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15545 SW OAKTREE LN
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CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2005-00383
93128 SW Hall Blvd.,Tigard,OR 97223 503-639-4171 DATE ISSUED: 6/23/2005
PARPEL: 2S 111 DB-09600
SITE ADDRESS: 15545 SW OAKTREE LN ZONING: R-7
SUBDIVISION: SUMMERFIELD NO.10 LOT: 584 JURISDICTION: TIG
Project Description: Installation of A/C unit,
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCU�'ANCY GRP: R3 VENTS W!O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES 0 - ,1 HP: 1 DOMES.INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: L i U 15-30 HP:
FIRE DAMPERS?: 30-50 HP: REPAIR UNITS:
GAS PRESSURE: 50+ HP:
WOODSTOVES:
FURN-e100K BTU: AIR HANDLINCi ; CLO DRYERS:NITS OTHER UNITS:
FURN>=100K BTU: <=10000 r,fm:
> •0000 cfm: GAS OUTLETS:
Owner: FEES
THRAGF:cR,DARREL Description Date Amount
15545 SW OAKTREE LN _
TIGARD,OR 9723 [MEC11]Permit Fee. 6/23/200° $72.50
[TAX]8%State Surcha 6/23/200 $5.00
Phone: 503-620-5571 Total $78.30 I
Contractor:
D 4 R HEATING 4 AIR GOND
PO BOX 1292
CANBY,OR 97013 REQUIRED ITEMS AND REPORTS
Phone: 503.266-1229
Reg#: LIC 84489
a
oe:
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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
m Issuance,or if work is suspended for more man 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
0ilily Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these
w ru"or direct questions to OUNC by calling 503-246-8899 or 1-800-332-2344.
�
� ---
Issued By: , i ermlttee Signature: C.
Call 503-6394175 by 7:00 a.m.i*ir inspectlon4 It buslnlr day.
This permit card shpil no kept In a conspicuous place on the jub sits until completion of the project.
Approved plans are required on tho job alto at the Hr.*of each Inspection.
Mechanical Permit Amplieation Received Mechanical Mechanical
wte/By: �i41 L)S J 1ti Permit No.:�� J a J 0
�Iti of Tigard Plannine Approval Building
Y DaWB : Permit No.:
13125 SW Hall Blvd. -Plan Review Other
Tigard,Oregon 97223 Date/B : Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Ito-.few [And Use
DaluB : Cue No.:
Internet: www.ci.tig,.rd.or.us contact lureff See Page 2 fir
24-hour Inspection Request: 503-6394175 Name/Method: _ _ Supplernental Information.
TYPE OF WORIC COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
RAddition/altcmtion/re
ew construction Demolition Mechanical permit fees"are based on the total value of the work
lacement F1 Other: performed. Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
1 d.2-Family dwel:lng F1 Commercial/Industrial value: s _ See Pape'for Fee Schedule
Accessory Building 0 Multi-Family RESIDENTIAL E UIPNIENT/SYr 5 FEE*SCODL)LE
---— - Deacrlptlon Fee ea. Total
Master Builder Other: _ Heaaaa/Coolin
1,1MA SITE INFORMATION and LC TION Furnace-add-on air conditioning•• 14.00
Job site-ddress: 1,56%Af5 �5can heat pump _ 14.00
Suite#: Bidg./Apt.#: Duct work 14.00 _
Project Name: - - -- H rr tic hot water system 14.00
R.er:
Cross street/Directions to job site: denboiler
tal
f�;radiator or hydronic system) 14.00
Unit heaters(fuel,not electric)
in wall in-duct suspended,etc. 14.00
Fluelvent for any of above) 10.00
--"
Subdivision - Lot#: T Repair units Other Fael� llaam 12.15
Tax map/parcel#: �;� Water heater_ 10.00
DESCRIPTION l.Ia'-,V0RK _ _.. Gas fireplace 10.0C
Flue vent water heater/gas fireplace) 10.0f
�� -- -----— - Log lighter(gas) __ 10.0)
- - -- Wood/Pellet stove 10.06
Wood fireplace/insert 10.00
_ Chimne /liner/flue/vent 10.00
ROPERTYOWNER ��[JTENANT_ _ _ -- Other: _ 1Mon
Name: (vim Environmental Esdaust A Ventudoe
Range hood/other kitchen equipment
Address: — --,
- Clothes dryer exhaust 10.00
Clt /State/Zi i 74 Single duct exhaust
PhoneiGd(D- Fax: (bathrooms,toilet compartments,
PLICAlV CIUNTACT PERSON utilityrooms 6.80
Name. _� _ Attic/crawl space fans 10.00
Other: 10.00
Address: x� el."Hx_
City/State/Zip: ; "(115.40 for first 4,$1.00 each addition.
