Permit A �w
C ITY OF TIGARD MECHANICAL PERMIT
rri� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00369
� °�' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/4/2006
PARCEL: 1 S133AD -14000
SITE ADDRESS: 12723 SW SORREL DOCK CT ZONING: R -7
SUBDIVISION: SUMMER LAKE LOT: 021 JURISDICTION: TIG
Project Description: Installation of heat pump & air handler.
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
CHRISTIAN LARSEN Description Date Amount
12723 SW SORRELL DOCK CT
TIGARD, OR 97223 [MECH] Permit Fee 8/4/2006 $72.50
[TAX] 8% State Surcha 8/4/2006 $5.80
Total $78.30
Phone: 503 -521 -0298
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 235 -0454
PRI 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: - �L(� Permittee Signature: , nn
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.
0g/03/2006 13:59 5032350454
SKY HEATING PAGE 01
,
Mechanical Permitt _''.. iolD Foltort.u.I.:1,sv().1.,
City of Tigard Rkt IA Rccei -. Nw _,, z __al /
Permit No. - ,...,.A 6 , -00 l c..
13125 SW Hall Blvd., Tigard, 97224, "S Ly - Plan Review
Phone: 503,639.4171 Fax: 503.598'l'960 ,9t50 .••.,. , , Date/13y: Other Permit:
Inspection Linc: 503.639.4175 ,,,p5k i •:"':';' I
- Of 1 ‘‘AlkS\0 14 .. .1i Data Ready/fly: mil 0 See Page 2 kr
Internet: wvp.v.ci.tigard.or. us ' 0 i - n D. - - NotifiseVMethoell Supplemental Information
: 003:4114 . --
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Mechanical permit fees' are based on the value of thc work
0 New construction ;gAdditionialterationireplaccment performed, Indicate the valuc (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labs overhead, and profit.
Accessory building Value* $
• ." ' •-• . '..• • ' : .. ..t.::.: 0 P l:4,500.4.1.4**.0i4C:.::IF:;,'..- .•*„. .'.., :.; `, A
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0 Master builder ,:••• .:.:itaititivrtLAtquitirAarrfravatoi
2-family dwelling 0 Commercial/industrial I: ilding
1. 1 - and 2-fa
Multi-family 0 Other: • For special information use checklist
Description I Qty. I Ea. [ Total
. • , ' .
JOB IITi.,ipirotimino.*:.414re-te*ittON'-' "ei'' ' - ... — :• : ., HentinaLcoollog - -r- e , f
Job site address: 1 1 , s • el l Da z- e_.1-- Air conditioning or heat pump 1--/
(requites site plan showing placement) ) 14.00 -
City/State/ZIP: • Furnace 100,000 BrUiducts/vents) 14.00
1.A. a • liP. .1 N
. "" 6..- _ , Furnace 100,000+ BTU (ducts/venia) 17.90 _
Suitc/bldgJapt. no.: . Project name: Gas heat pump . 14,00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14,00 - -
Residential boiler (radiator or
hydronio) 14,00
Unit heaters (fuel•type, not electric),
in in stsendcd, etc. , 10.00
Fluc/vent for an_of above 10.00
gubdivisiun: i Lot no.: Other, 10.00 I___
Tax map/parcel no.: • Other fuel appliance.;
• - •--
• • • • : ! ' •• . .' o ' • •,:0,wouc, .,?•.;:...,::•,•: .!.. •.:...,... ,, . , Water heater 10.00
. Gas fireplace 10.00
• ---
• 4 1... ' f -II - 0 • Flue vent for water heater or gas
( hia n • e..r fireplace 10.00
4.4
— Log litter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
• . ...- •-• , ..,... - ,..... ,... • •• .. ,. Chimney/liner/flue/vent 10.00
• • ' • VfPROrIERI:iNc? .. ..!;
_
Name: 0, \ I( IS trtin Lri r SIC' in Environmental exhaust and ventilation _
- Range hood/other kitchen
Addrcss: equipment _ _.---
City/State/ZEP: Clothes dryer exhaust 10.00
,,i), I I) -
Fax ( )
i Single-duct exhaust Fatlirooms,
Phone: ( ) ...
toilet compartments, utility rooms) 6.80
El(APFLICANT.: ''''..2 .. :.',..':`.., ..'..:.'7.;?.r.,:.:1Z1?;cipiSriA.c , ....:. :, Attic/crawlspacc fans 10.00
.
••..• .„,
. . ' Other: 10.00
Business name: . .„• .1 .,
.
Fuel piping
Contact name: . .
S5.40 for first rot2Ei_..-M,—.-----0for each itdditiona
Furnace, etc.
Address: —
- Gas heat pump
City/State/21P: Wall/suspended/unit heater - —
Phone:( ) I Fax; : ( ) Water heater , .
— , Fireplace
E-mail: R4lage —
,
• • • ". '' • '• • :t"
CO ;• -.,iiiiiifiR.t-..!-...':1''.'.:!. r''- Barbecue
Business name: di A Clothes dryer (Ras)
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Address: / • , ' 4. ..A _ .Z‘.7•:::TOCYFAN,Ii0;:ti:124901t:t1X.0,...::...:
i Subtotal ..--
Minimum permt fee ($72.50) 1,P.SID
Phone: ( ) e R3s --. 1 ) 8 - 3 Fax: ( ) c;'35 6 (.t Plan review (25% of permit fee)
CCB lie.: cS Q9 Li Ly State surcharge (8% of permit fee) S. ...
Authorized
nth permit application es L o wlthht I
sigrushrre: 80-
175 - P -1-A-1"--3 .
r Print namr• L i Lo prt_r) . •na'" S 3 -3:e,
ej _
days mutter it has been accepted as complete.
1 • Fee inethodolovy sot by Tri•County Buildina lodustry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006.00369
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2006
Phone: (503) 639 -4171 ���
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7 :01AM PAGE: 79
ti ok r,+ (>44 via 1 5 p P..c 4.1G-, 010 , Svc►+ -
SITE ADDRESS: 12723 SW SORREL. DOCK CT CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 021 TYPE OF USE:
PROJECT NAME: LARSEN
DESCRIPTION: Installation of heat pump & air handler.
OWNER: LARSEN, CHRISTIAN PHONE #: 503- 521 -0298
CONTRACTOR: SKY HEATING & AIR CONDITIONING PHONE #: 503
Inspection Request Scheduled For: Date: 11/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact #
tig__4 M ��
699 Mechanical final 039183 -02 503-235-9083
Corrections /Comments /Instructions:
I
<PASS ❑ PARTIAL APPROVAL LI CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C -/ 1P Date: t 1 /5/7 Phone #: (503) 718- Z4.9.7