Permit ,4. CITY OF TIGARD
MECHANICAL PERMIT
Il DEVELOPMENT SERVICES PERMIT #: MEC2005 -00152
,� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/6/2005
PARCEL: 2S 112CC -02200
SITE ADDRESS: 08035 SW CHURCHILL CT ZONING: R -12
SUBDIVISION: BOND PARK NO. 3 LOT: 050 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
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
KRUM, CATHY Description Date Amount
8035 SW CHURCHILL CT
TIGARD, OR 97224 [MECH] Permit Fee 4/6/2005 $72.50
[TAX] 8% State Surcha 4/6/2005 $5.80
Total $78.30
Phone:
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Phone: 503- 650 -9602
Reg #: LIC 71878
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: G ^C Permittee Signature: ,5_,,
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.
FROM : .-TEMP FAX N0. :5035572990 Apr. 05 2005 11:49AM P2 /3
Mechanical Per r " rrt)II t)FI ': u
I('1se. t)N. ,Y
City of Tigard EBERIMMII P sio. — / - p'Uj
13125 SW Halt Blvd,, Tigard, OR 97223 Platt Review ether Permit.
Phone: 503 639.4171 F ax: 503,598 0 i -' f gf a ('` Date/By:
Inspection Line: 503.639.4175 005 � ' I bate Ready/By; Jul,: 121 See Page 2 for
Internet: www.ci,tigard.or,us Notified/Method: ; (r I Supplemental lnformadoo
, . CITY OF TIGARD
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Mechanical permit fees* arc based on the value of the work
] New construction Addition/alteration / replacement performed. Indicate the value (rounded to the nearest dollar) of ell
C] Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
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0 Multi family 0 Master builder 0 Other: Ea. Total
1 t Description Qty
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Job site address: v �' ` . ) L.-J 4 ` 1/ �. -. re. I .e a e . an ehowin; •laoemam 14,00
City /State/ZIP: r ; {t 1/,D - Furnace 100 000 BTU ducta/vents 14.00
} urnace t t 1'0+ ' TU ducts/vents' 17.90
Suite/bldg. /apt, no.: Project name: r IA „ (las heat •ump _ 14.00
Cross street/directions to Job site: Duct work 14.00
H (ironic hot water s stem _ 14.00 Y
Residential boiler (radiator or
h dronic 14,00
— . . Unit heaters (fuel -type. not electric),
in -wall 1n-duct sus .ended etc, 10,00 _
- - Flue/vent hr an of above 10.00
Subdivision: Lot no.: Other; 1000
Tax map /parcel no.: Other fuel a ..11ances m , _
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�, heat" • ... 10,00 v , n D , d u l ii /c 1 I t , � 01; � ' AB ;4;l :fl$lifa14/sti,. �f.,lrA;ii;;•�W ?rt�" ,t: Water boat -._
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.1 l �* Flue vent for water heater or gas
fireplace 10,00
Lo• lllhter :as - MO 10.00 Milli
Woad /•drat stove 10.00
Wood fire.lacc/insert 10.00,,_
Cttimne /li /fltta/vent 10.00
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Name: I v L Environmental exhaust a nd ventilation _ • - n Mange hood/other kitchen
Address: �')(/�) ) ( �l e ui i local M 10.00
•
City /State/ZIP : - r -lb h 0 r - --_ L w Clothes d er exhaust 10.00
,a Single -duct exhaust (bathrooms,
Phone: a) (J! 0 L. 6 1- Fax ( ) toilet cam .artments utilit rooms 6.
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1�1t: 1 �_��
Other:
Business name: ...e t . ' f '— Fuel .1. In.
Cot toot narrte: $5,40 for first four $1,00 for each additional
I Furnace etc,
' Address; Gas heat urn.
City /State/ZIP: `�� . Wa1U'sus ended/unit heater EM
Water heater
Phone' Fax::( )
( ) Fire lace
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Business name: _ 4+ -• .v. Other: p >,t,
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Address: t1,6(:)00 , 1 .u: , ∎,- ,,.1, ri„Ait,„ /.•i ,,,h,„ y , A, ,. f:lxq. mi h b ,,., M r.) S f 1 „E , . l tS t
� r �� Subtotal
C ity /State/LIP� C , t Cdr �0. tlV�F� - 1 , 9 Q i< _ •. Minimum perm fee ($72,50)
Phone: (9 )3) (05 ( Fax: 603 ~ r`l, a,' 0 Plan review (25% of permit fee) _ _ I
(/y f State surcharge (8% of permit fee • 1
TOTAL PERMIT FEE � /���
`gyp n , � This permit application expires if a permit is not obtained within 180
Authorized signatil rI \A --34 days after it has been accepted as complete.
Rate: l -E • Roe methodology cot by Tri- County Building industry Service Board
Print name; .51 '�C . Y .�
t. \ nrd ldlna \PennitYUMEC-PertnllAPp.doc 12t05 440.1617T (11/02 /COM/WER)
FROM �A—TEMP FAX NO. : Apr. �� 2005 11�58AM P 3/3
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customer N„,„e:/47 Acidross: IP 15 5 4rd
ly Line
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•
CITY OF TIGARD ;p
BUILDING DIVISION PERMIT #: MEC2005 -00 62
13125 SW Hall Blvd., Tigard, OR 97223 i ��n��'d�0 DATE ISSUED: 4/6/2005
Phone: (503) 639 -4171 ,... 401111111 .
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 99
SITE ADDRESS: 08035 SW CHURCHILL CT CLASS OF WORK:
SUBDIVISION: BOND PARK NO. 3 LOT #: 050 TYPE OF USE:
------PROJECT NAME: KRUM
DESCRIPTION: Installation of A/C.
OWNER: PHONE #:
CONTRACTOR: A -TEMP HEATING & COOLING PHONE #: 503 - 650 -9602
Inspection Request Scheduled For: Date: 6/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009880 -02 503-650-9602 Y
Corrections /Comments / Instructions:
vin
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(' F -
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ ) NO ACCESS
❑ AIL
Inspector:
7 [1]
CALL FOR INSPECTION
El ADDITIONAL FEES ASSESSED
Date:
Phone #: 503 718 -
° `� �� - (