Permit `.- Cr
C1TY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005-00162 •
6C1111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/8/2005
PARCEL: 2 S 103 C C -04400
SITE ADDRESS: 13815 SW 124TH AVE ZONING: R -4.5
SUBDIVISION: EAGLE POINTE LOT: 019 JURISDICTION: TIG
Project Description: Installation of A/C.
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ELMORE, CLAUDE D + MELISSA E Description Date Amount
13815 SW 124TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 4/8/2005 $72.50
[TAX] 8% State Surcha 4/8/2005 $5.80
Total $78.30
Phone:
Contractor:
COMFORT MECHANICAL INC
17936 SE DIVISION STREET
PORTLAND, OR 97236 REQUIRED ITEMS AND REPORTS
Phone: 503 -761 -1500
Reg #: LIC 79558
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: �� Permittee Signature: _ wc- 0 \p\
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.
Apr 08 05 09:48a COMFORT MECHANICAL, INC. 503-762-5394 p.1
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard r
r" 'Bi - '
4...t„. Received - ......-
13125 SW Hall Blvd., Tigard, OR 97223 t Date/Br (/' - d )---1;6/L'' Permit No.!\‘ 6 - cd /6 . 2 ...,
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
affi' ipp61 A Date/By:
Inspection Line: 503.639.4175 s Et r! t-. li Date Ready/By: luns• 0 See Page 2 for
Internet: www.ci.tigard.or.us APR 0 8 • --... Notified/method: i i( s - Supplemental Information
.. ...., " ; . .. 1., ' ; ' -i: ' ' ' .: . , '. . !. 1• :1;::0.5*MMCM'Itt.S6E
0 New construction i AcgajfittRa ON Mechanical permit fees* are based on the value of the work
• performed. Indicate the value (rounded to the nearest dollar) of all
ci Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
-.. r. ''.'' -1, • '.: .:: . ',..'' . : XiiEddoteir: 01? ; ;;0l`igTili'IO1■i',.:!.;' ; .: '';'.. ::•• ... ' 4 :', .. ' ::!:-S; Value: $
,. ' ENT.Y.SYSTEMS FEES
r5iP 1- and 2-family dwelling El Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description 1 Qty. 1 Ea. Total
•:,.:'-: : " . :T:. .!;.•::` TOc477ON,, : : -1 : , ,:: :. 1 ,!.... .: ;- 5. ' . Heating/cooling
Job site address: LS S 15 3 i 24 4 h Ayerlt.le- Air conditioning or heat pump
(requires site plan showing placement) I 14.00 1-4
City/State/ZIP: 1 1 0 CL(-CL Cl p ... . Ci 7 1 ;;; 13
A i Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents)
l 7 .90
Suite/bldglapt. no.: I Project name:
Gas heat pump 14.00
Cross street/directions to job site: L- 5'.5 ' f 5 Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.: '
Other: 10.00
Tax map/parcel no.: Other fuel appliances ,
). , ;,: Water heater 10.00
10.00 Gas fireplace
_....L1).-S-1 t / .c...r,C1 1 c. n1/4-4 Flue vent for water heater or 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
-.. . :: - . 0 1 iii - .... " (1 ' : - , f :', `:
10.00
Name: ( CA k_.',_ ( e- E I mo-re, Environmental exhaust and ventilation
Range hood/other kitchen
Address: )3 g i 5 ,:s W I 2. 4-1 A ve_ r Li t.___ equipment 10.00
city/State/ZIP: --1 c t-L-A-- Ck. 0 V,. q 3 1. 2 . 3 Clothes dryer exhaust 10 00
1 A I Single-duct exhaust (bathrooms,
Phone: (f 5 .1ci _ 74,../ Fax: ( ) toilet compartments, utility rooms) 6.80
.
,.,,,, x.th :::.!!:-,!; Attic/crawlspace fans 10.00
..:.-:...".',:,?--!;;-.. -.,...,... ...... . X1.•: it.:.:C..:.'t1:34'.1. --.. -.- :,.':,.,-- -; , • ".....- Other:
_ 10.00
Business name:
Fuel piping, Contact name: $5.40 for first four; $1.00 for each additional
• Furnace, etc.
Address: .
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail: ,.. Range
.•::;''';'•';:-.';''.:C:';'..-.!,.i.--.,f:.:...1..c9m#4c:r9fc;,it4iy,-..;-:::::.,;--41::;.1,.;.-:_,,•-4.,;.:.,..::.,„,-..i-i Barbecue
Business name: eLJTYI-CCpr--4.- rf\P hi? nt red? t ( r- Clothes dryer (gas) )C 4 Other: -
Address: ric136, '5E - Dwtsccryl 5 71..,.!;1 -- ..Wc.gw-Nicp:iwY..n.E!'' •
City/State/ZIP: ,--pay-÷tro_r_vt 41 2-3 Co Subtotal li ce
Minimum permit fee ($72.50)
Phone: (5 - 16 : ,( _15 on Fax: ( 5 f ) - 3 1G2..- Plan review (25% of permit fee)
CCB lic.:
.--li 556 State surcharge (8% of permit fee) 5 2e 1
TOTAL PERMIT FEE . 1 e...34.,
Authorized siqt
Ilii: 1C d c_.; • This permit application expires if a permit is not obtained within 130
days after it has been accepted as complete.
Print name: c nc . Li 4 I ec19 Date: ,- ifv (4 \
I 1 - - 5 • - 05 • Fee methodology set by Tri-County Building industry Service Board
iNduilding1Permits\MEC.PerrnitApp.doe 12/03 440 ( I 1/02/COM/WER)
Apr 08 05 09:4a COMFORT MECHANICAL, INC. 503-762-5394 p.3
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?wi OpTSIDE UNIT * •
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MEC2005 -00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 95
SITE ADDRESS: 13815 SW 124TH AVE CLASS OF WORK:
SUBDIVISION: EAGLE POINTE LOT #: 019 TYPE OF USE:
PROJECT NAME: ELMORE
DESCRIPTION: Installation of NC.
OWNER: ELMORE, CLAUDE D + MELISSA E, PHONE #:
CONTRACTOR: COMFORT MECHANICAL INC PHONE #: 503 - 761 - 1500
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 004500-01 503-761-1500 Y
Corrections /Comments /Instructions:
LIP L ,l 414 �� � ! 7�� .
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL (i CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r 1 Date: Phone #: (503) 718