Permit C ITY OF TIGARD MECHANICAL PERMIT
;,�I� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00385
��' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/24/2005
PARCEL: 1S134CB-03000
SITE ADDRESS: 12270 SW SUMMER CREST DR ZONING: R -4.5
SUBDIVISION: SUMMER HILLS PARK LOT: 028 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: 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
WOLLER, CRAIG Description Date Amount
12270 SW SUMMER CREST DR
TIGARD, OR 97223 [MECH] Permit Fee 6/24/200: $72.50
[TAX] 8% State Surcha 6/24/200f. $5.80
Total $78.30
Phone: 503- 709 -0243
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Phone: 503- 624 -2704
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: -2 , Permittee Signature: .t..i c.oe
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business ha .
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.
Jun 24 05 08:39a Columbia Heating 5035980270 p.2
,
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Mechanical Permit A plication FOR OFFICE USE ONLY
city of Tigard R
13125 SW Hall Blvd., Tigard, OR 97223 R�� � D atrJB y �j �L)� �� I Perr°itNa `JI�CIJd� 5
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review •ln _
. „. ..,, Date/By: Other Permit
spcction Line: 503.639.4175
Internet www.ci.d onus L • :� Na Date Ready/By: keit // Supplemental see P Information
for
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•�• '. r� t�t'�.L���. ::s,:` :r: C�2►' IlV1EiI, ��F' �P. �.��1�$1- 14S}3�f."13tC- la',EST
❑ New construction (' Addition/alteration/replacement Mechanical permit fees` are based on the value of the work
Other: performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Othe
:t �..��'.. 4 eY ,� ,�:u� , . _� mechanical materials, equipment, labor, overhead, and profit.
p` NC ._. fir •;L_ .p .,. Value: S
- ....:..a _.: F9)1 '�` •,"yG�i3 .•a -•... � � ��� ..: . .:�.��:?: :T.1..; +t:... !-ti�rt� ia +i` i ^r _, �w r:..z•.
E1- and 2- family dwelling ❑ Conu ercialrindustrial ❑ Accessory building ''*`f 5 <Fj� N ! SY S FIE;ES•
El For special information use check/isi.
Y ❑ Master builder ❑ Other:
y.^ Wit.: ' :V 4 sir u,..r- v. ; Description I Qty. ! Ea. ' Total
i ► ,...: ., ..‘•' " � «' SeatinpJcoo[ing
"1°b site address: /0 7 0 5 .4A4 1/4 .. /� Air conditioning or heat pump
C 7 � (requites site plan showing placement) f 14.00
City/State/ZIP: Furnace 100.000 BTU (ducts/vents) 14.00
Suite/bldg./apt. aP t. no.: I Furnace 100,000+ BTU (ducts/vents) 17.90
8 Project name: Gas heat u
P mp 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system [ 4.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric), `
in -wall, in -duct, suspended, etc. 10.00
Subdivision I Lot no : Flue/vent for any of above 10.00
•
Tax map/parcel no.: Other: 10.00
Other fuel appliances
_
v h, ++•• -• Water hearer
::'r'd' --��{� 7t• _`�t;('+!?7?.!•;'i ���� . ��' klcS,s, �: �•.. � ter
�' ay • ^ h m, .T<,.t 10.00
�, Gas fireplace 10.00
S"-'>- --_i - 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
�j ib 9 gA w ,w.j: c� tti ..; 1Z : ► cf• k
W -r : r.. : i . �. .r. .•.-.L. r` :"•f" a Chimney/liner /fluelvent 10.00
'• , .. ;. 4..) r t t:. . .At •�.+ H: .:z s. Other
Name: �/ 10.00
a /�CiZ Environmental exhaust and ventilation
Range Address: A:72,--. 7/) ,S-7A./ . �r'•1 _ nw equipment hood/other kitchen
� !yv 4 iP 10.00
City/State/ZIP: l
Single-duct dryer exhaust 10.00
r tr
Pho S -) 7 > f l toilet e uct exhe
omparantt (bathrooms,
s , utility roo
SJ,� y-/-,,R � Fax: ( ) tcompartments. slity rooms} _ 6.80 _
:. , - .iii h f ?a+r l:> ,e,4a =„;`' " :te, , ,r ; � iii! r s:.∎ .4!S1,� Attirlcrawlspace fans 10.00
-Business name: Other: 10.00
Fuel piping
Contact name: /9 ,4 O.-/b/ SS.40 for first four; $1.00 for each additional
Address: Furnace, etc.
•
Gas heat puma
City/State/ZIP:
Wall/suspended/unit heater _
Phone (y ,03) ril"., V *2'7 0 t I Fax:: d3 .59( e9 7D Water heater
E -mail:
Fireplace
�'�ft i.+*�? ,- +.,.� age
WI; p 7u> FE3:.�' NVTgalfic? •Q. w. • c::.v' „ ..t4r ..i ;•:i ; : x:.f... ;;. 1.- . . t Barbecue
- Business name C...,=, AA ./41 6 /4, �04 #JC .s- - / •
Other: dryer (gas)
Address: 1 ,60Y. 3 6 .3 97 ° ' _6 Other:
.•: "il.?c1:: • °in. ti. .y... �_ a
city /state/Z1P: T _. 409-4.,r, 02. 97 r S3 s
ptm ( ) a �� Fax: ,(5b3 Minimum permit fee (5/2.50)
..50.E ) s > Get 7c. Plan review (25% of permit fee)
CC lit.: '74,9,1' 9 State surcharge (8% of g ( permit fee)
TOTAL PERMIT FEE I'7 ' 3 Q
Authorized signature: 17 rI,GSei r l e Q ►e. This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: /., �� /- Date: - • Fee methodology Set byTri- County Building Industry Service Board
L BlIadmatPervdLANCEC- PeradttApp.aDe 12/03 440.461Tr(IIIO21COM/WBB)
RECEIVED
aragnigie JUL 0 6 2005
CITY OF TIGARD
HEATING & COOLING, INC. BUILDING DIVISION
P.O. BOX 230397 • TIGARD, OR 97281
(503)6242704
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SITE PLAN
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ADDRESS / &
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CITY OF T'IGARD
BUILDING DIVISION PERMIT #: MEC2005 -00385
i .._...
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/24/2005
Phone: (503) 639 -4171 & A :4A ,. �� ,�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/22/2005 TIME: 7:09AM PAGE: 59
iyl sr
SITE ADDRESS: 12270 SW SUMMER CREST DR CLASS OF WORK:
SUBDIVISION: SUMMER HILLS PARK LOT #: 028 TYPE OF USE:
PROJECT NAME: WOLLER
DESCRIPTION: Installation of NC unit.
OWNER: PHONE #:
WOLLE CRAIG, 503-709.0243
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624 -2704
Inspection Request Scheduled For: Date: 7122/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 011923-01 503-624 -2704 N
Corrections /Comments /Instructions: �,y
M l^lo (C Z. Pty 3 S -ZS 2 1 s / - } -L: L -e
A (z_ K tea r-
�le__ vM�� - So M
._C" t .... t
PASS U P. RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL P 'ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 17, zi
Inspector: iw Date: Phone #: (503) 718-