Permit a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2007 -00166
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/27/2007
PARCEL: 1S134DC-12000
SITE ADDRESS: 11375 SW SUZANNE CT ZONING: R -4.5
SUBDIVISION: CASCADIAN PLACE LOT: 009 JURISDICTION: TIG
PROJECT: CARTMILL
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:
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
RANDY CARTMILL Description Date Amount
11375 SW SUZANNE CT.
TIGARD, OR 97224 [MECH] Permit Fee 3/27/2007 $72.50
[TAX] 8% State Surcha 3/27/20W $5.80
Total $78.30
Phone:
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: Permittee Signature: fj-h
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.
art y1 F i�
(c4 'Mechanical Permit Application r.
City of Tigard 1� � 9 �1 � f
I'i ml1 I • V 1001 Dale/By: 3 aZ ! e / 8 6 vomit No. - - C / We
13125 SW Hall Blvd, Tigard, OR. 97223
Phone: 503.639.4171 Fax: 503.598.1160 r , ,, y� D Plan R
y Other Permit:
1 ! c i A F b Inspection Line: 503.639.4175 t , Y it �a � Ea
Date ReadyBy: nrir. Ed See Page 2 for
Internet www.tigard - or.gov I T r p: f a (�
qr Notified/method, ' I Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' arc 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: Y 7
o 1- an m
d 2- family dwelling ❑ Comerciaiindustrial ❑ Accessory building RESIDENTIAL EQUIPiHENT/ SYSTEMS FEES
12 Other;
For special information use checklist.
❑ Multi - family ❑ Master builder
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /' 9 / C + Air conditioning or heat pump
77.5 „/ i4J g ;(z is/ f/'L [may (regLares site plan showing pinoemenl) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg. /apt_ no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: • Duct work 14.00
Hydronic hot water system • I 14.00
Residential boiler (radiator or 1
' hydronic) 14.00
• Unit heaters (fuel -type, not electric),
•
I in -wall, in -duct, suspended, etc. 10.00 '
Subdivision: Lot no.: Flue/vent for any of above I 10.00
Other: I 10.00 .
fax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
. /,r/ l � / Gas fireplace ent 10.00
Flue vent for water heater or gas ■ i
_ fireplace ' 10.00
Log lighter (gas) 1 0.50
• Wood/pellet stove 10.00
i Wood fireplace/insert 10.00
•
•
• FBROPERTY OWNER I ❑ TENANT Chimney liner /tlue/vrnt • 10.00
`C A Other: 10.00
Name: 4 A/ (/// Environmental exhaust and ventilation
Address: Range hood/other kitchen -
' equipment 10
City/State/ZIP: Clothes dryer exhaust 10.00
Phoney )Q27 7 SO / F ( ) Single duct exhaust (bathrooms,
[[[[]]]] �`� ! `r toilet compartments, utility rooms) 6.80
APPLICANT I ❑ CONTACT PERSON Anic /crawlspace fans 10.00 .
Business name: Other 10.00
Fuel piping
Contact name: / i n �/ Up $5.40 for first four; $1.00 for each additional
Address: . Furnace, etc. I
Gas heat pump
City/State/ZIP: Wall /s
tlspcnded/uail heater •
•
Phone:
a 4 )q - �7 V !L I F ax: : P S �Q p -- 6 p. � 6 W a t er heater .
E -mail: r fa Fireplace
Range
CONTRACTOR Barbecue
Business name: p - d• • C / fJ ! r Clothes dryer (gas)
Address:
40 At-0711#1 nu # Qyl Other.
6 K e2 -3 D MECHANICAL PERMIT FEES* .
City /State /ZIP. /L 1 U c) - 7,?-., / Subtotal
Ll
Phone: (7)3) 6, ...--a"7 `� 0 Fax: I f) -- 0 77D Minimum permit fee ($72.5 v J 7 / V Plan review (25% of permit fee) ) ,
CCB tic.: 7$ 3,. 9
+ State surcharge (8% of permit fee) TOTAL PERMIT FEE a
•
-Z )' ✓ r/
Authorized signature: �� This permit application expires if a permit is not oblained within ICU
I �f / z ;C
Print name: days after It has been accepted as complete.
,/,, n I Date: - 63,26 / 47 I • Fee methodology set by Tr County Building Industry Service Boarc
i:,BoadingVenni e- permitApp doe 04106/06 440- 4 (1 �it02/t /PNWF.B)
Z OLZO 969 ONI1d2H viewniOO e£9 :OL. LO 9Z -I8 IN
HEATING & COOUNG, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
£'
SITE PLAN
J
ADDRESS: //37s' ,Sw' ,S UJ zei.1),Ii.e C7
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00166
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27/2.007
Phone: (503) 639- 4171 ll$
Inspection Requests (24 Hrs.): (503) 639 -4175 "I L�
INSPECTION WORKSHEET FOR DATE: 4/3/2007 TIME: 7:00AM PAGE: 56
A N - r 4 6A2149
DDRESS: 11375 SW SUZANNE CT CLASS OF WORK:
SUBDIVISION: CASCADIAN PLACE LOT #: 009 TYPE OF USE:
PROJECT NAME: CARTMILL
DESCRIPTION: AC install.
OWNER: PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503. 624 -2704
Inspection Request Scheduled For: Date: 4/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa•e AO 699 Mechanical final 045892 -01 503.624 -2704 I-IL/CI
Corrections /Comments /Instructions:
111Ato 1 L2 # 1 Zz -
/ li e
M /(/, 28 . � t vi ms ,f7›
Gig
PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑
FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: r 07 Phone #: (503) 718 -
•