Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00469
p1 I I° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/3/2006
PARCEL: 1S135BD-01200
SITE ADDRESS: D9800"SW SHADY LN ZONING: C -G
SUBDIVISION: 970,-- LOT: JURISDICTION: TIG
Project Description: Replace gas pack in same location. Value: $3390
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 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: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
FORBES, DONALD CAROLYN Description Date Amount
BURDICK, DONALD LINDA
434 RIDGEWAY RD [MECH] Permit Fee 10/3/200€ $118.50
LAKE OSWEGO, OR 97034 [TAX] 8% State Surcha 10/3/200€ $9.48
Phone: Total $127.98
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503- 692 -1565
Reg #: LIC 5193
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: � „` / _ Permittee Signature: 1 �/
Call 503 - 639 -4175 by 7:00 a.m. for inspections tha • i : • - y.
This permit card shall be kept in a conspicuous place on the job sit: until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. _
Mechanical Permit Application -,'', /77 D I:012 OFFICE US!: ONLY
Ci0 of Tigard PI L - \\-- J ' - u -- ' R I 00 • . . till e Permit N°- • • /
000( 13125 SW Hall Blvd, Tigard, OR 97223 OrT 0 3 2006A Plan R Dete/By. eview
Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 • . II(
41. -. I Date/By:
Inspection Line: 503.639.4175
. C : OF T I C A ,!„. ...... Date Ready/Sy: El See Page 2 ter
Internet www.ci.figard.or.us
BUiLDIN3 CIVIS1 si Notified/Method. WA Supplemental Information
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E] New constructicm Addition/alteration/replacement perf Mec onn hani et cal in permit dicau f th ees e e value are bas on val the u n e earest ofthe do w il ork ao of all
El Demolition A Other . mechanical materials, equipment, labor (warhead_ and profit
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El I- and 2-family dwelling yj CommerciaVmdustrial 0 Accessory building
• For special Information use checklist.
0 Multi 0 Master builder 0 Other
Descripticrn I Qtyn Ea. I Total
P Heating/cooling
•
Air conditioning or heat pump
Job site address: . 8L.) 2_ - <LA/ 1D? L■4111 (requires site plan showing placement) 14.00
City/State/ZIP: 976..,A Az , c; ( i ? 2-2- 3 Furnace 100,000 Bill (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: 1 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
hydronic) 14.00
Unit heaters (fuel-t)pe, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other 10.00
Tax map/parcel no.:
Other fuel appliances
ITS 74r if.. , 4 1 i j 0§:Ni.14' 1' '' --'7 4 'II 1. i47-- - ::::i'707.,,,. - 7::" . - .5 Water heater 10.00
Gas fireplace 10.00
AouLl__=. Re--piOv- a.)6,-As PA c..ict Flue vent for water heater or gas
/ fireplace 10.00
i -6 P L-AS
Log lighter (gas) 10.00
e ..... Ii/' (- 4- ocA r i emi Wood/pellet stove 10.00
Wood fireplace/insert 10.00
- M
Chimney/liner/flue/vent 10.00
t ''. ..- other. 10.00
Name: 5 wzo f ck / /Y -1- Al i/g Environmental exhaust and ventilation
Range hood/other kitchen
Address: 4. (.../ At t ot. LI R 0
equipment 10.00
City/State/ZIP: t,.. 4 , / ,, e 05- 1....)e - e019 , . Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( s-O3 ) .z.„ 1.6 - 2.../ a3 Fax: ( ) toilet compartments, utility rooms) 6.80
EN t 4n 1 Attickravilspace fans 10.00
Business name: A
Other. 10.00
4,2,01,-„, m&f.6...$4-aAficove._
Fuel piping
Contact name: 32-/-e ge....4...4"2... $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: /03 3 cp StA) 7riN__4r-/N7 e° Gas heat pump
City/State/ZIP: -77;4 v or< 93.06, 2, g Wall/suspended/unit heater
/
/56:4' I Fax: : ( T5 O4 , / --- 7- 9 Water heater
Fireplace
E-mail:
Range
Mlle Zgr 1 k 17 1 1 r1 Barb ecil e
Clothes dryer (gas)
Business name: Clothes
Other
Address j
:
&--.. _ 4 A E
City/State/ZIP: ,-.27-0 ' - Subtotal / 7 . 0
, ,
• , Minimum permit fee ($72.50)
Phone: ( ) Fax ( )
Plan review (25% of permit fee)
CCB lie.: 7 4 3 2 State surcharge (8% of permit fee) . q
TOTAL PERMIT FEE /A 7, Se
Authorized signature: • rids permit appUadleo ezpires Ira permit Is not obtained within 180
days alter it has beea accepted as complete.
......
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