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Permit
S P. C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00350 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/28/2006 • PARCEL: 25111 CA -10200 SITE ADDRESS: 09823 SW KABLE ST ZONING: R -7 SUBDIVISION: TAMI PARK LOT: 009 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: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES RON BOSSERT Description Date Amount 9823 SW KABLE LN TIGARD, OR 97224 [TAX] 8% State Surcha 7/28/200E $5.80 [MECH] Permit Fee 7/28/200E $72.50 Total $78.30 Phone: 503- 684 -4033 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: 12 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. Mechanical Permit A plication RECEIVED Recd ©U 6t- 2Jl./6� 3� City of Tigard !/ R D: e.By eive: Permit No �� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4 171 Fax: 503.598.1 2006 Other Permit �UL 2 7 U r"r"' ' 'fltlld I Date'By: Inspection Line: 503.639.4175 L. p „ ! , ,, � � Dale Ready /fty. lnne. ® See Page? fur Internet. wuw.ci.tigard.or , us CITY OF TIGARD t otnled:3vlathod: ..y) Supplemental Information ■ BUILDINr fLwclnnl TYPE OF WORK COMMERCIAL FEE* SCHEDULE -- USE CHECKLIST Mechanical permit fees" ate based on the value of the work ❑ New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT I SYSTEMS FEES' ❑ 1- and 2 - family dwelling ❑ Commercialfindustrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. 4 Ea I 'total JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: gQ �{ /e4 ' 4/114/ Air conditioning or heat pump / p l/ f !� / / !/� H 1requites site plan o r i placement) / 14.00 CCitv%State/Z]P: Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,0004- BTU ;dtcts;venist 17.90 Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00 • Cross street/directions to job site: i Duct work 14.00 Hydronic hot water system 14 00 ' ' Residential boiler (radiator or I ' hydron ix: ) 14OC ! Unit heaters (fuel-type, not electric). ' in -wall, in -duct, suspended, etc. 10 0C Flue /vent for any of above t 0.0C Subdivision: Lot no.: - ' Other: 10.0C Tax map /parcel no.. ! Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 -- // Gas fireplace 10.0C / / �7/_ /� G^ Flue vent for water heater or gas fireplace OAG Log lighter (gas) 10.00 . Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ROPERTY OWNER El TENANT Chimney/liner/flue/vent 10.00 (((((( Other: 10.00 , *lame. , .461 -55��-1/ Environmental exhaust and ventilation Address: Ranee hood /other kitchen equipment 10.00 Cily'StatciZ]P: Clothes dryer exhaust 10 00 ' / Sinele -duct exhaust Ibathrooms, Phone$? ) /f � cl 3 Fax: ( ) ! toilet compartments. utility rooms) 6.50 ! ✓✓ E:1 N APPLICAT l / .22 CONTACT PERSON Attic. /crawlspace fans 10.0C Business name: Other: 10.0C Fuel piping Contact name: /9 24 /61 1 $5.40 for first Cour; 51.00 for each additional • Address: / Furnace, etc. ' Gas heat pump • City /State/ZIP: Waft/suspended/unit heater . Phone ) G 11 rzi?1-70 Fa : n;;') S? , 77) • Water heater i Fireplace E-mail: Range CONTRACTOR Barbecue 1j / • Clothes dryer (gas) Business name: / ? ///C! bi G [0' ,7 7e- � 2/) / /, � Other. Address: i / OX 3 a . 9 y I MECHANICAL PERMIT FEES* Cily /State /ZIP: T9- Q� �� / Subtotal 1 �1 Minimum permit fee ($72.50) Phone: •( y) G T� / Fax: ,,(2,,:i .� ) � C ✓t .. Q Plan review (25% of permit feel CCB lie.: 7/G _ 5 C1'j State surcharge (S% of permit fee) L TOTA PERMIT FEE l 7� --.7 4 Authorized signature: This permit application expi res if a permit is nut ubtninrd o'itltia ISO days after it has been accepted as co ruptele. Print eatneA) ,(,� 4 z:7,41,6/ ate; /) 1 �/b • Fee methodology sot by Tri- Count}' Budding Industry Service BJarii i.tfsuildinh\Permi,i Sel °_C- ' P ` ermitApp.dec 17.07 440-461 Tr ;11 /0?JCOM:WEO) Z'd 0LZ0869E09 6ul }oaH eigwnIoo dZO :ZI. 90 LZ Inf • ar HEATING & COOLING, INC. P.O. BOX 230397.1IGARD, OR 97261 (503)624-2704 SITE PLAN ,11 . 0 . ADDRESs: 9 � s /74 6A- / £'d OLZ0969£09 6uileaH eigwnlo3 dZO :ZI 90 LZ Inf CITY OF TIGARD BUILDING DIVISION t . PERMIT #: MEC200 €-00360 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2006 Phone: (503) 639 -4171 10 µnt jm ill (r Inspection Requests (24 Hrs.): (503) 639 - 4175''' I .. INSPECTION WORKSHEET FOR DATE: 1/4/2007 TIME: 7:OOAm PAGE: 28 SITE ADDRESS: 09823 SW KABLE ST CLASS OF WORK: SUBDIVISION: TAMI PARK LOT #: 009 TYPE. OF USE: PROJECT NAME: BOSSERT DESCRIPTION: Installation of NC unit. OWNER: BOSSERT, RON PHONE #: 503. 61344033 CONTRACTOR: COLUMBIA HEATING & COOLING INC . PHONE #: 503-624-2704 . Inspection Request Scheduled For: Date: l/412OO7 Pour Time: Code # Inspection Description Confirm # Contact # Me = 699 Mechanical final 04 -02 503-W4-4033 Corrections /Comments /Instructions: dilp . 04( • ►� PASS PARTIAL APPROVAL I I CANCEL NO ACCESS n FAIL fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Ckfi Date: f / Phone #: (503) 718- __