Permit ,.
A CITY OF TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00275
h1. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/25/2005
PARCEL: 2S111 CC -20000
SITE ADDRESS: 10255 SW GREENLEAF TERR ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.5 LOT: 259 JURISDICTION: TIG
Project Description: AC install.
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:
ELE 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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MULLER, REGIS R + NEOMI JEAN Description Date Amount
10255 SW GREENLEAF TER [MECH] Permit Fee 5/25/2001 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 5/25/2001 $5.80
Phone: 503 - 598 - 3019 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97224
Phone: 503 453 - 4822
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
or 1- 800 - 332 -2344.
Issued By:
ZL d a � Permittee Signature: �j _ .:I _ /_ ! ` - mob
(
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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Mechanical Permit 4 I. iikatical .-,. FOR OFFICE ISE ()I.1' , • •
.--rt
-
Date/By:
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review'
Phone: 503.639.4171 Fax: 503.598.1960 - - Other Pennit:
4,4,, 11 Date/By: .
Inspection Line: 503.639.4175 MAY 2 . 4 2005 ,,ig_ii',.; I Date Ready/By: , • 1L16,1: IRS See Page i for
Internet: www.ci.tigard.oi.us . CITY OF TIGARD Notified/Method 116,4k Supplemental Information
•
,2 ---- , -- - - -, -- ,, e - •-.D. , •,v , ii4,4 -,,,, , ,,,, I.7.,,.... , 4„,...tli4•AitefitA;441-1tIi.01,4.-.:.._ ,, ,-..441.11..-- , - , ,..-',4 iaewisigka--'0 -- 4WitelIe - Igt - '6 , •'''''' .. '''''':• - "'''''"
, - .....__,....: :.....:I.4.1.........
Mechanical permit fees* are based on the value of the work
ci New construction Addition/alterationireplacement
• performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition I=I Other: mechanical materials, equipment, labor, overhead, and profit.
-4r....-3,.ak?5 Value
ONAEMOMPOPPRAt0416i#0*Mg0.4(0.gOlarnikrifigONTAW ----'"' ''."'.---="'---"-''''','"-,zi-'
Ail • dwelling D . ' • I=1 • • • ifitA*-4:
- and 2-family dwelling Commercialhndustrtal Accessory building
For special information use checklist.
El Multi-family ID Master builder ['Other: • .
Description I Qty. Ea. I Total
..- -------------- ----;.:;., - ;, --, :, - + - Hia ,, , - ...v.wiimel&W:kviv.ifig&:4:..,..Hin , ..gligil , , , ..4..:P.:
50. Heating/cooling
Air conditioning or heat pump .
Job site address: 1 u3 • C ‘,ex V-., , (requires site plan showing placement) 1 14.00
City/State/ZIP: -.--\--;.34...f-A -7/ Furnace 100,000 BTU (ducts/vents) • 14.00
I Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: 3 - 0.5 1 O
Gas heat pump 1,4.00
Cross street/directions to job site: &55 17) • Duct work 14.00
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. . 10.00
• • Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: . 10.00 .
Tax map/parcel no.: . • • Other fuel appliances . •
lititti:ltggtt1 Water heater • 10.00
. p.--: - ,7 - ,-..-:,4- t
t ' Gas fireplace 10.00
- A ck_. /6,', (- (Ov\A i 41 c "--• I \1 ,. Flue vent for water heater or gas
fireplace 10.00
, Log lighter (gas) . ' 10.00
'a. Wood/pellet stove 10.00
Wood fireplace/insert 10.00 .,
0
*6iiiiWi;'45Wi .iy. 1:::g4i ChiInuerlineriflueivern 10.00
, ii , :' ,, aiEirIE - 41h7: , - . "...... ,, V.^ . ,,,,,,,, ;(. 0 ' • •=i,,i'V' 71- Other: 10.00
Name: 4 ' CS A.AA,Ut( e---C - Environmental exhaust and ventilation : •
.(:),?--, - "in LA.) 1
N
. e--CAT 0(...t •As Range b ood/other kitchen
Address: 1
equipment 10.00
City/State/ZIP: / - T i c ... , ‘ „,,,.K , bc?------ q - 1 -0--(9-.1-( Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (675) 5 sc- 3 0 1 -- Fax ( ) . toilet compartments, utility rooms) 6.80
;Li;; tiR - ---„, Att fans • 10.00
•!7 .. ".:er.:1?tr '
Other: 10.00
Business name: r I •
C 11 W1 tek..+P _ .. C2 rVilr c==o \ Fuel piping
Contact name: K .A... .44 . .
&lurk ei....vvi . 55.40 for first four; $1.00 for each additional
Address: t t„ 5 6 L.43--) 7 42,14±_ 2tk-de__ .. Furnace, etc.
Gas heat pump •
City/State/ZIP: -.--
45 r t (U/NZ. / . P---- 9 - 7 g_9L4 Wall/suspended/unit heater
Phone: (5 Lf 5 - 3 -4/ ea.....„ Fax: : C3
Fireplace - .
E-mail:
Range
. ::4_:!.‹ ..7:-.....
I447:-,1,4!-.:4 Barbecue
•
d
Business name: 1; wy 0 .4,_ (..... Clothes ryer (gas)
Other:
Address:. ! /.., 5 0 , 5 U.) 7 l _--- .
':igfigfP:KgM,W.9:tgN KW !G7T.P.RIVOTROW9Art:3.5.7.47:054;
City/State/ZIP: ‘i "r \ cLv \_ A , D R_ e: - 7 :-?-t-1( Subtotal i -1 ti .------
, - . . Minimum permit fee (S72.50) . . - 79.. Sr..
Phone: (G76 L i:S - 3 - 44.S3• Fax: ( 503) CI C 5 - 74 -
Plan review (25% of permit fee)
CCB 1 ic.: (..., a ( e , • State surcharge (8% of permit fee) 6" , -
.... ., , - / TOTAL PERMIT 'FEE - 7.6 , --- •
Authorized signature: / "
. This permit application expires if a permit is not obtained within 180
-
days after it has been accepted as complete.
Print name: K..ck,+:1 .C-- (-4 to,IA - • AP Date: -5 ",,D 4 • . Fee methodology set by Tri-County Building Incluitly Service Board .
OBuildingTermits\MEC-PerrnitApp.cloc 12103
\ --..) .i. A
440-4013T (11/02/COM/WEB)
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I • ci .17aaL896Eos 3141 10d1W03 31WW113 Wd6i7:a sooa 1 7a ReW
Ma 24 2005 2:49PM CLIMATE CONTROL INC 5039687224 p.3
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CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MEC2005 00275
Phone: (503) 639 -4171 v N @gyp 5/25/2005
, Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
117
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 10255 SW GREENLEAF TERR LOT #: TYPE OF USE:
PROJECT NAME: SUMMERFIELD NO.5 259
DESCRIPTION: MULLER
AC install.
OWNER: PHONE #:
CONTRACTOR: MULLER, REGIS R + NEOMI JEAN, PHONE #: 503 - 598 -3019
IMATF CwIUTRD' IjV.0 503-4,53
Inspection Request Scheduled For: Date: Pour Time:
9/30/2005
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016968 -01 503- 153 -4822 Y
Corrections /Comments /Instructions:
' � — s _ - �a G is J `G JZG
ASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9-..50-695 Phone #: (503) 718-