Permit C ITY OF TIGARD MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00476
Atil c 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/4/2005
PARCEL: 2S111 AD -13700
SITE ADDRESS: 15073 SW 91ST AVE ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT: 003 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:
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
HUBBELL, KIMBERLY A Description Date Amount
15073 SW 91ST AVE
TIGARD, OR 97224 [MECH] Permit Fee 8/4/2005 $72.50
[TAX] 8% State Surcha 8/4/2005 $5.80
Total $78.30
• Phone: 503- 968 -2661
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
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Phone: 503- 624 -2704
Reg #: LIC 76359
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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
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: 116` ,��2,5C Permittee Signature: ._
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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.. Mechanical Permit _4
QllinD FOR OFFICE USE ONLY '
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City of Tigard .
Da _ 4 -,/ I 1.4...... Permit No . ie . , 57(
13125 SW Hal; 3Ivd., Tigard, OR 97223,;
Plan Review
.:.. Phone: 503.639.4171 Fax: 503.598.I980 2 200 44°45 • '4)• 4 Other Permit:.
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Date/8y.
InspectIon Lire: 503.639.4175
....i ..4:4414/ i
Date Rea dy.rB y: ;•iz Ea Sc ".` P2ge
.- Internet ww us
CITY OF TIGARD Notified:Meihoc: 11(r Supp:eutal I istortuaLon
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HECis-
Mechanical pe7mit fees. are base on th •,, ILI e a 1 the :ivork
New construction VAdditionialterationfreptacement
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performed_ [ndica:e :he value rjounded to ire neares: do or: d!
0 Demolition 0 Other:
mechaMcal rnaterials, equipment, labor, overhead, ar ::. *Jr'? :
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'•''1.- VillifigaitgOO ''! 4 ., '- , . . : 4... . ,..• ... • • V • 3 I" : 3 • . -
Co / SYSTF.NIS 7b •
f and 2 dwelling E Commorcia]iindus:rill E Accessory nuilclir.g
r special :::formalio.
E Multt E Master builder 0 Other:
Description . Qt -:a - cta
;!4.:. He "'" c c° 11 rg
Job si te address: A5 93 ,5 0-) fr 5, Air conditioning or heat pump
(requi:es sitr. plan showing placemen( i
Clry/State/ZEP
Furnace I OC,000 BTU (uetsfeots I 1 4.0..::
Furnace I OC,000- STU iductsi,:elits; 17 ,-....:. .
. I Suilefaildg./apt. no.: • Project name:
Gas heat pump 1 4 up:: •
. ; Cross sae-et/directions to job site: I
Duct work 14 00
Hyd7oMc hot water sys:ern : 1.4 OC.
Residential boiler ;radiator or
hydrcnic) 1-i iX:
Unit heaters (fuel-ype, not electric),
in-wall, in-duct, suspended, etc 10 Al
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1 Flueivent for any of above 1000
Subdivision:
.
Lel no.:
1 .. ...:u ,
. Other: iu
Tax map/parcel no
Other fuel appliances
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'1,t,1•••''''ialejiTttIV:0,.W.„„M#11,7f6riit91gPVtaAjett4:?,3:--..L,g--Wl..ti,lat.i).'7',i',Yl?,:.:#!.. eater 1 0:2 ''
tr - 'K'zt •-+ r 4 .4 ...,.• •..\.'r,t',,,s4.4.A 4...,,11 . We.',;:,:s74/7,3?",..Z.,`4,;;J:;'1'.;;;;+•••1;1SVei, W h
ater _
- - 1 Gas fireplace
7 •' ...-1
Flue vent for water hearer or gas
. 1
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fireplace 1 ,-... i)c....
I
.1 •
Log lighter (gas) ;o 0
Woad/pellet stove • 10 0C2
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Wood fireplace/insert :
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1
g
;• :if.:*Olit Chirtnney/lihe Nflueiveni
•) ; : tt . iialann,Eh l j,T1E41 .4:.....i'`,'74i1V2
Name:
4 • 10 5 1 A11117AK....... _.4. - . Environmental exhaust and Velltill1(10 :I
Range hood/other 'Kitchen
Address: Z 73 ,5"6„) '''- equipment • 0
City/State/ZIP:
Clothes dryer exhaust
i Single-duct exhaust (bathrooms, . 1
t Phone .e3) 9Z42t‘ Fax: ( i
, 1 toilet compartments, n.it rooms ---- ) 1 •.::,,.:.
rgariptien itt.iiir :•,..,.....ii„..., rtgat ; AL:it:I:raw:space fans I I C.01i I
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- i i Otner: 1 I C.OU .
.: Business name:
Fuel piping
Contact name: / 6 i 1
55.40 for first four; 51.00 for each atd.oio lal
P etc.
•, Address:
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Gas Ilea: pump
i Cc.
Wall;suspenOediunit heater
: Water heaer !
P h°11e ) iv; q )7( Fax: : (j-• ) _.'.( ‘2 ; ‘ ) /7
ra
ce
E-mail:
Range
vi: ::' -'...- s 77 14k ti ITS14 f7...t.,14.F.0i"r4V9'lf...7F64:• Barb
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C: i .. o t 'c. .e 5 dryer (gas) i
Business name: 4 ./. h fet_. : /1-C - r7,,,t / /1,C.• _.
Ochcr I I --
Address: 3b 3 ..P.,-+i'4I:K. titi'!`71100t•MiC4•01dffj--'
City/S tate/ZEP:
Subtotal I
7 / (... ...9—,47—t? :7_• 9 7-"-71 .
Minimum 7:ermit fee tS 50;
Phone: k ) c c 2 4e- ,... .2.7 0 . . 4 / Fax:- ) , s e 6 c z 7 6
I Plan review (25% ci.f• perTT11: - :•.:c . :
C_'CB Ito.: 9' State Surcharge (g% of perr.1 : fee,.
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' TOT,AuL I' ERNLIT FEE '
Authorized sig-nature. .(f...; c2-4--16-4-/ This permit applicztion e.spt%s .: .1 pertain iS :10[ (.01.:111,.; •■.. !1;1'. 15
days alter ii has ',wen acctptecl 3S CO:11;11! I:
• I Fr:nt'narne: )‘,4 2 /r I ‹./,4 -''
/j/ 1 Dale: 2 - . Fe metnodOlogy set by — 0-Czu:1:y Build:11 I [:-..b.,str:. .Se . .:3...•:',1
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z'd OLZ086909 6u!)eeH eqwnioo d60:Z0 GO 30 6nV
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
ADDRESS: ,5 73 L 5c 457'
9'd OLZ096SCOS 6uigeeH eigwn1o3 d60:30 SO ZO 6nV
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CITY OF TIGARD
BUILDING'DIVISION PERMIT #: MEC200G -00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2005
Phone: (503) 639 -4171 41 H�ji1�����1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/10/2005 TIME: 7 :05AM PAGE: 89
SITE ADDRESS: 15073 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 003 TYPE OF USE:
PROJECT NAME: HUBBELL
DESCRIPTION: Installation of A/C unit.
OWNER: HUBBELL, KIMBERLY A, PHONE #: 503.950 -2651
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503- 624 -2704
Inspection Request Scheduled For: Date: 8/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013213 -01 503.624 -2704 N
Corrections /Comments/ Instructions:
wt- t N46 x. 104) 3 c41-14-
fit 40,.i U%z4 !1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\ Inspector: Date: "� �� Phone #: (503) 718 -