q, Furnace etc. ••
Phone: Fax: Gas heat pump _ *�
CO) E-mail: _ , " Wall/suspended/unit heater *•
CONIRACTO� Water heater ••
Business Name: — Fireplace ••
Ad4ress: / RangeBBQ
'•
Ur Ci /Staiw/2ip• Clothes dryer as ••
PV, Fax: ? — ''1 Other: •:
CrB Lica # 5e<8`� _ Total:
Authori /"r,'® _ Meehan eal.•rm!t epees*
Si i*T_�►-�' nate: Subtotal:TS
Minimum Permit Fee$72.50 $
Plan Review Fee(25%of?EM t Fee $
(Please print name) Stat►Surchpr 8%of Pmnit Fee $ _
TOTAL PERNrr REE S
Notice: This permit application expires if■permit Is not obts:ned within "ree methodology set by Tri-County llullding'ndustry Service^ mrd.
Igo days after It has been accepted as complete. "Site plan requirrd for exterior AK'volts.
is\Dsts\Permit Fomu',MecPermitApp.doc 01/03
Mechanical Permit Applicatior. -City of Tigard
Page 2 -Supplemental Information
Com-aercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52
for each additional$100.00 or fraction
thereof,to and including$10000.00.
$10,001.00 to$25,000.00 5148.50 for the first$10,000.00 and
SI.S4 for each add itiprtal$100.00 or �—
fraction thereof,to and including
$' )0.00.
$25,001.00 tr$50,1700.00 S .50 for the first$25,000.00 and
S..45 for each additional 5100.00 or
action thereof,to ani including
l (100.00.
$50,001.00 and up S7 00 for the first S50,000.00 and
51.20 each additional$100.00 or
(Faction of.
Assumed Valuations Per Appliance:
Va otal
Description: QtyElt Amount
Furnace to 100,000 BTU,including 955
ducts&vents
Furnace>100,000 BTU including ducts 1,17
&vents
Floor 965.
Suspended heater,wall heater or floor55
mounted heater
Vent not included in liame peffnit 445
it units _ 805
<3 hp;absorb.unit, 955
to 100k BTU _
3.15 hp;absorb.unit, 1,700
101k to 500k BTU _
15-30 hp;absorb.unit,501k to 1 mil. 2,.710
BTU _
30-s0 hp;absorb.unit, 3,400
1-1,75 mil.BTU
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU
Air handling uni:to 10,000 On 636
Air handling unit,I O 0,_00 Sft
Non-portable evaporate: ole,
Vent fan connected to a single duct
Vent system not included in appliance 656
,mit _
Hood served by mechanical exhaust 636
Domestic incinerator 1.170
Commercial or industrial incinerator 4,390
IL Other unit,including wood stoves, 656
a inserts,etc.
N Uss piping 1-4 outlets 360
Each additional outlet _ 63
�j TOTAL COMMERCIAL s
VALUATION:
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i:\DsisWermit Forms\MecPermitAppPg2.doc 01/03
H EATING &AIR PO.Box 129 T•Canby,OR 97013
(i0 )678-2517 Fax(S03)678-2097CONDITI®NTNG
www.drheatinb.ro n
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CITY OF TI^AR® r ELECTRICALPERMI'�
�J V PERMIT 0: ELC2005-00487
DEVELOPMENT SERVICES DATE ISSUED: 7/8/2005
13125 SW Hall Blud.,Tigard,OR 97223 503-639-4171 PARCEL: 2S111D13-09600
SITE AV:D^ESS: 15545 SW OAKTREE LN ZONING: R-7
SUBDIVISION: SUMMERFIELD NO.10 LOT: 584 JURISDICTION: TIG
Project Description: (2)branch circuits,A/C unit,!work plug.
