Permit p
CITY TIGARD I MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00005
- I 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 1/4/2006
PARCEL: 2S115AA -08100
SITE ADDRESS: 10533 SW TITAN LN ZONING: R -4.5
SUBDIVISION: BERKLEY ESTATES LOT: 013 JURISDICTION: TIG
Project Description: Replace a/c unit.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
KEVIN CIULA Description Date Amount
10533 SW TITAN LN [MECH] Permit Fee 1/4/2006 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 1/4/2006 $5.80
Phone: Total $78.30
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97217 -2952
Contact #: PRI 503 281 - 0752
FAX 503 282 - 5722
Reg #: LIC 8897
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 -3 23 .
Issue By: Permittee Signat 611W /
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.
Mechan' cal Per I. ED �!_tE11�)<'O �.. �. . _ ''.; � 'FOR OFFICE USE ONLY. "' . ,
City of Tigard . , DRetdvByf / 06 • 4.)( Permit No.: ht
eto 'GAS
13125 SW Hall Blvd., Tigard, O1 9 2 ' II 0 n ?Q�5 C Plan Review
Phone: 503.639.4171 . Fax: 503.59 a50 ,,', ,. 1� bate/14; Other Permit:
Inspection Line: 503.639.4:75. S „4 - f II!” • Date Ready/Sy; El See Page 2 for
Internet: ww*.ei.tigard.or.usCITy OF 1 �� Notified/Method: Supplemcnta. Information
• BUILDING T? nrre
TYPE OF WOR& COMMERCIAL FEE SCHEDULE - USE CHECKLIST
Mechanical permit fees* art based on the value of the work
1:1 New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition : ❑ Other; mechanical materials, equipment, labor, overhead. and profit.
CATEGORY OF CONSTRUCTION Value: S J
+ RESIDENTIAL EQUIPMENT f `SYSTEMS FEES*
si l and _ family dwelling ❑ Commercial/industrial ❑ Accessory building •
For .special information use checklist.
❑ Multi family ❑ Master builder • ❑ Other:
Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 Air conditioning or heat pump
ID533 _so �QS1 (\ - (requi0C3 Silc plan showing placement) 1 14.00 114.M
City /State / "LIP: 1.;ga('e) t Uf�1 Furnace 100.000 BTU (ducts/vents) 14.00
Furnace 100,0004 BTU (ductswents) 17,90
Suite/bldg./apt. T
apt. no.: + Project name: w \ . \ (1,-10\a Gas heat Bump 14.00
Cross srreet/directions to job site: Duct work 14,00
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
F
DESCRIPTION OP WORK: Water heater 10.00
Q Gas fireplace , 10.00
Ql \n I l U`1 NP P l.Nr\ \- meR.,_ _,,_ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove - 10.00
Wood fircplace/insert 10.00 i
® PROPERTY OWNER El TENANT
Chimneyflincr/flue /vent 10.00
Other. 10.00
Name: . • • ' ,f.\ a ' Environmental exhaust and ventilation
• Address: /� �� /• �` Range hood/other kitchen
/V Z i l
\ j 0A u,rx equipment 10.00
City/State /ZIP: - ltaja O • • S . - �. Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone; ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
.�
APPLICANT ❑ CONTACT PERSON Altic/erawlspacc fans , 10.00
Other: I 10.00
WA t. • 0 t tit, I AI.* VI Fuel pipit
Contact nartte: /y . At 55.40 for first four; 51.00 for each additional
Address: Furnace, etc. -
Gas heat pump 1
C'iN•'Sta[e LIP. - Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
F
,� L ` `S ` ^ �t ire place
E -ma il: \l\c�Ctl.lQ'\ 11 \� \1141 .r.nry\ Range _
CONTRACTOR Barbecue
_
Business name: ` i 1 • I ∎.— • r - \ Clothes dryer (Gas)
1
Other:
Address: l ' 0 1.), kZil\\B
S . \) MECHANICAL PERMIT FEES•
Ciry /State/Zip: v s 0
_ • C� Subtotal /H
Phonc: (5b$, S) - 0 Fax: __________ _ `rc n^ _ Minimum permit fee (372.50) . `�a,�
` f � UU Ot O' O t o e .... ( 2 5 %
i �. 0 � ,.• Stale surcharge (8% of permit Pee) I, �j .
Authortred sit :l attire. ' :� J- Th is perm applicariuu expires if a permit is nut obtained within 18u
. . - -- ; • _._ . _ .. Z .. (19) S after it has been accepted :a) cumplete.
i I n,intc t l)atc: • rec u,ciIi kilo . Set I.y 1 I•('ocnly Building Ilitlustry ti rvI.e lion; tIA
Id WdIti :L0 900Z £0 "JET ZZLSZBZ LOS : 'ON 2NOHd 6u11003 '8 6u taleaH 1IlONd : WOZId
. N
a CONTRACTOR
4:1----H41 I''
E
Ckc A/C-HEAT PUMP -- UNlT SITE PLAN
itz
1 C c c c +
al
� TO SACK PROP ER [J'E R'Yec'r�o n
5 •
0
"' --
m
i.
1 6° fro ns
. -C IDE PRQPERTY LINE N N in
m N Z2 f
M 0 o- co „k p co pe 1 . t . J LiAe
ci
z
W •
z •
o
ro STREET
•
. k \kcl.n 1-Y\ .
CUSTOMER INFO TION _..___...._. _... .._._
cn
o I�L4�E .
o Y\N .
Ls
oa
ADDRESS ' ' n U,\0. w -
•
al
0
10533 I aka
as
ro
nV
J TIOS4C l (3 C 2 \ ° R . g'
Z
z
•
CC
E
0
C
i
CITY OF TIGARD y rYl
BUILDING DIVISION PERMIT # Qe*-0000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ��mw 1
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS/053 3 "T:A.,..4..„" CLASS OF WORK:
SUBDIVISION!: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: I — 49-3 - °(. Pour Time:
Code # Inspection Description Confirm # Contact # Message
R-L,;■—•& 7 - o/
Corrections /Comments /Instructions:
del /`v 04, L Z74s---
a A/P
PASS ❑ -A- ' L APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I Z 3 Phone #: (503) 718-
,