Permit C ITY OF TIGARD MECHANICAL PERMIT
. I; DEVELOPMENT SERVICES PERMIT #: MEC2003 -00531
" -' F ' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/29/03
PARCEL: 2S103CC -07400
SITE ADDRESS: A
SUBDIVISION: WHISTLER'S WALK /3s o /� , /4- -- z_- ZONING: R -4.5
BLOCK: LOT: 021 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A/C unit. Do not place within the required setbacks
Owner: FEES
MICHAEL & CHERI D'BRIEN Description Date Amount
13575 SW HATHAWAY TERR
TIGARD, OR 97223 [MECH] Permit Fee 8/29/03 $72.50
[TAX] 8% StateTax 8/29/03 $5.80
Phone: 503 706 - 6319 Total $78.30
Contractor:
AAA HEATING & COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Phone: 284 - 2173 Final Inspection
Reg #: LIC 222
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 -00
Issued By: - 1 -- / . • -/i Permittee Signature: / 4 . 2
Call (50 ) 639 -4175 by 7:00 P.M. for inspections needed the next b si • ss day
Mechanical Permit A plication FOR OFFICE USE ONLY
`J
Received Mechanical r �
Date/By: Permit NohltiC I� 'V-.7 (
City of Tigard E v E' Al Planning pproval Building
Date/By: Permit No.:
13125 SW Hall Blvd. AUG 8 2 Plan Review Other
Tigard, Oregon 97223 2 i � Data//By.: Permit No.:
Phone: 503- 639 -4171 Fax: 503- 98 -1960 Post- Review Land Use
C r TY OF TI � �� Contact .tuns.: Date/By: Case No.:
Internet: www.ci.tigard.or.us
_ ,.?.L '� I El See Page 2 for
24 -hour Inspection Request: 50j-t Q tem Di '')O " Name/Method: Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
2. & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
• Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE* SCHEDULE
❑ Master Builder Other: Description I Qty I Fee(ea.) I Total
M
❑ Heating/Cooling
JOB SITE INFORMATION and LOC TION Furnace - add -on air conditioning ** 14.00 ( !_l - pry
Job site address: k _ W Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: k-LV \ 0 ` LQxI Hydronic hot water system 14.00
job site: (or radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: 1 Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK , Gas fireplace 10.00
C A - CJJ CAL■. Nn I --C Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert _ 10.00
Chimney /liner /flue/vent 10.00
gPROPERTY OWNER ❑ TENANT Other: 10.00
Name: . (C Ct AQ 4- t g k( Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address: t SCAD WIS LOC 1-€.} .
Clothes dryer exhaust 10.00
City /State/Zip: 1 CA(t� (J� C t i'2,7...., Single duct exhaust
Phone: lute - � k Fax: (bathrooms, toilet compartments,
❑ APPLICANT ❑ CONTACT PERSON utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Address: Other: 10.00
Fuel Piping
City /State /Zip: * *(55.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: Fax: Gas heat pump **
E-mail: Wall /suspended/unit heater **
CONTRACTOR Water heater **
Business Name: f V l C ,. 4- 0,0D1 Fireplace , **
Range **
Address: l, �F \-& - . Y UC.
City /State /Zip: p�nCt ( \J Z- C 12-0- Clothes dryer (gas) **
Phone: D -c k - t t; I Fax: D- LA - \C5 L Other: ' **
CCB Lie. #: 77 Total: (i -t
Authorized � • ) Mechanical Permit Fees*
Signature: v l� 'w w� `� cij c Subtotal: $ Date: - a�J -ab - C7t
Minimum Permit Fee $72.50 $ —1 7- .C.7
�l ` S \tk_ CX (4 Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 5 .
TOTAL PERMIT FEE $ ° (g . �j
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri - County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
•
AAA HEATING & COOLING, INC.
2915 NORTHEAST MLK JR. BLVD.
PORTLAND, OREGON 97212
(503) 284 -2173 FAX (503) 284 -1552
CCB # 000222 / 35g6
Air Conditioning Site Plan
Customer /Lt 1 0' 13r
Address
City, State Ty d D Zip ? 72-.23
_ 15 — i
� I
;/
r o r ---( 3 e
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) .; .- 4175 ..- . a
INSPECTION DIVISION Business Line: (5 ) MST
BUP
Received Date Requested �( AM PM � �' ' C / BUP
Location 1►f - 11..14 1 f_% suite 3 —6 S3/
Contact Person f _ a.... _ � Ph 1 ) 2 j- ?- I "73 PLM
Contractor / 3 s 86 la y'""` -Ph ( ) SWR
BUILDING Tenant/Owner ELC N wlA..
Footing
Foundation ELC
Access:
Ftg Dr i rain �. `. i ELR
Crawl Slab Inspection Notes: 3 _ C SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear () �i /,
kit Sheath/Shear `"4 n �— �✓�•�X O / U
Framing I ,
Insulation
Drywall Nailing �(
Firewall \ J\ '� b/4 0
Fire Sprinkler 1
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam +�
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS AR FAIL
NIC
Post & Beam ` ✓
Rough -In n
Gas Line
Smoke tampers
j T PART FAIL
TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line C'f
ADA Approach/Sidewalk Date (� �� Inspector Ext
A
pp Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL