Permit CITY TIGARD MECHANICAL PERMIT
� � DEVELOPMENT SERVICES PERMIT #: MEC2006 -00324
°7 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/19/2006
PARCEL: 2S 103AA -03200
SITE ADDRESS: 10465 SW CLYDESDALE PL ZONING: R -4.5
SUBDIVISION: CLYDESDALE LOT: 012 JURISDICTION: TIG
Project Description: AC install.
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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
VALERIA VILLALOBOS Description Date Amount
10465 SW CLYDESDALE PL
TIGARD, OR 97223 [MECH] Permit Fee 7/19/200E $72.50
[TAX] 8% State Surcha 71191200E $5.80
Total $78.30
Phone: 503- 624 -1741
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.
` Permittee Signature: • - �� � -
Issued By: C L. �! / /_ r or �. .1 P itt Si 9 _
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.
•
f•
M echanical Permit Appl' t at
@" Received
• City of Tigard Date/D 7 /% 54 Permit t\1 4‘ , 6 \ J P06 -0032
13125 SW Hall Blvd., Tigard, • o ,iti C Plan Revi v
Phone: 503.039.4171 Fax t . °t O /knN ti Date/By: Other Permit:
•
Inspection :inc. 503.63941 • '' /� $ � rya to }) n D ateReady /By' luny H See Page 2 for
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Internet: ww.ci.tigard.ous t y !mss Notified/iblelhod• Supplemental Information ��� - t � 4 r) C'
X'1143 4 —
TY COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
• M. echanica: permit fees• Are 17aSed Ott the Va'•lIC of th v usr4. •
❑ New construction ❑ _i i rati /replacement
performed. Indicate the value (rounded to the nearest Collar) of all
❑ Demolition 4 mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCCION Value:
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 -and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Pa, 1 2tital
JOB SITE INFORMATION AND LOCATION Heating/cooling
j �� Air conditioning or heat pump
Job site address:
`0 " 5-a/ (/ 5 ��'IC .r� (requires site plan showing placement) i 14.00
CityiState/ZIP: r Furnace 100,000 BTU (ducts/vents) 14.00 .
Furnace 100,000+ BTU (ducta':eicvi 17.90 I
Suite /bldg.iapt. 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) ! 14.03
Unit heaters (fuel -type, not electric), •
in- wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 1 0.00 i
Other: 10.00
Tax map /parcel no.: 1 Other fuel appliances 1
DESCRIPTION OF WORK Water heater 1 0.00
• / Gas fireplace 10.01; i ��
! e-' Flue vent for water heater or gas I
I fireplace 10 010
' Log lighter (gas) 10.00
•
Wood /pellet stove I 10.00
Wood fireplace /insert 10.00
-
ROPERTY OWNER I ❑ TENANT Chimney /liner'flue /vent 1000
Other: 10.00
Name: 7e_ /e /�z4 �: / / a / p .6� Environmental exhaust and ventilation
Address:
Ranee Range hood /other kitchen I
equipment I 1 0.00
City /StaturZ Clothes dryer exhaust i 10.00
/ �/ Single -curt exhaust { bathrooms.
PhonLd ' l��7 , 79/ Fax: ( ) toilet compartments, utility rooms) 6.80
El f , CONTACT PERSON Attic /crawlspace fans 1 0.00
Business name: Other 10.00
///��� Fuel piping
�
Contact name: 47 , /2/2/6/. $5.40 for first four; $1.00 for each additional
Address: / Furnace, etc.
Gas heat pump .
City /State/ZIP: Wall /suspended/unit heater _
Phone ;� ) /7 p �� � � � „7, ! O Fax: (S�,) � 1 � � t/ ) Water heater
Fireplace 1
E-mail: Range I
CONTRACTOR Barbecue 1
//� Clothes dryer (gas)
Business name: � /�� ! G (n"77 -t 14 ..07),/,,,ii- Other:
Andress: Ppr JO/ ,� 5o. g i MECHANICAL PERMIT FEES*
City /5tatefZlP: r)-2 e24 e24 �� y f Subtotal
y
( J Fax: Minimum permit fee ($72.50)
Phone:
.(.2.5 ) � 7V 7 ��) �/� 7 /) Plan review (25% of permit fee)
CCB lie.: 7 ', . r% State surcharge (£% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is net obtained within ISO
days after it tins been accepted as complete
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•
HEATING & COOLING, INC.
P.O. BOX 230397 • T IGARD, OR 97281
(503)624-2704
SITE PLAN
_ .
ADDRESS
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CITY OF T - -
BUILDING DIVISION PERMIT #: MEC200E�d10i24
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/19/2006
Phone: (503) 639 -4171 d9 p i b ' i I cl
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/2912006 TIME: 7 :06AM PAGE: 73 ,
SITE ADDRESS: 10465 SW CLYDESDALE PL CLASS OF WORK:
SUBDIVISION: CLYDESDALE LOT #: O12 TYPE OF USE:
PROJECT NAME: VILLALOBOS
DESCRIPTION: AC install.
OWNER: VILLALOBOS, VALERIA PHONE #: 503 - 624 -1741 .
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 - 6242704
Inspection Request Scheduled For: Date: 9129/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 037362 -01 503-624 -27114 N
Corrections /Comments/ Instructions:
fro F rte i. ,,.„ ;,_ /y�4-,c__ ;e- $ 4s 32 (2,' r e z,7.- ,/c
•
1 PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL C LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: • , Date: 9 - 21.E - 2 Phone #: (503) 718- ^�^