Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00733
" ^II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/3/2005
PARCEL: 2S102BD -01503
SITE ADDRESS: 12750 SW PACIFIC HWY 122 ZONING: C -G
SUBDIVISION: VILLAGE SQUARE LOT: 001 JURISDICTION: TIG
Project Description: NO HEAT install 1 furnaces. Value $4345
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: 0 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
GOSPODINOVIC, ROSE Description Date Amount
12770 SW PACIFIC HWY [MECH] Permit Fee 11/3/200: $127.70
TIGARD, OR 97223 [TAX] 8% State Surchaq 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: // ,
, (jf Permittee Signature: c7' & G cti.
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
SKY HEATING
- - -- PAGE 02
• 1 ,
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Mechanical Permit Application 101; oil I( 1. 1 .:I. 0 Ni
City of Tigard lo Received
DatriBy: t MO6 igli Pcm " ° ' : 14
13125 SW Hall Blvd., Tigard, OR 9,m,ECEIVEDA Man Review
Phone: 503.639.4171 Fax: 503.598.1960 Dtellar.
Other Permit:
•:..,t;,, i % a
Inspection Line: 503.639.4175 .:4 411 Date Reedy/By: 8 See Page 2 for
Internet: www.ci.tigard.ra.us NOV 3 2005 ." — Notifi.vme,thod, LISI Supplemental Information
;.:'.:: :•-:':::'::.:.;.:.*:::.?.:.... • i , . ' ...,:-.. ' ....:.•%:f :::: • 't . %" ill;13ktiAW 4 ...: • ' '•••••';•.- '''• ...:*;:•': .:5;."; ••.::.:.. . • :-:.• I': ... : • :•:•*. %.... , r . ., ... , ...,,,,;;,.._. -;L•k .,..... .. -........„.„..t. .,...-• • ....... ,.. ...,. • , ..., ',' .,
0 New construction . - '. ' .
la.61 Addition/alteratiol replacement Mechanical permit fbes• art based on thc value of die work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition. 0 Other: mechanical materials , .•ui. e_i_ :d :..d . rofit
Va 9- 1111111- ' 1 " -VIV iZ i..7 .
' ;?•:...;'Y' f:-.'. • .....;" . . /..:_'. T.tavort*,,,p1 4vis1tcf1 ol7.77:::::;,.!..;:.:.: .::::.:..::.::::..:,.:
or,
I- and 2-fbmily dwelling g Commercial/industrial 0 Accessory building For special information use checldisi.
0 Multi-family El Master builder 0 Other: Description I Qty. I EIT1 Total
.1.:.•7:`::..-..7:10#,;*.ttrikXiiittM140;':iy,f0.%004.0$,::,;:,:',......,:.. , '.,..-.1::: : . 5 ., , I.., .::. Heating/cooling
Job site address: 12750 SW PACIFIC HWY Air — conditioning or heat pump
(Moires site plan showing ointment) 14.00
City/State/ZIP: TIGARD OR 97223 Furnace 109 am (ducts/vents) 14.00
Furnace 100,0004 dacts/veats 17.90
Suitc/bIdgJapt. n .:'izigtlil, Project name:
Cres heat . um . 14.00
Cross street/direetions to job site: -)6>'-- Duct work 14.00
— . Hydrottic hot water system 14.00 _
Residential boiler (radiator or
hydronicL 14.00
Unit heaters (tbel-type, not electric).
in-wall, in-du su: . ded. etc. 10.00
----- Flue/vent for any of above 10.00
Subdivision: 1 Lot no.: Other: 10.00
Tax map/parcel no.: Other feel appliances
' ''...'•':"••• j. .•';'.. .:' • • -• ".. . : . ;.c '.1, 4fielitif(061::•,•::.:•....*:•i ... :.:'.• i ;: . ..!'!,:....,.' Water heater 10.00
- ,
Gas fireplace 10.00
INSTALLiBRYAN/F 2.5, TON GAS PACK SYSTEMS Flue vent .for water heater or gas
‘ N 19 - . 11 , lace
Log lighter (gas) 10.00
, 10.00
Wood/pellet stove 10.00
. — — Wood fireplaordinsert 10.00
. . • . • • Chimney/liner/floc/vent 10.00
- . .....,....7L:.?... : •,;i:glittaitlytAtOttit'•.. '. ...' •:' ;:e r'. • ' : ' '..''; • ' . " - '
10.00
Name: ROSE Environmental exhaust and ventilation
---------- ----- Range hood/other kitchen
Addrms:
— e.ui anent 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
- — Single-duct exhaust (bathrooms,
Phone: (503 )598-1847 Fax: ( ) , toilet compartments, utility moms) 6.80
.:'•••-•:'',':':..........':::..421.41ketitill"':'::>'.";::.:" e0W401441,44t00:::::.:.;::',,K::-.0, Attie/cmwlspace fans 10.00
Odtcr. 10.00
Business name: SEE BELOW
— ______ Fuel piping
Contact name: $5.40 for first fear; 51.00 for each additional
- . Furnace. ctc.
Address: „ Gashed. .
City/StateJZIP: Wall/suspended/unit heater
_
Phone: ( ) Fax: : ( ) Water heater
Firs3lace
E-mail:
—
Range . -.
:,..,, .... •:.• :i.....; .: !.,... • :.. "tosit e...;.' ": " '! . Barbecue
, . ,. •• • ..,, • ■• • ,..... — • ••, .....- , • •
Business name: SKY BEATING & AC Clothes drycr (gas)
Other
Address: 1635 SE NEIIALEM ..
. —
City/State/ZIP: PORTLAND OR 97202 Subtotal
Phone: (503) 235-9083 Fax; (503) 235-43454 — Minimum permit fee ($72.50) /A 7 . 70
• Plan review (25% of permit fee)
CCB lic.: 50244 State surcharge (8% of permit (ec) i'). 9/2-
i ....1____ — TOTAL PERMIT FEE I /7.9
Authorized signature: er134 This permit application expires If a permit is not obtained within 130
days otter it ha* been accented aa complete.
Print name: JEAN LOPR1NZI 1 Date: 10-27-05 i • Fee methodology act by TO-County linilding Industry Service Board
iABuikliflePennitAblEN-reretuotpildcm Wo3 440.4617T (I
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11/03/2005 10:41 5032350454 SKY HEATING PAGE 04
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11/03/2005 10:41 5032350454 SKY HEATING PAGE 05
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CITY OF TIGARD , _ _ _ .
BUILDING DIVISION PERMIT #: � — 00733 CL 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 It
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: % L /CO TIME: PAGE:
SITE ADDRESS: 12, Pit G, ` CLASS OF WORK:
SUBDIVISION: LOT #: f 2:2_ TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
,1 Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments/ Instructions:
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Vt/
6 YLki SA.A-1 7 S r )X-f 2/LA j i7:1i) elift Cie -
4 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/f�
Inspector: ,' �` Date: 1 V 6 Phone #: (503) 718- �� 24
CITY OF TIGARD ,. i2'I CG
BUILDING DIVISION PERMIT #g0CZ5 — 0 0 733
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �j��
Inspection Requests (24 Hrs.): (503) 639 -4175 :. alt
�__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /275 a f , 4/ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: R .9_6.A-- .9_6.A-- PHONE #: O G
J Ige7
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: // h&c Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 /a o 203Z0 -oZ
Corrections /Comments /Instruc ions:
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PASS El PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
*AI bb ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V C l Date: /113/ l 6 #: (503) 718 -
Phone