RESIDENTIAL UNIT TEMP SRVCIFEE'IDERS MISCELLANEOUS
1000 8F OR LE S: i -- - --200 amp: -� —PO'MPI- RTATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401- 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FnR: 601+amps-1000 volts: MINOR LABEL (10):
SERVICE/FEF+DER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amu: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FOR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >iw4 RES UNITS: >600 VOLT NOMINAL:
Riccnnect only: SVC/FDR—2:.5 AMPS: CLASS AREA/SPEC OCC: J
Owner: Contractor:
THRASHER,DARREL CA'iBY ELECTRIC INC
15545 SW OAKTREE LN 790 S IVY
TIGARD,OR 9722 CANBY,OR 97013
Phone: 503-620-5571 Phone: 503-266-7878
FEES Reg!t: LIC 16071
Dsscriptlor Date Amount SUP 1
_ ELE 3-1 I12C
I�LPRMT] ELC Permit 7/8/2005 $53.50
['T'AX]8%State Surcharge 7/8/2005 $4.28 REQUIRED ITEMS %ND REPORTS
Total $57.78
Tnis Permit is issued subject tj the regulations contained in the Tigard Municipal Code,State of OR.Soocialty Codes 2nd all other applicable laws. All
work will be dr 1 accordance with approved plans. This permit will expire if work is not started wi!hin 180 days of issuance,or if work is suspended
for more than 181 ays. ATTENTION: Oregon law requires you to follow ries adopted by the Oregon 01111ty;lotification Cen'ar. Those rules are set
forth In OAR 952-001-0010 through OAR 952-001-0100. You may obtain wples of these rules or direct questions to OUNC at 503-246-6699 or
1-800-332-2344.
Issued By: l�t r1 Permittee Signature: %
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease,or rent.
OWNER'S SIGNATURE.: DATE:
L CONTRACTOR INSTALLATION ONLY
W
J I SIGNATURE OF SUPR. ELEC'N,: DATE:
LICENSE NO-
Call 5034394175 by 7:00 a n::for an Inspection that business day.
This permit card shall be kept In a conspicuous place on the Job alts until completion of the project.
App-oved plans are iequired on the job site at the 11.as of each Inspection.
e ' FROM : CANHY ELECTRIC iNC PHONE NO. 5032665543 Jul. 07 2005 06:03AM P2
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Fagetrical erttlit
City of Third
'l' /aY
Cj� �0
1)123!W HNI DIvA., : 9721) pi'- L.dJ.L.��� --• 1w+aitN.'ti/ r-� +f s��� I
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Phens: $03.639.41;1 P 1 SOA 1460�� `?PC\0C� o�„' " Otlu►ru�w�. '
bte0eeOw Lute 509.639.4 7,t �� �\ -ate— _
Can vn+ny:
I` ate t M
LIl1m, .t 1m.o'us
/. Supplan,earl Ufermatlen
; fi r,Ot:- 'r' ;. :r 71 ir.7
Naw conttrurrior. A dihon/a)terotion/rcplacement Plesse check ap that apply:
Mmoliaoll Uthet: QServiee ov9r 125 ampt,co:lltr'i ❑Mt2ardoue locstloo
A y C]Nawice ova 320 amps-rating ❑Buildne over 10,000 sq,f1,
Of 1-and 2-farNty dWellinp 4 or mot•naw residendsl
IQ
I-end 2-fatrul) dwe!ling M Couunereial/industrial Memory bV tom{ []System ove-600 volts novmfnel units in v„e strumm
MYIA httiil( (jBuildinS overt three stories (]Feeders,40C amps or more� ❑Master builder Other.
y 00coupaqw,load over 99 persons ❑Manuraanlred immures or
❑BQresy1ltihlin`plsr Rv pdrk
Job no Job:Ise Iddress, S W /J� ON t ❑Hedth.0-Sm fee liry ❑ocher;
Ci /$ /TZp Submit L sett ofplana with any of the aoovs,
tl/ j 1 O 'r lite above are not applicable to unwarary eor-truoden service.
5uitc/bld3./apt.no. 'reject name: 1111,11mi
`a ►ore. I Total .•.. ••
CtOte mtwdirety ions!o job site; , Now rullim” w�.or mul mlly dweilliq unit.
'`— — --=-�-•----+ Iacluda attaabsd res a.
1sq.ft.orless Willi 4
Subdivifioa: no.:
� Y EL edd'1500 .fl.ter pardon )9Mt: 1
---�1- t
Ta7t el no.. Let OW ettu ,r_"Weadal 15r00 :2
I.ttnited oncro,non-tasidential 75.00 3
menu two or rrtedulu
_ 4- WON- dere oa er
swvtm or reside"Installadsnattaraptra) cath r4locatioe
100 ttsnpG a less 00.30 2
101 m to 400 aMts 104.135
401 amps to 400 attiits 1 d0.tf0 1
Name: 405 to l.000 s 140.110 1.
