Permit p 444fr - ytttel -- / 0 CITY OF TIG R D MECHANICAL PERMIT
in DEVELOPMENT SERVICES PERMIT #: MEC2004 -00273
111 DATE ISSUED: 5/13/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DD -07000
SITE ADDRESS: 09605 SW VENTURA CT
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 ZONING: R -4.5
BLOCK: LOT: 078 JURISDICTION: TIG
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:
ELE 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC install. 5 - 27 - 2004 add furnace.
Owner: FEES
BRUN, KIM E + SUSAN E Description Date Amount
9605 SW VENTURA CT [MECH] Permit Fee 5/13/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 5/13/200 $5.80
Phone: 503 922 - 9502 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Cooling Unt Insp
Final Inspection
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 - 0010 through •AR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699. W
Issued By: 1 � � Permittee Signature: Qy 4 , 13 p4 ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
.4
lanical Permit Application. FOR OFFICE USE ONLY
Received / Mechant'�}��� ']�
}!
i t of �'i ard� �(s � � � � ® Date/3 : d 0 I Permit Ngo — dal ■
y b Planning A .ro 'I Building
13 r..:5 Sit Hall Blvd. Date/13 : Permit No..
Plan Review Other
Tigard, O •egon 97223 MAY 1 3 2004 E •, D°tr/13 : Permit No..
Phor.e: 5(3-639-4171 ax: 503- 59S -19 0 Post - Review Land Use
OF TIGARD
Internet vww,ci.tigardCtalTu�;' ' "''fl'�!tl�l�� Datc/B : CaseNo -
24 -hair Ir spec R tDta$N : , * �" "- 4 Contact ® See Page 2 for
Name /lvtethod; NM Su Iemental information.
CITY OF TIGAhu
TYPE. OF WORK OU�� ®i IvlS Io�l COMMERCIAL FEE- SCI EDULL - USE CELECKL[J r •
L New c onstruction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addit on/alteratton/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION - mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2. Family dwelling n Commercial/Industrial Value: S_ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENT1A.i. :EQUIPMENT /SYSTEMS FEE* SCHEDULE
Dexeri. Non J Qty I ree(ea.) 1 Total
MI Alastc - Builder n Other:
J 313 SITE and LOCATION /'`- Hca • Coolin
Furnace - a d - on air corfditionin -4 1 I
Job site address: 9 ( U V is lievg ,- el Gas heat DI
Suite #:
BldgJApt.#: Duct work 14.00
Pro . tact N. me: Hydronic hot water system 14.00
Cros; street/Directions to job site: Residential boiler
fun iadiatur or hvdronic s tern> 14,00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) • 14.00
Fln ie /vent (for any of abovo) 1 0.00
Subdivision: I Lot #: Repair units 12.15
Tax map/parcel #: Other Fuel Appllunecs
DESCRIPTION OF WORK Water heater _ l 10.00
Gas fireplace
Flue vent (water heater /gas fireplace) 10.00
(I 4%.-_1-1-0-44%.-_1-1-0-4,.k „ j4-/- Lo. lighter gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent I 10.00
r PROPE1ITY OWNER I ❑ TENANT - . Other: 10.00
Nam.. le t. rte, r t.l.•vt Environmental Exhaust & Ventilation
Address: _ ••• • 10.00
Cit /State /Zip:
10.00
Phony 4 - C, .1 Z Fax:
Single duct exhaust
r CONTACTTERSON' `: • •
• APPLICANT • 6..,,
0
Nam,.
10.00
Address: Other: 10 00 ,
Ci /;Mate /Zip: - Fuel Pi ing_
•*(55.40 for first 4.51 -00 each additional)
Phon Fax_ Furnace, etc. •'
E -mail: Gas heat pump
_. _ Wall /3uspended/untt heater
CONTRACTOR ' , • Water heater
Business . Marne: S t'` < < c_i_ _ i -k c--1 r\ Fireplace
Address: 1 ie c L cc W t t, •,- .r . Ran:e
Q
Cit /State /Zip: f- h•$. (Si,/ c ,.� , i7 ti , e7 / 2_. T CB
Phone,' E -R) - �j C } Fax: Wg 1.- O t h er. dryer (gas)
' C � `1,3 Other.
CCB Lic. I : 1.7 Ci C 3,S Total: Author zed ( L ,_
t
Signature CJi_e . Date J " Subtotal. S
(Please print name) of
Notice: This F omit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Service Board -
180 day i after it has been accepted as complete. •*Site plan required for exterior A/C units.
i \Dsts\Permit I nnns\MecPermitApp doe 01/03
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STREET
Specialty Heating & Cooling, Inc.
9528 SW Tigard Street
Tigard, OR 97223
Phone 503.620.5643 Fax. 503.598.0718
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
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