Permit F
CITY OF TIGARD
MECHANICAL PERMIT
f - DEVELOPMENT SERVICES PERMIT #: MEC2004 -00327
,. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/1/2004
PARCEL: 1S136CA-03300
SITE ADDRESS: 07935 SW PFAFFLE ST
SUBDIVISION: FRIENDLY ACRES ZONING: R -7
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: AC unit and furnace install.
Owner: FEES
LOOS, HELEN A Description Date Amount
7935 SW PFAFFLE [MECH] Permit Fee 6/1/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 6/1/2004 $5.80
Phone: Total $78.30
Contractor:
THERMAL FLO
14865 SW 74TH AVE. #160
TIGARD, OR 97224 REQUIRED INSPECTIONS
C_c2 L1 IJ� U N 1 TN V' ,
Phone: 503-670-8383 Heating Unt Insp
Final Inspection
Reg #: LIC 151847
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.
Issued By: ,/,/ /1if , Permittee Signature: 077 � � � ,� ,
-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
r— r i
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Pit N
13125 SN1ial1 BI'vd., Date /B �/ �`
Permit o. rn � , „ d _ 00 a
: _ COED Plan Revie
Phone: 503.639.4171 t' / / g p f i Other Permit:
firU�l�i� Date /By:
.
Inspection Line: 503.639.4175 „ i,l ' Date Ready /By: WM ® See Page 2 for
Internet: www.ci.tigard.or. g 2 8 2004 Notified/Method: Supplemental Information
CITY OF TT6PArhfr WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction BU I LDI I� JII3 �Qeration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
Multi family ❑Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: 7 q J 5 � ,, \ ' .0 (�,`� r Air conditioning or heat pump
1 I� �f
(requires site plan showing placement) 14.00 I - 1
City/State /ZIP: -'r A-./) (A-7g_ .- Furnace 100,000 BTU (ducts/vents) ( 14.00 i' i
/ t J l 2 � 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 I 4 is
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
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater ( 10.00
(� ,,1 n Gas fireplace 10.00
I CCQ1 � 6 < < J .Z1- /U Flue vent for water heater or gas
f' „ C � t `' ` fireplace 10.00
t�C ���` F l/� bu- ( f - Log lighter (gas) 10.00
�t a �4 -Q/fl� Wood/pellet stove 10.00
r, V Wood fireplace/insert 10.00
tl2 PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00
Other. 10.00
Name: 1,14 Q Q A , LIZ) O Environmental exhaust and ventilation
Q _ Range hood/other kitchen
Address:
q 3 c-, Lk) () -C-4 ILL equipment 10.00
City/State/Z1P: f> � el-g. r'1 G ,9 2 3 Clothes dryer exhaust 10.00
• / Single -duct exhaust (bathrooms,
Phone: (503) C -3 4- (, q Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT 421'CONR'ACT PERSON Attic /crawlspace fans 10.00
Business name:
Other: 10.00
T Aes. `'T ia_ (..LA ,k- • Fuel piping
Contact name: C ,IR A `S t-F.....1 ( C $ $5.40 for first four; $1.00 for each additional
Address: ( c, 5 Si...) -7 LI -41-.� Ave ,t j q Gas h eat etc.
f� V� Gas heat pump
City/State /ZIP: 1, i /, / tryi.,_ g 7 _2;7-4- Wall/suspended/unit heater
Phone: ( e ) (c/ v . t) .3 Fax: : (r' o )) (o- o _ 9064 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
n Clothes dryer (gas)
Business name: X/ F-61) L Other:
Address: (../g 6 s 51 ,l) •74+1 fili•E_ / Cl 0 MECHANICAL PERMIT FEES*
City/State /ZIP: '`r „^_ I / J � � L,! )"- / � (� Subtotal •
�
7' � " �' 1. Minimum permit fe ( 2.50 ' Q
Phone: (S0-6) ro O 2'g 4 - 7 Fax: (5oS ) 06 e
` '
b / Plan review (25% of permit fee)
CCB lic.: (5 /9' •/ 07 State surcharge (8% of permit fee) 9- 0 U
v TOTAL PERMIT FEE 78 ` S
Authorized signature: O' v v 0 ��WJ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: C / S p 1-6/c( P J p Date: 5 - 7_ - Q 51 • Fee methodology set by Tri -County Building Industry Service Board
B \ P
i:\ uilding emtits\MEC- PermitApp.doc I2/03 /` 440-461 Tr (11 /02ICOM/WEB)
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CONTRACTOR NC-HEAT PUMP 0/D UNIT SITE PLAN
THERMAL FLO, INC.
14865 SW 74TH AVE #190
TIGARD, OR 97224
503 - 670 -8343 OFFICE TO BACK PROPERTY LINE
503 -670 -9064 FAX
TO SIDE PROPERTY LINE
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TO STREET
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CUSTOMER INFORMATION •
NAME / / oS•
ADDRESS
-79 3 5 Stu Wcc,
�Cli ��
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