Permit i c .. CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00283
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/5/2008
PARCEL: 2 S 109 D D -09100
SITE ADDRESS: 12689 SW DA VINCI LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 021 JURISDICTION: TIG
PROJECT: QIAN
Project Description: Installing A/C.
CLASS OF WORK: ALT 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
DAVID QIAN Description Date Amount
12689 SW DA VINCI LN
TIGARD, OR 97224 [MECH] Permit Fee 6/5/2008 $72.50
[TAX] 12% State Surch 6/5/2008 $8.70
Total $81.20
Phone: 503 -312 -5912
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -1950
FAX 503 -538 -0165
Reg #: LIC 97152
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: c f s •�r6/1-/
Call 5isfi . 175 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.
• A " s x I A'' ' n '. r d' ° ° . ' v sr ` X0 c '� � E' 1 �" �' "°r ., ° r�' "v
McCilla ca Per mit App ieatiOn 4, ,51, d - °, ,I to/ I(thy,l Ii If I tiI :(tN.l ti xti �itM ` ' ,,t i
: : :n, City of Tigard Da !. P ermit No.:
- 13125 SW Hall Blvd., Tigard, OR 97 CEIVED /n !u �KJU %�
i ,,/ .; Phone: 503.639,4171 Fax: 503.59 Plan Review
Date/By Other Permit.
^ '.', Inspection Line: 503.639.4175 Date g /g
; , s14 J 0 4 2008 N otitle � y: fa lite Page afor
Internet: www,tigard- or.gov d/Metlwa, KVI Supplemental Information
TYPE t?F rr tt , ;COMMERCIAL FEE* SCHEDULE - usE �T
['New constriction Addition /altei liicement Sis7N Mechanical permit lots* me based on dre value of the work
petrmed- indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF C{1 7i 'lf�UN Value: $ . 6 c
.. ,,' ': R'EA'L FiIQa(lIPMENT / SYMMS FEES
,l• and 2- family dwelling {J Commercial /industrial ❑ Accessory building I
For special Information use ehecklui.
❑ Multi- family 0 Master builder El Other: Description
Qty. 1 Ea_ ! Total
JOB SITE N PORrwaio�l',►iW' +i , ,;' '"/` ,', ;, 'r Heating/cooling
CO \ e I — Air conditioning or heat pump
Job site stidress: • • A . W 1 V • ... 1 Lot_ IA (regaires sit pll■n showing placement) 1 14.00
City /State/ZIP: ~ it 1 • /C IF ' - Furnace 100.000 BTU (ducts /vents) 14.00
•Furnace 100.000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt, no.: Project name: I A -IA Gas heat pump 14.00
Cross street/directions to job Site: Duct work 10,00
- 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. 14.00
Flue/vent for any of above I 6.80
Subdivision: Lot no.: Other I 10.00
Tax reap /parcel no.; Other fuel applisoccn
DE JPT!UIN' & ;1 _ ; ' '/, ::::;.s `.;:::7 Weiler heata 10.00
Gas fi 'lace 10.00
L'___ ((( Flue vent for water heater or gas
lire .lacC
10.00
Log lighter (gas) 10.00
Wood/pellet stove 10,00
- Wood fireplace/insert 10.00 - -
� �' '4 * - Chimney/liner/flue/vent 10.00
1 ' ° Other 10_ -00
Name: \, " CZ. ( ().\ _ Environmental exhaust and ventilation __ _ _
� A t Range hood/other kitchen
Address: J Co q - W 4� �C� J ( G t (.--- - d Ire .` e 10.00
City /State/ZIP: -n- d v. C7 r q "7 y '-f - Clothes dryer exhaust 10.00
Rime -duct exhaust (bathrooms,
Phone: [tz, . - - - .S C? Fax: ( ) toilet compartments, utility rooms) 6.80 .
F. orpurANT - , ' ' , . , F appilijr.ArrAtif. r�i; craw p fans Att{a/ Is ace 10 00
Other 10.00
Business name: Fuel piping
Contact name: ND A R C:CMIOITPQN z , 55.40 for first fours 51.00 for each additional
Address: 1005 INDUSTRIAL PKWY Furnace, etc
- -. Gas heat pump
City /State/ZIP: - ' Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater ,
Fireplace
E -mail: Range
C4NTQD . .. .. ,,:'" Barbecue - .
Business name: Clothes dryer (gas)
Other:
Address: D ITIONING, INC. , , r4#l,citAMCAL PEI M T
City /State NEWRERG 7i subtotal
- , / _ Minimum permit the ($72.50) -7,a. s
Phone: 2 l 5 -is C)' S 'r - Fax: (��. ' 5 I S `-3 I (la 5 Plan review (25% of permit fte)
CCB Iie.: I - 7 i c _ State surcharge (12% of permit t e) .- o 7 Q
TOTAL PERMIT FEE el, 20
Authorized signature: This Permit application invitee if a permit to not obtained within 180
gel days after It has been accepted as complete.
Print name: I rig Date: , — • r • Fee methodology set by '1'6-County Building Industry Service Board
lASw iParmits>tdEC-PormitApp.
lac OI /I9l07 440.4617r(1102/COb WEB)
b00 / XVA EL GO 800Z /170 /90
AA pO�7'7��
I 5
1 ,
A/C -HEAT PUMP-UNIT SITE PLAN °
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FEET BACK OF PROPERTY i LINE V E
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C "h FEET TO SIDE PROPERTY LINE SEASONS HEATING
. Cr izti . - , (.._ •
ND CONDMONING, INC.
1005 INDUSTRIAL PKWY
FEET TO FRONT PROPERTY LINE NEWBERG, OR 97132
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PLEASE .REF APPLICATION SITE PLAN
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CITY OF TIGARD
BUILDING DIVISION ' PERMIT #: MEC2008130283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/200B
Phone: (503) 639-4171 Alit i il\
. n 1 1 1 i
Inspection Requests (24 Hrs.): (503) 639-4175 ,,,,..61 - 1 -!...
INSPECTION WORKSHEET FOR DATE: 6/18/2008 TIME: 7:02AM PAGE: 65
SITE ADDRESS: 12689 SW DA VINCI LN CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 021 TYPE OF USE:
PROJECT NAME: ()IAN
DESCRIPTION: Installing NC.
OWNER: ()IAN, DAVID PHONE #: 503-312-5912
CONTRACTOR: FOUR SEASONS HEATING & NC INC. PHONE #: 503-638-1960
Inspection Request Scheduled For: Date: 6/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Poet.lbeam mechanical 071503-01 503-312-5912 N
62 9 9 14460/1/4--d-e‘ '64 t-- - , - , , ,i-4- c_.
Corrections/Comments/Instructions:
p& /00 6 77 4, eri c1,
PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
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Inspector: Date: 6 -/d- e• Phone #: (503) 718- - 2-44.- -
I