Permit t
rt /� �
C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006-00353
DATE ISSUED: 8/1/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S133DA -02600
SITE ADDRESS: 12855 SW GLACIER LILY CIR ZONING: R -7
SUBDIVISION: AMART SUMMERLAKE LOT: 048 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:
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
KEN WILKERSON Description Date Amount
12855 SW GLACIER LILLY CIR
TIGARD, OR 97223 [MECH] Permit Fee 8/1/2006 $72.50
[TAX] 8% State Surcha 8/1/2006 $5.80
Total $78.30
Phone: 503 -524 -3819
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -9602
FAX 503 -557 -2990
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: L> P Permittee Signature: �A, p) g
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.
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i-FPi3M :-TEMP FAX NO. :5035572990 Jul. 31 2006 04: 06PM P2/3
07/31/2006 1445 FAX 5035981960 ' - CITY OF TI GAO 001
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City of Tigard Ig,‘dil.- D.e 7 -- - i , , -fr - A --it 14..INte,e.,,zeog. -'3, 13125 SW Hall Blvd., Tigard. OR 97223
w 3 1 7 ..' 36
Phone 503.00.4171 Fax 503598.1960 3 ,.., ,... ITil illIll1=1111 Mar Pennit
Inspection Line; 503.634.4175 Aft 1 j , r v .rs, : et See Page Z 110P
Internee treite.thperd-or gov evi'N/ 0 nNIS
. - kil:INIIIMNI dupplcoseritil infOrinatinn
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130 -
,: A■tv• , .1?.. - 4 * * ,,. ' : „ . , '' 7 r 6 argiiii;iW :7100 iliati OVA *
I " borad art the value oldie work
0 New cons AffAi4111taiirdan/replaocmc11t performed. ladieate thg value (rounded Tv the nearest dollar) of all
0 Demolition I Other: m ,,,,b an i ca t materials, eeitMaramt labor, overhead, andfuralit.
t . 1, ; v.! of i g o pe."71. , . tw. ;,-- : s. ... - , ' :., .,- . . . value: s .
,- ,..4,10,armr440***seir git*Ossliite.
VI,1- and 2-family dwelling 0 Conunacial/industtial 0 Accessory building
AV giecial ietfbneedion use ahadlio
0 Multi-family 0 Master builder 0 Other: , Basoription 1 Qty, I , Ea_ 1 Total
171 , , ,,, r , . i.; tibedt ' 1 ' ., ''. 1 iimatig000thig
- .
Job site withesz Z_i'L3C e 1 , / C . CIYILL4 Air conditioning crr heat OUtng
1 14.00
.4 , (ropdms site plug shawitiorcarttano
CitY/Statle 17440(rA i OYL., el`7222 ti,„„... 100.000 BTU (dkailvvogl, , 14.00
. Amapa 100,000 STU (dnetsivea) 17.90
suitotbldg./apt uo.: Project name; I' t .
ILwv.,..,6),7) Goa heat pane la ()O
CMS streathlireetions to job site: Duct work 14,00
Hydrunie hot wino swam 34.00 _
__ Residential boila (radiator or
hydrealo) 14.00
....--
...-- that haters (thel-typc, neracctrio,
in-wall, in-duct,zwended. eta- 10.00 , ,
FluishomE for any of strove 10.00
Subdivision: Lot no.:
_.....--- - -
Tax map/parcel no.; Oder &dap:414nm _
77 77771 - 1 Rt o t s beyikliciir , dariiiipoonise. 1,. : 0 1 . ! V' q.1 . -, "Ag h 1000
. .,..
