Permit CITY TIGARD MECHANICAL PERMIT
I k DEVELOPMENT SERVICES PERMIT #: MEC2005-00197
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/27/2005
__...._
PARCEL: 1S125DD-03900
SITE ADDRESS: 09855 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 047 JURISDICTION: TIG
Project Description: Gasline to cooktop.
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: 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: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
DON LOVE Description Date Amount
9855 SW VENTURA CT [MECH] Permit Fee 4/27/200° $72.50
TIGARD, OR 97223 [TAX] 8% State Surchaq 4/27/200E $5.80
Phone: 503- 452 -1788 Total $78.30
Contractor:
SUNSET HEATING & COOLING
PO BOX 42289 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97242
Phone: 503- 234 -0611
Reg #: LIC 161085
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- - -
Issue By: / Permittee Signaturer_e_
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.
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C 1 t■ of Tigard Dail:43. illigr ",,,,, ,,, Hej
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h. 0 See Nage 2 fur _ ..
11 •"" •:, 11 01 , i- CITY OF TIGARD Notified - Method / / a. 1 Supplemental Inforni.iiiiin
BUILDING DIVISION _
:
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST :
Mechanical permit fees• are based on the ‘ aluc of the uorls
E \e eonstitiLtiiiii g1ddiiton "alterat lon'replacement
performed Indicate the \alue (rounded to the nearest dollar' ol all
0 Demolition 0 Other: mechanical materials equipment. labor o\ erhead and profit
----
i CATEGORY OF CONSTRUCTION Value S
• RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Eil - and 2- lainil■ t.1% ■ell no El Commercial industrial 0 Accessory building
, For cpecial Information um: checklist
r] \ lulti-lamily 0 Master builder D Other _
Description I Qty I Fa 7 "mai
_______, - .
JOB SITE INFORMATION AND LOCATION I I eating/cooling '
...._ i
Air conditioning or heat pump
lob site addres C[g_c:;- C-___;-. v_e tturs_ C.4-- (requires site plan silos, in placement} I 14 00
Cii,State LIP. - 1 i e... 11) 1 2 CO ;),;) 5 Furnace 100.000 13Th rchicis'xents) 14.00
Furnace 100,000+ BTU idocas',enist I 7.90
Suite:bldg.:apt. no : Project name: iDxj
Gas heat pump 14 00
Cross street. directions to job site: Duct work 14.00
r ----- Hydronic hot water system . 14.00
Residential boiler (radiator or I
F
hvdronic)
14 00
Unit heaters (fuel-type, not electric). — '
in-wall, in-duct, suspended. etc _ 10.09
i
Flue/vent for any of above 10.00 I
i
Subdis ision: Lot no.:
Other 10 00 1
as map..pareel no.:
Other fuel appliances
DESCRIPT/ON OF -'- ' . -' '
Water heater
fireplace 10 00
10 ((0 i
_____
__.:
_ Gas
u ._ - 4 - 6 .:. c Crj'v g ) Flue vent for water heater or gas
.
1
..... fireplace 10.00
Log lighter (gas) 10 00
Wood/pellet stove 10.00
Wood fireplace/insert 10 00 i
Chimney 10 00
/liner/1111ex ail I 10 00
r2i., PROPERTY OWNER ..'? ,- I ' , -- :, ,' ' , _13- TENANT -, - '• • I 1
: Other: _
\ tune Dp..- 1__t ,, Environmental exhaust and xentilation
f— Range hood/other kitchen ;
L Address' q s rfif - .4-e,i,d-uure,, (_j equipment 10 09 i
—,
Citx.'State-ZIP' - TA c?j. CC C 13 u Clothes dryer exhaust 10.00 --
Single-duct exhaust (bathrooms
I ('hone: ( St:)5) ( I .. -)sa • n 6 Fax: ( ) toilet compartments. utility rooms) 6 80
0 APPLICANT - . . - .: . , ,- '-'C3 •,CONTACT PERSON. Attic/crEmIspace fans 10 00 —1
Other 10 00
Business name.
F piping
I
Contact name: 55.40 for first four: 51.00 for each additional
Furnace. etc
Address •
Gas heat pump 1 _
Sit■iState;ZIP Wall/suspended/unit heater
I -..
Phone ( ) Fax: : ( ) Water heater 1 j
Fireplace j
E-mail:
Range L L Lie, I
'- >: - Y 1.:-1 4:400.*:7:0gONVATZ : AV : 244, -- .; :' " : : Barbecue
Clothes dryer (gas) 1
Business name: Sunset Heating and Cooling
Other.
Address: PO Box 42289
' kfea k' " Ii i -. .: 1 40.
Cit)/StateIZIP: Portland, OR 97242 Subtotal
- 7;21
Phone: (503) 234-0611 Fax: (503) 234-0439 Minimum permit fee ($72.50) .cl,"
Plan review (25% of permit fee)
CCB lic.: ...roil :.. State surcharge (8% of pennit fee) E.; 4 ce - 1)
I /7 .. TOTAL PERMIT FEE 7$ .3E)
Authorized signature: <..(\/.\ t (./---" This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Date: 4--ii,- • Fee methodology set by Tn-County Building Industry Service Board
i•UluildinglPenniiAMEC doc 12/03 410-4617T i I 1/02/COM/WEB)
. . . _. . . „.