cross street/dim:60ns to job site: Duct work MI 14.00 11111111 •
I-1 . ronic hot water : em 1111111 14.00 EMI
Residential boiler (radiator or
MI
h dronic 34.00 111111
Unit heaters (tbel-tye, not electric).
in-wall in-du sn . ded. etc, 111 10.0 11111
Flue/vent for a of above IIIIII 10.00
Subdivision: Lot no.: Other: OM 10.00 1111111
Tax map/parcel no.: Other feel a • 10 00
.:,.:::.;-.':',':•':.. '... . ..5::: .. ..: 7 .' .S.':•;'''.:;:.::''...0tPtiOttliOlf:Or:'_-.!'..-;,,. -;i' t'..,:i...",....;.3.: Watcomrefrrimmimm.111
111.11 10.00
INSTALL BRYANT 2 TON GAS PACK SYSTEMS Flue vent fer Water heater or gas IIII
, lace
30.00
LO • 101W ! as 1.0.00
Wood/ • gild neve
MI 111111111
/II 10.00
Wood Ii .lam/insert ME 1 MI
/liner/flue/vent OM 10.00 MIMI
.:...:!;.'7.';::?".::':02.100101Mt::#0.14Ati• -::•.:.:'.. ':. r. .,. .:;'-.;.1:3;:ltit.. itiV.':':.:;:•.'"::1.*,,,,4•1;.:: .... NO 1.0.00 NMI
Name: ROSE Environmental exhaust and ventilation
Address'
Range hood/other latehen
i anent 11111 10.00
City/State/ET: Clothes • exhaust Mill 10.0 11111111
Sinduct exhaust (bathrooms.
Phone: (503 )598-1047 toilet corn. ; i nth util moms 6.80 1M
• :f. , :. ;:: : ',.; .: .... :-. :: 7 ... v : :. , ::.-18016$100.10::.-'.' : ',i . ' ; : : i: ' ; ... : -''':. ; i ' : '.. . ' . : - : ; ;-.. . : ' :' .: ' 11 titi$Vii#1 : :. s'.:,I.e :': (::, :; 1 Attie/crawls fans OM / NM
• 011111.111 10.00 Mill
Business name: SEE BELOW
Contact name: 55.40 for first fbnr 51.00 for each addidonal
Address: 1111111111111111111
) 41.5 recnnimil ....Furnac de. immomilini
City/State/ZIP: •.■ / • 00 wall/su . - ded/unh heater 11111111.
Phone: ( ) Water heater 1.111111.11111..11
, 11=111111111111111111".1111111111111111.11
E-mail: '• 0 Ran ..e 1111111.1111111.0 /
; •::;';'::. :: -..,.: .: i': ::.;:',.... ;:-". :`...'.; ....:'•..:':." Barbecue MOM -
Business name: SKY HEAT .:;.
ING & AC Clothes d r as
_ ligilarsig11.111111
Other
'',;..:1' . :'.i.i1+110*;064410.W.000.ifik4:::•.:71:.:: .....':
Cit.r/Smte/ZTP: PORTLAND OR 97202 11110111111111111.1111111.11.21=1,50111M
Minimum - 1 fee (57250) 7,=jrialli
Phone: (503) 2354083 Fax: (503) 235 Plan review (23% of perrni t fee) 111Rnag
COB lie_: 50244 State surcharge (8% of permit fee) "Vela
411 i . TOTAL PERMIT FEE IMAM!
Authorized signature: i 6134ftir) • This permit application expires If a permit Is not obtained wi a ISO
days after Rhos been accepted as comolete-
Print name: JEAN LOPR1NZI Date: 10 • ee methodology act by TO Building IndostrY ScrAct awed
ivuiusesWeneine.mnc-rennitApp.eue lam 4404617r 0 lievcom/WEE0
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,11/1d/'L115 11:41 5132.1514b4 SKY HEATING PAGE 04
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C P NO0 3 2005
CITY OF TIGARD
BUILDING DIVISION
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11/03/2005 10:41 5032350454 SKY HEATING PAGE 05
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CITY OF TIGARD - m E
BUILDING DIVISION PERMIT #mod ps_a 0 731/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /*
Inspection Requests (24 Hrs.): (503) 639 -4175 " I I-.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: io`_J f I z 3 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 1
OWNER: PHONE #: .5 /O p 1 7
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: /1 /3 `6S Pour Time:
Code # Inspection Description Confirm # Contact # Message
/ 0 0 0 3 2 _ 0 — ° / •
Corrections /Comments/ nstructions:
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P , ,,,,-t :. vuz_e_,K__ 4-73 _.e V--.;‘,0-- _gzS) - ric/
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAI L@ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 i/y ) #: (503) 718-
CITY OF TIGARD VV'c
1
BUILDING DIVISION PERMIT #: Z--410 D07 3 /
9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 . , yn� r,
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: / , /q /Q c TIME: PAGE:
SITE ADDRESS: / ,?-7 S Z1 , pc.., 4G CLASS OF WORK:
SUBDIVISION: le LOT #: / TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
0■1A. e_Je--
pc( -
L
6 74. 1 2„3 : 1 - c 5 A S ,
r 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: vz)i Date: 1 1 /,v6 Phone #: (503) 718- Z Si-(