Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00371
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/20/2007
PARCEL: 2S 103AD -03600
SITE ADDRESS: 13065 SW 107TH CT ZONING: R -4.5
SUBDIVISION: PATHFINDER LOT: 026 JURISDICTION: TIG
PROJECT: TUCKER
Project Description: Install 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:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KELLY TUCKER Description Date Amount
13065 SW 107TH CT
TIGARD, OR 97223 [MECH] Permit Fee 6/20/2007 $72.50
[TAX] 8% State Surcha 6/20/2007 $5.80
Total $78.30
Phone: 503- 620 -1311
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued n ,: j / /// / /� ri Permittee Signature: rc2p f ��" /07 1
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.
Mech i cai'Pernlit A rc>,,it o,'ru'I: USE c>,4t:1
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City of Tigard NOISMIi] ONI ®71118 / ® Permit No.: 0-0'" _,
f • 13125 SW Hall Blvd., Tigard, OR 97 I,i A04110 Plan Rene
Phone: 503.639.4171 Fax: 503.598. % 91„6 Date/By: Date/By: Other Permit;
•fI<:A (()JIG 0 It1) Inspection 503.639.4175 [[
a Nnr DatoReady/By; 1 �'• El SeePx Page �p�y ,
Internet: www.tigard -or.gov NndfiodrMghod: I Supplemental Information
I: ;..,. t ... :. .N {; !'C. 4 . , t •t ; {� , a. 1 ]P. (�LEP ■a C11. C IC
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' Mechanical permit fees' are based on the value worx
❑ New construction - Z Additionfa1teration )replacement
❑ Demolition ❑Other: performed, Indicate the value (rounded to the nearest crest dollar) of all
mechanical materials, equipment, labor, overhead, end profit. j
GATEO1tY,OI+"GQH`�'�t31J,1Q r., a r Value: $
1 -and 2- family dwelling ❑ Commercial/industrial S�ENTIAI Q.JII"!•,iNT/ SYSTEMS FEES'
❑ Accessory building
❑ Multi famil ' For speclal information use checklist.
y ❑ Master builder ❑ Other: i
Descri lon
p I Qty. I Ea. Total
• • JOB SIT INFORMATION ANDi 1;OC.:0 y_ >'. i k *�+ 0 ; •(??t?�y
. • � :,r, ". °e.s.!�,:° ` , � ::�''•,�.; Heating/cooling
Job site address: ? ; - Air conditioning ar heat pum
D 5 � (`, (� c, (requires site plan showing placement) 14.00
ity /State/ZIP: -. G 20 U 2_ 5' 7 .2-2,13
Furnace 100 ,000 BTU (ducts/was) 14,C0
Suite/bldg. /apt. no.: I Project name: 1 C � Furnace 100,000+ BTU (duets/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14
Hydronic hot water system 14.00 '
. Residential boiler (radiator or
hydronic) 14.00
• Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended; etc. 10.00
Subdivision: + Lot no.: Flue/vent for any of above 10.00
Fax map/parcel no.:
Other. 10.00
Other fuel appliances
• DESCRIPTION. OF WORK . "s'. '.: '' `` ".'`): " a t : 4} " i Water heater 10.00
it? 51..,, .q 4, A t G Gas fireplace 10.00
( �• Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.
Wood fireplace./insert 10.00 '
ROPERTY OWI' ER ... Chimney/liner/flue/vent 10.00 I
k ame: /61e -T� (i �i r. Other: (0.00
/ Environmental exhaust and ventilation
es
Addrs: / s 6 S / D7-1 J) G/. Range hood/other kitchen
equipment 10.00
City/State/ZIP: ••y ; Gam 4 6 q 7 - -3 Clothes dryer exhaust 10.00 I ^
! (1 _"� Single-duct exhaust bathrooms,
Phone: ►) 6 y0 - f - 3 f f Fax ( ) toilet compartments, utility rooms) 6.80
•
❑ APPLICANT - C] `;.CONT N ',, : Atticicrawlspace fans ' 10.00
Business name: Other: 10.00
Fuel piping
Contact name: lY1 /] �'q / 1 1 • $5.40 for first four $1.00 for each additional
Address ` ' Furnace, etc.
•
City /State/ZIP: Gas heat pump
Waillsuspended/unit heater
Phone: ( 3 / 7 ) ...(f _ 3 - 7 0 r / 1 F 1 3 S -- 9i p — 6p... a Water heater
E -mail: . `�' C - Fireplace i i
1 ., ar. .. Range i
CONTRACTOR : s = '�;* ;•.>., . si:':: n, ?:>~�; ' ' � :, :� Barbecue
m 99 .. Y . i Clothes dryer (gas)
Business na
1u.•.��/ rt 1 #.ezt.7 6• x IL
Other:
Address: e:
v X X1 ' PERMIT FEES* '
C :t r ., v 7�� f Subtotal (I.
Phone: csD3) / ...-d..2 /L pax: r -,� ? (y rl 77) Minimum pertnit fee ($'2.501 2�
{ C, � 7 U p V Plan review (25% of permit fee) I
CCB tic.: J ►
I p
State surcharge (8% of permit fee)
J l
TOTAL PERMIT FEE x '.30.
Authorized signature: This permit application expires if a permit is not obtained within ISO
��� days aver it has been accepted as complete
Print name: . if / •0 - I Or Gate: • Fee methodology set by Tr( -County Building Industry Service Board
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)6242704
SITE PLAN
ADDRESS: ►1 p)7' C7
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CITY OF TIGARD . . ._ ...
- - 1
BUILDING DIVISION PERMIT #: MEC2007-00371
13125 SW Hall Blvd., Tigard, OR 97223 1 D TE SUED: 6/20/2007
Phone: (503) 639-4171 k b
I 1 /
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/90007 TIME: 7:02AM PAGE: 71 I
SITE ADDRESS: 13065 SW 107TH CT CLASS OF WORK:
SUBDIVISION: PATHFINDER LOT #: 026 TYPE OF USE:
PROJECT NAME: TUCKER
DESCRIPTION: Install a/c unit.
OWNER: TUCKER, KELLY PHONE #: 503-620-1311
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 603-624-2704
Inspection Request Scheduled For: Date: 7/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 051449-01 503-624-2784 N
Co .6)-- 1311
Corrections/Comments/Instructions:
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V ' A' -1nA-t Csr-u(,
313 itr =LA ) kik/ 3 tt\
-.2 60A-
1 .
?T:;;; 1 i PARTIAL APPROVAL 0 CANCEL 7 NO ACCESS
I FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Vi. 1 `-' M
Date: (/ Phone #: (503) 718- 7 - -
— - . • .