Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00435
� .� � I 13125 SW Hall Blvd., Tigard, O 97223 (503) 639 -4171 DATE ISSUED: 7/1/2004
PARCEL: 1S133CD-08800
SITE ADDRESS: 13865 SW CRIST CT
SUBDIVISION: COTSWALD MEADOWS NO.3 ZONING: R -25
BLOCK: LOT: 111 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A /C, do not place within the required setbacks
Owner: FEES
JOHN TYSON Description Date Amount
13865 SW CRIST CT [MECH] Permit Fee 7/1/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 7/1/2004 $5.80
Phone: 503 443 - 6156 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 453 - 4822 Final Inspection
Reg #: LIC 62196
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.
Issued By: Permittee Signature: /"/
Call (50 639 -4175 by 7:00 P.M. for inspections needed the next busi ess day
,
Mezhailical P 'iirifittWifilitation • - Received FOR OFFICE USE ONLY • _ ,
Mechanical
JUN 2 Date/By: Permit No : a e -
1 ,
Planning Approval Building
City of Tigard 200i Datc/By: Permit No.:
13125 SW Hall Blvd. CITY Plan Review Other
Tigard, Oregon 97223 B'p' OF T,.
D'ill " --"ARD Date/By: Permit No.:
Phone: 503-639-4171 ax: Sug504%9601 '. . 4 Post Land Use
Internet: www.ci.tigard.orms L ,A1 ,... .1
1
_ ./7 Date/By:
Contact Case No.:
luri,,s.4: 1:3] See Page 2 for
24-hour Inspection Request: 503-639-4175 """ -""- Name/Method: , /12_ Supplemental Information.
::',Vetl'OPLIVORIC•.!'.;W::.::::"l'j'k...:::....:' .:l•-..:,i,;!;COIVIINitIVIU'Otsii:=SOLLtift.Mgilln.,(AttflaW St -,:l4,.
LI New construction 0 Demolition Mechanical permit fees* are based On the total value of the work
i Tip ' ddition/alteration/reaacement D Other: performed. Indicate the value (rounded to the nearest dollar) of all
!'il!*W'.:;: N§.ge:Ai_Mat.i.7 rg.0 : mechanical materials, equipment, labor, overhead and profit.
& 2-Family dwelling 0 Commercial/Industrial Value: $ See Page 2 for Fee Schedule
0 Accessory Building 111 Multi-Family :::,• .ESI 0415Zit)1411:10111'.7:SYSMIVIMONSOlktUTIWRi
Description I Qty I Fee(ea.) I Total
0 Master Builder El Other: Heating/Cooling
0:6;;IMOVS.Iniagg3M03.90014002§0DI4.::i!:iW;?-•`; Furnace - add-on air conditioning** ..... 14.00 .,5; " 56-
Job site address: 131 03 Lc t SA Li-. Gas heat pump • 14.00
Suite #: 1 Bldg./Apt.#: Duct work 14.00
Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions to job site:
(for radiator or hydronic system) 14.00
.. .‘
bk) OA ntA+ I' Cct 5t- Unit heaters (fuel, not electric)
(in wall, in-duct, suspended, etc.) 14.00
Flue/vent (for any of above) - 10.00
Subdivision: . . Lot ii: Repair units . . 12.15
Other :EnevAppliance ' ....
Tax map/parcel #: Water heater 10.00
rltuottomo Gas fireplace 10.00
III rte.u> AG 1)-1/%4 ailtd■ Flue vent (water heater/gas fireplace) 10.00
Log lighter (gas) 10.00
LAX^ Wood/Pellet stove 10.00
_ Wood fireplace/insert . 10.00
Chimney/liner/flue/vent 10.00
k:17460:04MCNOSAMA:C'!'!Ifil it RIMOS1P :' Other: 10.00
,
.: RiivironmentatEihauit:ittVeatiliithip
Name: Z 1 Ty 5 0 vl Range hood/other kitchen equipment 10.00
Address: i 3 2, u 6 5Lo 6., c s‘ .5-I (L4-. aothes dryer exhaust 10.00
City/State/Zip: - 1 - 1 - A.04-e,l k , c R. ci, i ..-._14 Single duct exhaust
Phone: 03 - Li 3-'-6,1, Fax: (bathrooms, toilet compartments,
gc- '''). ; ,5%; ":0M I1I :sotmok _ ,,.... utilit rooms) 6.80
Name: C 6__,4 n 4...„, t Attic/crawl space fans 10.00
Other: 10.00 I
Address: ( t 5 t _o - 7 3 A.A. 7 1‘...._
• .:. • ..:- . , ..FUel tin ' ..... . : • .-
City/State/Zip: ci), ., 6R___ 9 - 7.p.o, q **($5.40 for first 4, $1.00 each additional)
Phone: D3 Ai 53 - 1,60-,; Fax: cl) - .7 Furnace, etc. **
Gas heat pump **
E-mail: Wall/suspended/unit heater **
..:1-•:'•„:::•:.::;•-f;1.;.--.:':_••:S4H;:,'..:;1;:40.SitUdraD'''it.irlirs..:':::::'''.''f;: . _ Water heater **
Business Name: CI ;„A,A.A4-e__ Cor-A-c--6 Fireplace **
Address: i/A7S t..;0 . 7.:) " \ Ali-e--' Range ■le *
, Blip **
CifyiStatC/Zip:"Fo c-4-kaAAA , 6R__ 9 -
/ Clothes dryer (gas) ** .
Phone: 53 - 43 g -- 1 -12:3;1.. Fax: s 3 __ 16, g - -7,,,.. Other: *5
CCB Lie. #: Total:
Mechanical Permit Fees*
Authorized , . j j
Signature: lira -1 iii,/, '; I 4 W , 9"1 A 7 Subtotal: $ - 1 7 ) .00
I ,.. ' Minimum Permit Fee $72.50 $ 7,D. , .5
Kst4i ___, 41iH1 ,
4. Plan Review Fee (25% of Permit Fee) $
(Pleas print name) State Surcharge (8% of Permit Fee) $ .
TOTAL PERMIT FEE $ -- pli , 3 o
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
180 days after it has been accepted as complete. **Site plan required for exterior A/C units.
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CITY OF TIGARD
BUILDING DIVISION - PERMIT #: MEC2004 -00435
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1/2004
Phone: (503) 639 -4171 ! .. tt ��qu��i;�pit° ,I .
Inspection Requests (24 Hrs.): (503) 639 -4175 J .. - 2 L.
INSPECTION WORKSHEET FOR DATE: 4/16/,' 06 TIME: 7 :08AM PAGE: 63
SITE ADDRESS: 13865 SW GRIST CT CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 111 TYPE OF USE:
PROJECT NAME: TYSON
DESCRIPTION: Install exterior NC, do not place within the required setbacks
OWNER: JOHN TYSON, PHONE #: 503 -443 -6166
CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503-453-4822
Inspection Request Scheduled For: Date: 4/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 004633 -01 603 - 453.4822 Y
Corrections/Comments/lnstr ', ., .,
Mill
PP ASS ji PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL 111,CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/S0 l� I- 7
Inspector: _ Date: Phone #: (503) 718-