Permit CI TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00439
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/25/2008
PARCEL: 1 S134CA -09100
SITE ADDRESS: 11190 SW 118TH TER ZONING: R - 4.5
SUBDIVISION: FEHRENBACHER NO. 2 LOT: 010 JURISDICTION: TIG
PROJECT: MCCOY
Project Description: Install a /c.
CLASS OF WORK: ALT 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
MICHAEL MCCOY Description Date Amount
11190 SW118TH
TIGARD, OR 97223 [MECH] Permit Fee 8/25/200E $72.50
[TAX] 12% State Surchai 8/25/200E $8.70
Phone: 503- 579 -3982
Total $81.20
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.
Issuec y: , j / 9 / Permittee Signat 4111110.0. ��.�� r-
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.
1
4.
Mechanical Permit Appll < ; ,�ED role OFFI('E SJ/ ONL1
l City of Tigard Received r .'O a�
Datel o OD PcrmitNo: rt ,9- 6 0 yr?
• 2008
] 3125 SW Hall Blvd., Tigard, OR 9M-1.1 ` QQp
> : Phone: 503.639.417 ] tax: 503._5y tzp Plan Review Date Other Permit:
T !GA A R D inspection Line: 503.639.4175 Re
Internet: www.tigard- or.gov CITYOF TIGARD Date ed/M By: Ills-
! $1 See m ental r
NNotified/Method: � - l � Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMEJICIAL FEE` SCHEDULE - USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement Mechanical permit rtes• are based d on the value of the wor 1 ,
❑ Demolition CI Other: performed, indicate the value (rounded to the nearest dollar) o all 1
• mechanical materials, equipment, labor, overhead, and profit,
CATEGORY OF CONSTRUCTION Value: $
•
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi - family For special information use checklist.
y ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Ileatingfcooling
Job site address: // p d // 9 Air conditioning or heat pump
/// 7. A- - ) / ,�',/' _y. (reeuires aiteplan showing placement) / 14.00
City/State /ZTP: Furnace 100,000 BTC (duets/vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17 90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14 00
Cross street/directions to job site, Ductwork ' 14,00 •
- Hydronic hot water system I 14,00
Residential boiler (radiator or
hydmnic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: r Lot no.: Flue/vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK _Water heater 10.00
/� � f / Gas fireplace 10.00
/7 G Flue vent for water heater or gas I
_fireplace . 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney,1iner /flueivent 10,00
• PROPERTY OWNER 0 TENANT Other: • 10.00
Name: / 'aa4 e--1 G G V 1 / Environmental exhaust and ventilation i
Address: I Range hood/other kitche j
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
n Single -duct exhaust (bathrooms,
Phone v ?) j7 9 L 5 LJ Fax: ( ) toilet compartrnents, utility rooms) 6.80
❑ APPLICANT !O p' - ❑ CONTACT PERSON Attietcrawlspace fans 10.00
Business name: Other: 10.00
Fuel piping,
Contact name�T l 'DR / b >*" $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: WalUsuspended/unitheater
Phone: 93 ) 6 2. LI , 2 -) P i 7 l Fax:: 3) S 9I., o a 7 6 Water heater
` Fireplace
E -mail:
Range
CONTRACTOR Barbecue 1
Business name: � /.t)-7 Lick., »„� 1 -1 ( // � �yt Clothes dryer (gas)
/� Other.
Address: r e c3 0 X' ,2 3 d 3 9 -.7 . MECHANICAL PERMIT FEES* •
•
City /State/ZIP: // d 4,0 2.p 0 7 -72,f---/ Subtotal
Phone: (M) Zn } q " - 7V Fax: ( ,, 0 - l Minimum permit fee ($72.50)
0 d Plan review (25% of permit fcc)
CCB lit.: 761 3 S 9 t State surcharge (12% of permit fee) - I
TOTAL PERMIT FEE
Authorized signature: i%:;;'/je/ -i� This permit application expires if a permit is not obtained within 180
r+Crlf ly ^'��' days after it has been accepted as complete.
Print name: / / - > J , f -‘/ 9 Date: ? (/ J * Fee methodology act by Tri- County Building Industry Service Board
I: lBuildiat \Pris \M
niEC- Perrui,pp.doe 04/C5/os / 440.4617T(lI/0211 /WE
Z OLZO DNLLV2H V trZ:OL 80 9Z 6nd
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
ADDRESS:
0LZ0 - £09
SITE PLAN
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CITY OF.TLGARD ^ ' _
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BUILDING ' :. DIVISION PERMIT #: MEC2008-00439
| 1312G SW, Hall Blvd., Tigard, OR 97223 DATE ISSUED: ' 0/26/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 630'4175 - �01- »-1..
INSPECTION WORKSHEET FOR DATE: 02EV3008 TIME: . 7:00/0M PAGE: 23
SITE ADDRESS: 11190 SW 118TH TER CLASS OF WORK:
SUBDIVISION: FEHRBN@ACMBR NO. 2 LOT #: 010 TYPE OF USE:
PROJECT NAME: MCCOY
DESCRIPTION: Install a/c.
OWNER: MCCOY, MICHAEL PHONE #: 503-579-3982
CONTRACTOR: COLUMBIA FIEA1ING & COOLING INC PHONE #: 603-624,2704
Inspection Request Scheduled For: Date: 8Y29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 074843-01 503'024'2704 Y
Corrections/Comments/Instructions:
:fr/ �� 4I Cm— 24,t ^,`~n,,e. , 4^4,4-e -+I 5.— ,/ 9 .
P.
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G PARTIAL �� CANCEL ALAPPROVAL --
[l N{�AC{�ESS
_ _
FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
|nopectoc �� A Date: 6 - 29' —aa Phone #: (503) 718-