Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00232
a '' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/24/2006
PARCEL: 2S103BD -02200
SITE ADDRESS: 11765 SW CARMEN ST ZONING: R -4.5
SUBDIVISION: LOT: 009 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
GREG RECTOR Description Date Amount
11765 SW CARMEN ST
TIGARD, OR 97223 [MECH] Permit Fee 5/24/200E $72.50
[TAX] 8% State Surcha 5/24/200E $5.80
Total $78.30
Phone: 503 - 524 -3310
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 By: Permittee Signature: P se
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business aaP.
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.
. A _k,
Mechanical Permit Ap,pliatinh‘, , - row on LSE ONLY
City of Tigard ;0 1k) to ' Received
Date/By: - . . ‘
. _./ ) Perinil No.
13125 SW Hall Blvd., Tigard, Oli ' .2- f
A lct% A Plan Review '--
Phone: 503.639.4171 Fax: 503.598.1960 c Lt L.- AvArevic• i :-• Date/By: Other Permit:
Inspection Line: 503.639.4175 \ 4' • - -.JI.J; Al Date ReadylBy: BM fa See Page 2 for
Internet. www.ci.tigard.or.us ' r --"-- \---
Notified/Method: Supplemental Information
.,()Y
-.11,110 _
...::: v -,-...., ,•:...' : . ;:::i.;:;e .-...:-:' ..,-. ' f:t WANVORiCS'....; '.- - . - . ' , . '. . .: . i 'COMMERCIAL , FEE*,,.SC1EIEDUI..E . 1... I.FSE 'CHECKLIST
Mechanical permit fees* are based on the value of the work
New construction Hiaattioibillteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition 0 Other: - mechanical materials, equipment, labor, overhead, and_profit.
..., • . - • • - • , • - • .. .• • CATEGORY OF.'CONSTRUCTION - • . - . Value: $
- .. . RESIDENTIAL EQUIPMENT! SYSTEMS FEES*
Ef 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description Qty. 1 Ea. 1 Total
:.: ••••••••:: ' - . •:: ...4013 SITE .INFORMATION AND LOCATION -• - .• •-• :. - • • • : Heating/cooling
Air conditioning or heat pump
Job site address: 1/ 2C ,5 ,$ - A.) C21/ryzyr2 L5`7 (requires site plan showing placement) / 14.00
City/StateallP: Furnace 100,0003W (ducts/vents) 14.00
Furnace 100.000 BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work ' 14.00
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
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water heater : 10.00
Gas fireplace 10.00
,//i./..5 7 "1" 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
-.- ,
•7211 OViiNER: .- .:.:. ...,[' .:...;'...', ,:•.: t".f.' TENANT.. • . -.-.---
. . . . ... .. .
• .."' , •• Other: 10.00 ,
Name: K; e 4-e_-7 i Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State/Z1P: Clothes dryer exhaust 10.00
Single exhaust (bathrooms,
Phone45) 5 - - , 7 7 v _30 i 0 Fax: ( ) toilet compartments, utility rooms) 6.80 ,
Anic/crawlspace fans 10.00 ..
Other: 10.00
Business name: .
Fuel pipit_tg
Contact name: /0,eptie aii/46)( $5.40 for first four; S1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP:
Wall/suspended/unit heater _
Phone :3 ) , ,. 7 2 y , ,,,7,7 0 Fax: : n . 3 ) _5 ,I,...,/(,.) Water heater
_Fireplace
E-mail:
Range •
cONTRACtoR Barbecue
, Clothes dryer (gas)
Business name: (7 / 1441 b e / ti ro _ d j _ y .. 6 7/?/ / i4, _
? Other:
Address: t .4 4ox ,,Z3.0.,91 • ,••••:::-----. •-• .• •IvitcHk4cALIT,RrinT.FEts......,
City/State/ZIP:
- 77 ' 9 7-f2,e' e9 0.2 .90 i Subtotal
Minimum permit fee ($72.50)
Phone: ) ‘ E ./ c.7,704/1 Fax: Q ) c, efog'7,0 Plan review (25% of permit fee)
CCB lie.: 7 -. 5'.9 Slate surcharge (8% of permit fee)
TOTAL PERMIT FEE "
This permit application empires if a permits not obtained within 150 m
Authorized signature: ...ieaP......,Ze...e • days after it has been accepted as coplete.
Print narne:4 / . ( 4 z
_,,,,, , ate: q.7‘. 4 . Fee methodology set by Tri-County Building Industry Service Board
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
ADDRESS-
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CITY ��� ������R��� �
�pm n n OF TIGARD ' - '
BUILDING DIVISION PERMIT #: MEC2006-00232
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/24/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (508) 630'4175 ~_ . � uoll �
INSPECTION DATE: tV3O/2DO� TIME: 7�D1A� PAGE: 65
� � � �
1 SITE ADDRESS: 11765 SW CARMEN ST CLASS OF WORK:
SUBDIVISION: LOT #: 009 TYPE OF USE:
PROJECT NAME: RECTOR
DESCRIPTION: Installation of NC unit. •
OWNER: RECTOR, GREG PHONE #: 503-624'3310
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503
Inspection Request Scheduled For: Date: 6120/2006 Pour Time:
.
Code # Inspection Description Confirm # Contact # Message
699 $Wechanical final 03195401 503-624'2704 N
Corrections/Comments/Instructions:
PASS �l PARTIAL APPROVAL �� CANCEL -- NO ACCESS
_ _ _
| | FAIL I CALL FOR INSPECTION 11 ADDITIONAL FEES ASSESSED
,
Inspector: Date: � & Phone #: (503) 718-