Permit CITY TIGARD MECHANICAL PERMIT
��► DEVELOPMENT SERVICES PERMIT #: MEC2004 -00479
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/21/2004
PARCEL: 2S103CC-14200
SITE ADDRESS: 12071 SW WHISTLER'S LP
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 089 JURISDICTION: TIG
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install new A/C unit.
Owner: FEES
HOWELL, SUSAN Description Date Amount
12071 SW WHISTLERS LOOP LN [MECH] Permit Fee 7/21/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchari 7/21/200 $5.80
Phone: 503 - 521 - 8553 Total $78.30
Contractor:
A- ACTION HEATING
18240 SW TV HWY
ALOHA, OR 97006 REQUIRED INSPECTIONS
Phone: 503 649 - 3524
Reg #: LIC 78369
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.
Issued By: � Permittee Signature: j� --C
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busihess day
Jul 20 04 12:56p TIM MULLEMIX 5036496095 p.1
Mechanical Permit Application : ()I; () r 1 1, 1: 1 H O \ I ,
City of Tigard • Received
PermitMo:V \.6C,7 ad 5/7
13125 SW Hall Blvd., Tigard, 0 R 9 E C E 1 V (� i .•��..:.. Plea Review
Phone: 503.639.4171 Fare 503.598.1' • L �CC DmdBy
on Line t
Inspection 503.639.4175 4.),1.. , - (Ii. Date Ready/By: Sore: 1 1a See Page 2 for
Internet www.ci.tigard.or.us JUL 2 2004 ' ' 4mprl tInformation
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction gAdd' Y r 1 u Rt, Mechanical permit fees* arc based oa the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Otg mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: S
RESH/ENi1I7AL EQUIPMENT / SYSTEMS FEES`
K l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For use checklist.
Multi - family ❑ Master builder ❑ Other. Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or Job site address: 1 pC.O "1 1 ' 5 . 0 100,.\.4 6+ 14.2 -,5 Lode LAP am
c site rhoowinga -) I 14.00 lg.°
City /State/ZIP: - ri J A i O . - CI - a - a 44 Furnace 100,000 BTU (aaa Bare) 14.00
Furnace 100,000f BTU (daeta/vmas) 17.90
Suitelbldgiapt. no.: I Project name; Oas heat Pump _ 14.00
9-11,- Cross street/dire ctions to job site: 1 1 Duct work 14.00
Nydmaic hot water system 14.00
Rcsidcrdial boiler (radiator or
hydronic) 14.00
Unit healers (fuel-type, not electric),
in -wall, in -duct, suspended, etc. 10.00 _
Subdivision: I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map/parcel no.: Other feel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
y..)5'W' A 1 'la_ - re).,) r1/4- f �'. Flue vent for water beater or gas 10.00
Log lighter (pas) 10.00
Wood/pellet stove 10.00
Wood fueplacc/insert 10.00
J a limney/limet/8arhree t _ 10.00
PROPERLY OWNER ❑TENANT Other. - 10.00
Name: v (�, 1/►- 51-0 U p (A) , 1 I}ltvirnamenled exhaust and vela ien
RlingP
Address: 1 9--0 1 1 C) /A) Lk) kas4-1 ie cs c_ode Lk1,AJ hood/other kitchm 10.00
City/State/71P: --Ti ctokiajl. . 9 "1 , -a'i cubes u 10.00
Phone: ( ) 5a. I , J.‘. Ts-6 Fes ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT Ft CONTACT PERSON Atticlerawlspace fans 10.00
Other: 10.00
Business name
i4 14 -ck-i a •. 11 f. 4 -113 4`k' CoA 11/, ) Iota piping
Contact name: C j oN t G G ( s t I J 55.40 for first roar S1.00 for each additional
Address: 1 IC a a) ` 0 S � - I t/l! e p
City/State/ZIP: ( \ a \eat. Cr C i O ev Wall/suspended/unit heater
Co 3s a 44 I Fax :: (j D T ) GA-49 - e 0 i 5 Water heater
Phone: ('03) y - Fireplace
E -mail: ,/ Range _
,^ CONTRACTOR BarbBarbecue _
/�
Business name: 1 . - f'T C 11 01J I I 4 (- + ('Da t 11113 Clothes dryer (gas)
�
Other
0 - ry t4 Other Address: 1 Y a, LA MECHANICAL PERMIT FEES*
City /State/Z1P: �`' r) ci-2 Subtotal
0,r .2 1 Minimum permit fee (872.50) 7 Z .6
Phone ( ) l --- J�� ` I F a x ( ) � p L C1 ' ( per C Plan review (2S %of permit fec) _
CCB tic.: `7 � 3,61 State surcharge (8%ofpermit fee) ,5 „Td
TOTAL PERMIT FELL 7 �. se) permit app ikation aspires Fla permit is amt amazed within I
O
Authorized signature: ��i days after itias berm accepted as complete.
I Print name: /2 I7ofer � I 0 I • Fee merbodobgy so by Tii -Canny Barrow Y Sexvieo Board
et) wI,✓1 C- c(� 4 4 cal
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Jul . 20 04 12:58p TIM MULLENIX 5036496095 p . 1
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CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEC2004 -00479
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2004 A nt
Phone: (503) 639 -4171 NI l l
Inspection Requests (24 Hrs.): (503) 639 -4175 L //,? / / •
INSPECTION WORKSHEET FOR DATE: 5/13/2005 TIME: 7 :12AM PAGE: 103
SITE ADDRESS: 12071 SW WHISTLER'S LP CLASS OF WORK:
SUBDIVISION: WHISTLER'S WALK NO. 2 LOT #: 099 TYPE OF USE: -
PROJECT NAME: HOWF_LL
DESCRIPTION: Install new A/C unit.
OWNER: HOWELL, SUSAN, PHONE #: 503 -521 -8553
CONTRACTOR: PH
A- AGTION HEATIN PHONE #: 503.643524
Inspection Request Scheduled For: Date: 5/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006566 -01 503.649 -3524 N
Corrections /Comments/ Instructions:
WI vv U t 1/ e L - 3 15
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL - ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
U Inspector: v v Date: V /tt °' V Phone #: (503) 718-