Permit (16) a
4 CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00577
TIGARD DATE ISSUED: 10/4/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110DD - 06600
SITE ADDRESS: 10650 SW SUMMERFIELD DR ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.4 LOT: F JURISDICTION: TIG
PROJECT: SUMMERFIELD CIVIC ASSOCIATION
Project Description: Clubhouse - replace rooftop a /c, same size, same location. Project Value: $6,475
•
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM 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
SUMMERFIELD CIVIC ASSOCIATION Description Date Amount
10650 SW SUMMERFIELD DR
TIGARD, OR 97224 [MECH] Permit Fee 10/4/2007 $168.50
[TAX] 8% State Surchar€ 10/4/2007 $13.48
Phone:
Total $181.98
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 230397
TIGARDRD, , OR 8 97281
REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 624 -2704 .
FAX 503 -598 -0270
Reg #: LIC 76359
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 OU NC by
calling 503.24 • 1800.332.2344.
Issue olot i t 4 / Permi ttee Signatu ;.,� , ��f /
Call 503.639.4175 by 7:00 a.m for inspections at • siness day.
This permit card shall be kept in a conspicuous place on the job s' e until completion of the project.
Approved plans are required on the job site at the time of each inspection.
V I lir
Mechanical Permit A I iii 0. +; 1 OK Ul I It 1 E IVEi Received / PettnbNo.: -�� r
13125 SW Ha Blvd., Tigard, OR 97T 3 ZOU l to ° y
R Phone: 503.639.4171 Fax: 503.598. Da,r/Ey; Other Pemilc
l I i n R U
Inspection Line 503.639.4175 CITY OF TIGARD Date Ready/Hy: )ar; • 1 2 See Page 2 for
Internet: www.tigard- or.gov BUQDINGDIVISION Notified/Method: «J Supplementallnrorn,nuun
1 ° • :1i i
_ .. _ ....TYPE OF WORK' i - •�:•; .i. , ..- �:� •-' ' ,� , I11MEItQAI; FEE•..SCHEDULE - USE CHECKLIST
❑ New construction El Addition /alteration/replacement M4;21114:31 permit lac are based on the value of the work
p .rated. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: m . henleal materials, equipment, labor, overhead, and profit ,
. CATEGORY O F C O N S E R U C 1 P I O N .. Value: $ / , ' 7 -
.'RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
El Multi- family ❑ Master builder El Other: '
De eription Qty. En Total
_ . JOB SITE 1IlVFORMA7ION AND LOCATION II - tinR/cooling
!�, e • conditioning or heat pump
Job site address:
/G , ) r �,t� Jr.��61. Gif F ..,O ,D,/t (. uires rue plan showing placement) / 14.00
City/State/ZIP: F . : • 100,000 BTU (ductv/vents) 14.00
//�� d l . • .. 100,000+ BTU (ducla/vente) 17.90
Suite/bldgJapt. BO.: , Project narne: . t�.NNfP I( s L� l.:l t.ic_ ei.55N,
G G. heat pimp 14.00
Cross street/directions to job site: I n a work , 14.00
I H • tunic hot water system 14.00
I R- idential boiler (radiator or
•nic) 14.00
Urat heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00 .
Subdivision: i Lot no.: I t Flu/vent for any of above
10.00 i
er • 10.00
Tax map /parcel no.: Oher fuel appliances
DESCRIPTION OF WORK ;...:;:.:...:-...;;;;...:17 War heater 10.00
Gas fireplace 10.00
/J � ' /4 e. /J1' � G / 4• vent for water heater or gas
�` / / dace • 10.00
�r?N 51 2r / ,�/d�vU /�_ <,� I.cglighter(gas) 10.00
W jod/pel let stove 10.00
*661--4- (�,) j _ U dG C i * W nod C',t fiteplacc/insen , 10.00
r0" .imney/Iiner /tluclvent 10.00
CI PROPERTY OWNER • I ❑ .E NAN . Other: 10.00
Name: Faiviroamental exhaust and ventilation
Address: Range hood/other kitchen
oc l patent 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) to let compartments, utility rooms) , 6.80
Q APPLICANT- 0' CONTACT PERSON : , ? '=; • Attic/crawtspacc fans 10.00
Oher: I 10.00
Business name:
I Feel piping
Contact name- R9 /71 E'/-r' /1" y SS.40 for first four; SI.00 for each additional
Address: Furnace, etc
G is heat pump
City/StateIZIP: a all/suspended/unit heater ■
Phone: ( 3 /,7 )..I./ — 3 :7 0 ft J Fax: 3 s G C - 6 p.. d VIt atm heater ,
Fireplace
E -mail: Range
CONTRACTOR I • . - B abeam
Business name I i /) l C othes dryer (gas)
J!1 /)'� c 1 ept ;7 !n • ��t� t Other:
Address: b 3 0 j MECHANICAL PERMIT FEES*
City /State/ZIP: J U12.. 9 7?-1 / Subtotal
!� / ...-,„1-7 1 1 F� ��, M¢lirtlm permit fee ($72.50) /4p t ✓v
Phone:
V b3 d '� ] 1`J ), 5 7j - 0 2 7 b Plan review (25% of permit fee) "tom`
CCB lie.: State surcharge (8% of permit fee) /' ,eig
TOTAL PERMIT FEE f $ i • et $ I
Authorized signature: b permit application expires if a permit is not obtained within 180
gn days after it has been accepted as complete.
[Print name: ,i9 4g/12/ I Date: /n /y /b 7 Fee methodology set by 'Gi- County Building Industry Service Board
o,o..a.,._�o..— .:MAtr • .v.....: A.,.. Mn M1dMAIM � 440-461Tr(11102XAM/WEa)
Z OLZO 969 ONILV3H viewll0O 0 91:11 LO CO 100
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007.00577
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2007
Phone: (503) 639 - 4171.E h1
Inspection Requests (24 Hrs.): (503) 639 -4175 ! �-� `'� �!
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AM PAGE: 71
SITE ADDRESS: 90650 SW SUMMERFIELD DR CLASS OF WORK: '
SUBDIVISION: SUMMERFIELD NO.4 LOT #: F TYPE OF USE:
PROJECT NAME: SUMMERFIELD CIVIC ASSOCIATION
DESCRIPTION: Clubhouse - replace rooftop a/c, same size, same location. Project Value: $6,475
OWNER: SUMMERFIELD CIVIC ASSOCIATION, PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 Mechanical final 059350 -01 503 624 -2704 0._,-
Corrections /Comments /Instructions:
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I
Si 'ASS % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FA L / 'ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 / Inspector: L — '� 11/1/0 Date: Phone #: (503) 718- ‘
1.