Permit ri
4 A q CI OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00319
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2008
PARCEL: 1 S133DA -04500
SITE ADDRESS: 12580 SW GLACIER LILY CIR ZONING: R -7
SUBDIVISION: AMART SUMMERLAKE LOT: 067 JURISDICTION: TIG
PROJECT: BANTA
Project Description: Replacing 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
HOWARD & JOAN BANTA Description Date Amount
12580 SW GLACIER LILY CR
TIGARD, OR 97223 [MECH] Permit Fee 6/19/200E $72.50
[TAX] 12% State Surch 6/19/2001 $8.70
Phone:
Total $81.20
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
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: :/ � _ � �� P Signature: - /, GGt N
Call 03.639.4175 by 7:00 a.m. for inspections that business da .
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.
From ...,, i 06/19/2008 13:44 #986 P.001/003
.. -
Mechanical Permit Application RECE ...: .:::: : : - i' ,-,. ; .. . - .-qi , ::]:!:. : :::;:!.•.i.. , .' ,., ' ,. ;':.:'.0- 1 ...4 . 'iiii 61:,:i:ii-i i_.
.-:
1 D ; Ae /A111=M
, 13125 SW Hall Blvd., Tigard, OR 97223
9 200' 1
Phone: 503.639.4171 Fax: 503.598.1960 i ■MillMllIl= Other Permit:
.i. Inspection Line: 503.639.4175 CITY Of 116 ,,
1DtAteady/By: 0 See Page 2 for
. • • • Internet: www.tigard-or.gov
1::D li r ign, Supplemental Information
Ti' '.
1,i3iI;x1,N E, r: . 7
1 l i - r" , *:ifgAi 4; ,7.:tir.itifi7oZ , ;:iVii'f.'tilff,1`;'-'74 ...,;„,-,,,,. ,,,,et.i.....,„.,,. -4 4,' ;4%1., trr.;;F: ..„.
Mechanical permit fees* are based on the value of the work
0 New construction vErAddition/alteration/replacement
performed. Indicate die value (rounded to the nearest dollar) of all
EJ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
i fSengiatiriagen4c0:4 1 *#.04 " .t 1 01:00:0 11 7 1 1,01.*:"RigaiRONMEGII
.4-1 .RogliprnAL__. IP— rwn sr masiv.,It wrat,'
'Err- and 2-family dwelling P Commercial/industrial 0 Accessory building p
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
, Description I Qty. I Ea. I Total
ic - Heating/cowing
Air conditioning or heat pump
Job site address: kisito 6 G1 (.1 c
(requires site plan showing placement) ( 14.00 I 4 1
City/State/ZIP: 11%, ... r o 6R.... 471,21 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: rg c
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
1---3, hydronic) 14.00
Unit heaters (fuel-type, not electric), -.
W
in-wall, in-duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no ove .
Other: 10.00
Tax map/parcel no.:
Other fuel appliances
MT Water heater 10.00
G as fireplace 10.00 _
i s .. 1 t ... c .1.. Alt Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
',:p;• • ',•.tu,": Chinmey/liner/flue/vent
Itartri;o IC*70:4 9 ' oth„: 10.00
10.00
Name: i4.....,..-. 3 ..... -,. Environmental exhaust and ventilation
Range hood/other kitchen
Address: a s- re s,‘ (;; 64,4. I. i CA,-,(4._ equipment 10.00
City/State/ZIP: 07;. 5 ,,,, d a /2_ 472,L1 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) i Fax: ( ) toilet compartments, utility rooms) 6.80
RiNaint fM30*t.:41011#11::40:Wailaq, Attia/arnwisPaae fans 10.00 I
Other: 10.00 ■
Business name:
Fuel piping
Contact name: ....774_,( 5 , LI. 1 $5.40 for first four; $1.00 for each additional ,
Furnace, etc.
Address:
C ***- w 5 (.1.-$
Gas heat pump
City/State/ZIP:
Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail:
Range
EiniNARIENffi.agNiFt-4**64::::0°:)16 Barbecue .
Business name: Ait 1..k...eek,--h 4-- totAkNekdt Clothes dryer (gas)
Other: i
Address: Ze \ V\E. 11...ki.X.iv ii? ""
!E :11011704,12..**.trigiF;;:gigfi: ,
City/State/ZIP: re5Vri CLAkik 1:7!— 41; k1 - 24 7- Subtotal ) el
Minimum permit fee ($72.50) 72,P.:: ;
Phone: 1 77 ) .) 1s14 _ Lii 3 Fax: (rtela) 2
Plan review (25% of permit fee) 1
CCB lie.: -2.2.2... State surcharge (12% of permit fee) l'" 71-1— i
TOTAL PERMIT FEE
This permit application expires If a permit is not obtained within 180
Authorized signature: UTEEZ.+Citt.----•
days after it has been accepted as complete. I
Print name: V I CinctrA- A-lltAN. I Date: (.9..1.0 g * Fee methodology set by Tri-County Building Industry Service Board i
1: \Building \ Permits1MEC-Permi1App doe 01/19/07 4404617T (11/02/COM/WEB) i
m
o �
AAA Heating and Cooling Inc. Air conditionin g !Heat urn P P Site � 1J
2915 NE Martin Luther King Jr. Blvd.
Portland, Oregon 97212
503.234 -2173 ; P lan
ccb -222 _ - -,
C,,;
co property line
LIP
... house
24
l street S C bl
Customer:
' ti of
Address: its sit 6(4.c:40 ( :iY
•
E
0
i
-'o
0 ,
CITY OF TIGARD -. '
BUILDING DIVISION PERMIT #: FA - f008 03 i0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: €41912008
Phone: (503) 639 -4171 1 a
Inspection Requests (24 Hrs.): (503) 639 - 4175±+1
INSPECTION WORKSHEET FOR DATE: 7/30/2008 TIME: 7:01PAivf PAGE:
SITE ADDRESS: 12680 SW GLACIER LILY CIR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #• 0617 TYPE OF USE:
PROJECT NAME: BANTA
DESCRIPTION: Replacing A/C.
OWNER: BANTA, HOWARD & JOAN PHONE #:
CONTRACTOR: AAA HEATING & COOLING PHONE #: 503-2M-2173
Inspection Request Scheduled For: Date: 7/3012008 ' Pour Time: 9
Nf
Code # Inspection Description Confirm # Contact # Message �
1' f
699 Mechanical final 073426-01 503 -284 -2173 N
Corrections /Comments /Instructions: // [( `��` �j
U`ci -; CG / ` II r 1, Gl zt .2 � / / b
C 5.e_ ' f ". . - \c--- \
m -A SS ❑ PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
MI FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 13- Date: 3 A y OY Phone #: (503) 718- 2y23