Addroa: t�wr I tntyl a valla 434.65 _
1,t0eatutetot Ott bftili5 2
City/Srate/'6Ip: TwWrary services or readers hen lation,q1temdas,aM et
Pbone:(,i►i) 1(,�.n j 7 / Fax:( ) 2lo�mPG a pew i e6•ts. ±, 2 Owhar twtaJion 77- ,Snu,—mwon ie being made on jx'otruty tut Own WhIeb IS not lot tom 100.30:inwood flu"I*,lease,rant,or elich=p,nceording to ORS 447,444,670,tod 70., 40attt�+a_eo doo 1 133.75
oww firmhm _ Vats: Ensaah dreul4-TpeM�nleer�tloh,or attmaie Yr
A,Fee fbT brunch atrmb"4th
w44ea or Roder fie,each r 6.65
Batitt>tea Male: nnoh t _
- - ••••• �ee ft ►rtnab cirm�
C wt tssme: wtrheut aarvfae oc tbeder ire, 46.ti3 y(j !
Add scalp aiteult r
6%6 WWI btynch circuit
IL c tty/StatdZIP IMeaallobeeus earriee or finder not Indud
N Phone: Naat WOOD Vh)S
or Outline ashft 53.00 ( $
Slsrtal routt(s)or United.
entre panel,atwmdoN or
(� 811 ttattte: extenaton.Describe: Fye 2 .q
, �; --� Q �• r S leach addltbra!trspeadsn over maaeble iN**.Off re creel
Per ecdon sp
-� Statd?t� Cl-1
1 Invatirman M hour(t tr ndt>) 62. 0
' raene:(;03) 'Z.lo ir+ Q-1 ' Fhx:(S�) Z bstlutalQ lute hour 7s.
CM Lic,:Z b p 1 131ectrleal Lia: '3•-111 L. 9**-U--:
subtotal
Sttprv.EltOlrieia0 signature,required: -- plan review(23%of lee)
Frittsn &941 t✓nl s n,..l Dae Mate sursltetllt(1>f of ptesrrtit pre) A
.• -
AttfSerised a e: h T47AY.lERMIT f)eE
T =V ,,..^ TbG t appiteaNee as tr a t b sot n b.e Wtbra t
Gaya atter to liar been saAaptaa at 40",to
Dtptt n>tlne: ��, Dab: Pa ewtbe4etoer sanity Tri-comm Dwmws t"Ustry ,etvlor heard
"N'utrAer or h►spcetions pw mwwt allowed,
CITY OF TIGARD
BUILDING DWISION PERMIT#: MEC200&00383
13125 SW Hall Blvd., Tigard, OP 97223 DATE ISSUED: 6/23/2005
Phony: (503) 639-4171
Inspection Requests (24 Firs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/13005 TIME: 7:10AM PAGE: 613
SITE ADDRESS: 15545 SW OAKTREE LN CLASS OF WORK:
SUBDIVISION: SUMMER FIELD NO.10 LOT #: f�1A TYPE OF USE:
PROJECT NAME: THRASHER
DESCRIPTION: Installation d A/C unit.
OWNER: IHRA%fl , DARREL. PHONE #: 503.620.5571
CONTRACTOR: D +R HEATING +AIR COND PHONE #: 50:'x-266-1238
Inspection Request Scheduled For: Date: 7/13/2005 Pou,Time-
.
Code # Inspection Description Co # Contact # Message
699 Mechanical sinal t Oi 603-678-2617 N
Corrections/Comments/Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL �] NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�`� 7I Inspector. Date: ,__ Phone #: (503) 718-
C1TYlOF TIGIQ►RD � R _
SUiLDING DIVISION PERMIT#: ELC200! 00487
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 7/00005
one: (503) 63+-4171
Inspe.:Jon Requests (24 Hrs.): (503) 639-4175
INPPECTION WORKSHEET FOR DATE: 1112/2005 TIME: TOGAM ?AGE: 5
SA`ri 1:
SITE ADDRESS: 15545 SW OAKTREE LN CLASS OF WORK:
SUBDIVISION: SUMMU01ELD N(')-10 L(T#: 584 TYPE:0F USE:
PROJECT NAME: THRASHER
DESCRIPTION: (2)branch circuits, A/C vinyl work plug.
OWNER: THRASHER, DARREL, PHONE A: 503.620.5571
CONTRACTOR- CANBY ELECTRIC INC PHONE#: X503.266.7878
Inspection Request Scheduled For: Date: 7/17/2005 POW Time:
Code # e Inspection Description Confirm # Contact # Message
P P 9
145 A/ ' or heating unit :ircud 01124101 503266.7070 y
Corrections/Comments/Instructions:
i
i'
I
PASS [] PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
❑ -All_ E] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
In pector: _ '" _ ,__ Date: J _. Phone #: (503) 118- Z-� _