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Permit - 14 C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00341 ` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/2512006 PARCEL: 2S 103DD -00405 SITE ADDRESS: 10765 SW FAIRHAVEN ST ZONING: R -3.5 SUBDIVISION: FAIRHAVEN COURT LOT: 001 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: > 10000 cfm: Owner: FEES JANE BROWN Description Date Amount 10765 SW FAIRHAVEN ST TIGARD, OR 97223 [MECH] Permit Fee 7/25/200€ $72.50 [TAX] 8% State Surcha 7/25/200€ $5.80 Total $78.30 Phone: 503- 639 -4350 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: 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. I (5 Y g, Mechanical Permit Applicati© ® FOR OFFICE USE ONLY J City of Tigard �� Received n o 4 P P trmit Nn e G3G �o - / 13125 SW Hall Blvd., Tigard, OR 9 2 DIIL•rBy f / Phone: 503.639.4171 Fax 503 598.1960 0 5 2006 � •y} , yl A. t / y..et` Oti}er Permit: 1 ' 11 Inspection Line: 503.639.4175 JUL —ta .' �II Da Date J[j Date Ready/By: fu/ rs i IA See Page far Internet: ww.ci.tigard or.us " " w CITY OF T IGARD Nc[ifiedMelF.ad: /� 5upplctnental Informariou Rt tI pI it DIVISION '�Y E O WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ' ❑ New construction I=3 Addition /alteration /replacement Mechanical permit tees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: S [ -and 2- family dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS FEES' ❑ g ❑ Commercial /industrial 0 Accessory building ❑ Multi-family ❑Master builder 111 Other: For special information use checklist. Description I Qty. 1 Ea. I - l'ota: JOB SITE INFORMATION AND LOCATION Heating,/cooling Job site address: " Air conditioning or heat pump �/ cl� I / �� .54 ,�/ lJe./t.i 0 site plan showiue, placement) / 14.00 City /State /ZIP: Furnace 100,000 BTU (daatsivents) 14.00 Suite /t IdgJapt. no.: Project name: Furnace 100.000+ BTU (ducts /vents) 17 90 Gas heat pump . 14 00 Cross street/directions to job site: Duct work 14.00 1- lydronic hot water system 14.00 Residential boiler (radiator or hydronicl I -.00 Unit heaters (fuel -type, not electric). in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 fax map /parcel no.: Other fuel a ppliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 �61 1`5-.7 , f 7 C" Flue vent for water heater ur gas fireplace 1 10.00 Log lighter (gas) 1 10.00 • Wood/pellet stove 10.00 Wood fireplace/insen 10.00 ROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 11.00 Other: I 0 00 • Name: � -eiG ./ 872 n Environmental exhaust and ventilation Address: Range hood/other kitchen • equipment 10.00 City /State/ZIP: Clothes dryer exhaust 10.00 ` Single -duct exhaust ;bathrooms, Phone:j, ) �3 ' / y j' Fax: ( ) toilet compartments. unlit:, ruomst 6.80 ee�`'"' ❑ APPLICANT ) CONTACT PERSON Attic/crawlspace fans 10.00 Business name: Other: 10 .00 Fuel piping Contact name: /0��77 jiM Q /11 /1 CC1I / /. $5.40 for first four; 51.00 for each additiouat . • Address: Furnace, etc. Gas heat pump City /State/ZIP: Wallisuspended/unit heater Phonc,5 ) c7 ? 7 61 Fax: : �� (,;') s? t ,--,7L) Water heater Fireplace E -mail: Range CONTRACTOR , Barbecue I Business name: 6 �J ' ,[ / / _. � / / 0 Clothes dryer (gas) . Il e /c//4 /2/ G /`7` 7 '7 7 r , v),/ Other: . Address: 1' e Q e v ,-,2, a . y 1 MECHANICAL PERMIT FEES* City /Slate/ZIP: 7/ D4' .?./ Subtotal Phone: ) R,/ �! , � ) Minimum permit fee ($72.50:! .,�) / t� 77 ! Fax ( �� l �/n Plan review (25 or permit feel _ CCB lie.: 7 / ,5:. 9 State surcharge (8% of permit fee) . C TOTAL PERMIT FEE Authorized signature: This permit application etpires if a permit is not obtained within 150 days after it has been accepted as complete. Print name: 5 (/i, 4 o..4 y a t e : #7 6 • Fee methodology set by Tn -Councy Building Industry Service Board 1 \Perm Is 1EC- PnrrOApo.doc 1703 / 4 I la2-/C0!dfµ'E9) Z•d OLZ0869C09 6ul.eaH eigt.unloo el V60 90 9Z inc .; .. s. ar HEATING & COOLING, INC. P.O. BOX 230397 • TIGARD, OR 97281 (503)624 -2704 SITE PLAN • ADDRESS: .J� c 0LZ0969009 6ugeeH elgwnloa eZI 60 90 9Z Inf CITY OF'TIG'ARD BUILDING DIVISION PERMIT #: MEC1tl( 00341 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/25/2006 Phone: (503) 639 -4171 / a m p. / ii v w i � Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 0/1/2006 TIME: 7 :02AM PAGE: 79 SITE ADDRESS: 10765 SW FAIRHAVEN ST CLASS OF WORK: SUBDIVISION: FAIRHAVEN COURT LOT #: p01 TYPE OF USE: PROJECT NAME: BROWN DESCRIPTION: Imstalla'tiori of NC unit. OWNER: BROWN, JANE PHONE #: 603-639.4360 CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 Inspection Request Scheduled For: Date: 8/1/2006 Pour Time: Code # Inspection Description • Confirm # Contact # Message 699 Mechanical final 034101-01 503.624 -2704 N Corrections /Comments /Instructions: %0 'Z ' i '_., i., a ; .L S — 5W-1- 1cld Czr - ��G- ASS I I PARTIAL APPROVAL ❑ CANCEL I NO ACCESS .1 I FAIL : CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: '�.� Date: - �i Phone #: (503) 718- `7-- 'rtc.-6