Permit n,
C ITY OF TIGARD MECHANICAL PERMIT
�I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00406
11 DATE ISSUED: 7/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103CC -14600
SITE ADDRESS: 12051 SW WHISTLER'S LP ZONING: R -4.5
SUBDIVISION: WHISTLER'S WALK NO. 2 LOT: 093 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:
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
WILLIAMS, EDWARD Description Date Amount
12051 SW WHISTLERS LP
TIGARD, OR 97223 [MECH] Permit Fee 7/6/2005 $72.50
[TAX] 8% State Surcha 7/6/2005 $5.80
Total $78.30
Phone: 503 - 590 -9502
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Phone: 503 -538 -2953
Reg #: LIC 125815
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: y U - Permittee Signature: Sp
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.
Jul 06 05 11:48a 503 - 537 -2172 p.1
Mechanical Permit Applicatic , A FFICE USE ONLY
City of Tigard 1 1� ` N !E
13125 SW Hall Blvd , Tigard, OR 97223 "-
Phone: 503.639.4171 Fax. 503.598.1960, Date/By: Other Permit:
Inspection Line: 503.639.4175 1 (,,p o , __ e A II Date Ready /By. �) I lens El See Page 2 for
Internet www.ct.tigard.or.us ,) �J), �... Notifted/Method: v Supplemental Information
,// r TIGARD
' TYPE ,( i' `'M7) n( ViSIQ`t. i- CO ERCIAL *, SCREDULE - USE CHECKLIST
' "�-O I11 Mechanical permit fees* are based on the value of the work
El New construction ddltlo tea teration / 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: S
__,� - RESIDENTIAL EQLIPMENT /. -SYST EN S FEES *'
, Lilly ad 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other. Descnption Qty I Ea. I Total
- ' , '- ] JOB SITE Lis FORMA TION LOCATION Beating/cooling
1111 �r � 1, () i 1 ✓S LCiap c ondite p g or heat ump i 14.00 i L
Job site address: L wires site tan showing placement) t
City/State /ZIP. t. .1-4/ 1ZZ 7 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00 _
Unit beaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 10.00
Flue/vent for any of above 10.00
Subdivision: 1 Lot no.: Other. 10.00
Tax map /parcel no.: Other fuel appliances
" pESCPJPTIQN bF WORIf _ Water heater 10.00
" i l � "}�uJ � J ) L� J ( i.4L -h cyl Tom Gas fireplace
' Flue vent for water heater or gas 10.00
fireplace 10.00
Log lighter (gas) 10 00
Wood/pellet stove I 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
, I100/PROPERTY O _ ,OWNER , ."7--.. ` `(].. P ANT, ` Other 10.00
Name: ' ; L14 ( 1' LL. ! r,( �` -ri— _ Environmental exhaust and ventilation
V ` s Range hood /other kitchen
Address: 1 �� `�,( 5 't �/� (�(, equipment 10.00
City /State/ZIP: l I_CI 6j 17 z3 ' Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: V)3 w°4-10 -- �Z— Fax: ( ) toilet compartments, utility moms) 6.80
' ''... • : ' „: IVAPPLICANT ' - - -- .I . i tCONTACl;' PERSON Attic%rawlspace fans 10.00
' l f; f] ,� „ Other. 10.00
Business name0, t l i Q f] ( � �` J n,�l� I Fuel piping
ccc"�" P P 1;
Contact name. }/�,�� $5.40 for first four; $1.00 for each additional
a Furnace, etc.
Address: g .:4 ` Gas heat pump
City/State/ZIP: JL I `/_, , 6 G n' L S Wall/suspended/unit heater
Phone )2,) r3S RoL., . J3 Fax:: ) C 3� z,/ � - Fireplaceater
E -mail: Range
C s 1 ITRACTOR • -' Barbecue
siness name. t ; '}Y /, (3_4), (jy Clothes dryer (gas)
Bu ri Other. I
Address: 1k `Z t) •14ECH.4IYICAL PERMIT FEES* - -
. ,
City/State/ZIP' Mt/1'11'14 _ 0 _ (/ 11 I LS— Subtotal 1 Li
C/ W — i Minimum permit fee ($72.50)
Y 11
Phone 3 � a3 t d3 Fax l '�,) 1 S 3'`7 Z l 7 Z
Plan review (25% of permit fee)
CCB lic.: I , • l < J State surcharge (8% of permit fee) 5.- U
L! I s TOTAL PERMIT FEE 7 7
Authorized s" • attire: , This permit application expires If a permit is not obtained within 180
C � � ' M i g 1 I , days after it has been accepted as complete.
Print name: t7Llt yifil��N� Date: J�j . `��% • Fee methodology set by Tri -County Building industry Service Board
� l 1 i��
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Jul 06 05 11:48a 503 - 537 -2172 p.2
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I
C"i 1
CITY OF TIGARD . ,
BUILDING DIVISION PERMIT #: MEC2005 -00406
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2005
Phone: (503) 639 -4171 � L
.N1d7 l I
Inspection Requests (24 Hrs.): (503) 639 -4175 . `'f
INSPECTION WORKSHEET FOR DATE: 8/12/2005 TIME: 7 :06AM PAGE: 78
SITE ADDRESS: 12061 SW WHISTLER'S LP CLASS OF WORK:
SUBDIVISION: WHISTLER'S WALK NO. 2 LOT #: 093 TYPE OF USE:
PROJECT NAME: WILLIAMS
DESCRIPTION: Installation of NC unit.
OWNER: WLLIAMS, EDWARD, PHONE #: 503- 590 -9502
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 - 538-2953
Inspection Request Scheduled For: Date: 8/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013390 -01 503 - 701 -2167 N (,,0/ Arpg ,'�
Corrections /Comments /Instructions: �'�I ( !1/
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tLi PASS 46 , El PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
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I ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: fl Date: Phone #: (503) 718-