_,...,...., . ,
_ ........ctifizra.)________
'''"''
vent water heater or
no gas 10.00
...4M3Iace 10.00 ,
__________- Log I IOW OW . 10.00 -,-
Wooddstikt stove 10.00
-.-.--- --,
Wood figulacelitaket 10.00
1-1111inerifluttIvour , 10.00
• . .. - .,,,, ;.,zr .: . , :,.. • . :" .,,, : .., . . : ,," • „, - ,- ,...,, • :,... -
Name: . ' 110 1 I (1--0)/SaY) -----
, Eneiria#ed ventiladoit_
_
lta kitchen
Address: ' ' rc < , A .C.- e/ _ A i t- . 10.00
_.... - codeine:It
City/Stata/ZIP: -- 1 - t ,. . f a , 0- cr--72_ J.. Clothes dryer exhaust 10.00
• Singioduct *Ong (bathrooms,
PhoTlw ( -
2 ) %-- - 3 s-,t q Pax! ( ) toga comparanem otilitylm jou 6.80
_ . .. .i' '! ' ...; . ' .,7 , , .„ ..,', .:.1:1 rEgserfir . ::.. -. Apfrastri.m. n. . ei - , 10.00
_, - Other: 10.00
Business name: A-. Telm... e w c,-,_-_- t ,,,,,, ) A., (DOIIC\--7))- Feel alpila ..
Contact ire; _Ctit.,/1 I ... VC.- k..... - ,,,,.....„ far tint ifnun SLOO for eoteb Withonal
--
Furnace, etc,
le_uldress;_l to GO 6 .-- IY ( Z . : - r - . C/01 hot pony
Ci '0-ACLQ- te_aitArLa. (5ye,_ (-2t2Lc.,_ i hot&
-----_______,-------- -,... 1
Phone: (G5j).3 ( ./9 .1....) L 6 -2_, Fax: : ( 5;1)23,. 7 - 2,5:n D :,_v_Istussit,
2
E.mail: Range ,•
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' - Clotho drYar (1E)
Business pan; , ,
ita„ •
Address: - -7
, iii I a Ilk r, ..*-.;,,c,. .1) ill'i . ...; ; R.. '`; • .',1• .1.. 't . ■:''',' ' • J * 1 :t:: . '., .. ' , 7 1 j r , : .:
4. ' ' 0 I - --" '- W. 'p ,--.., ......-.,... .a. 0
Subtotal
CO/State/MP: -
minimum permit fee ($'72.50) -) .)- .5'
Phone. ( 1 Fax: ( ) --
- Pain soviets (25% of permit fins)
CCE421e.: 1C7 ______
1 Mate surcharge (8% of Permit fL
-
- '' -/ TOTAL mwtheIT FEV. ;- - C.)
I - , pylA) (AC._ ! Tbis perenit Application expires If A "Mat is nst Owned within 1$1)
Authorized 3IS .
1Sature! days after it km eval acasetad a'S couiPletft
-. •
* Fee mediedeleay act by Td-County Stildlnu Isdustri Servise stromm
Print naiad: IV ■ i, Ci O 1 M. ) , II
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/-ROM:A -TEMP FAX NO. :5035572990 Jul. 31 2006 04:07PM P3/3
A Temp Heating & Cooling Inc
SITE PLAN
Prepared by: Date: 7J /
Customer Name: /4 1.L evs.,,,., Address
Customer Phone:5 o3 2 u7'• -c2�� _ (54--d " 7z 2 � .,..
Property Boundary Line
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4t
House
V'.
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4
3 5 .
Street ru
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MF 6-003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1/2006
Phone: (503) 639 -4171 , l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 0/•11/2005 TIME: 7 :06AM PAGE: 77
SITE ADDRESS: 121366 SW GLACIER LILY CIR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #: 04B TYPE OF USE:
PROJECT NAME: WILKERSON
DESCRIPTION: Installation of NC unit.
OWNER: WILKERSON, KEN PHONE #: 603
CONTRACTOR: A-TEMP HEATING & COOLING PHONE #: 503,650.9602
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 0347813-01 503.254 -6265 N
Corrections/Comments/Instructions:
0 & //4/ wr. a .a& 4 L7A./, 5 97/ e.6 f�.r2 , yr �,�C
ASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS
1
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: , Date: / /•� Phone #: (503) 718- 2