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11305 SW FAIRHAVEN STREET
CITYOF T I G A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00330
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/14100
PARCEL: 2S103DC-00815
SITE ADDRESS: 11305 SW FAIRHAVEN ST
SUBDIVISION: VIRGINIA ACRES NO, 2 ZONING: R-3.5
BLOCK: LOT: 017 JURISDICTION: TIG
CLASS OF WORK.: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS VwU APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPR%SSORS HOODS:
_ FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
GAS 3 - 05 HP: COMM[ . INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS?: 30 -50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
DRYERS:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS S:
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 Cf
Remarks: Installation of exterior A/C unit. Cannot be placed within It- required setback.
Replace gas furnace.
Owner: FEES
ADKINS, KATHRYN J TR Type By Date Amount Receipt
11305 SW FAIRHAVEN ST PRMT RCP 8/14/00 $50.00 0004478
TIGARD, OR 97223 5PCT RCP 8/14/00 $4.00 0004478
Phone:
Total $54.00
—
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Cooling Lint Insp
Phone:453-4822 Duct Inspection
Reg #: LIC 62196 Final Inspection
I his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if worts is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Orer •n I ,w
requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set forth in OAF(
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189.
Issue By: j; ,�., Permittee Signature.
Call (503) 639-41'. 5 by 7:00 P.M. for inspections needed the next business day
Plan Check#_
CITY OF TIGARD Mechanical Permit Application RecdTe
ByF-'I i�_..
13125 5W HALL BLVD. Commercial and Residentipl Date Recd
TIGARD, OR 97223 ECEIVEr) Date to PE
(503) 639-4171, x304 Date to DST
Permit#i��i!-..�d��0,336'.
Print or Type Called
Incomplete or illegible .ipplicationstyiiiiiM R4� accepted �-
-� Name of Uevelopment/Prulect ' Description Erb'y
Table 1A Mechanical CodeQty Price Amt
Street Address v---� sunea A) Permit Fee Virg$ 16.00
.Job 1) Furnace to 100,000 BTU
Address G � 57 _ includin ducts&vents see footnote 1,2 9.65 .0
Bldg# Cnyfstate Zip 2) Furnace 100,000 BTU+
-- 6 (,3�� y�Z including ducts&vents see footnote 1,2 12.u_o
Name for name of business) 3) Floor Furnace
Owner __ /NS includingven'_ see footnote 1,2 9.65
4) Suspended heater,wall heater
Mailing Address r� or floor mounted heater see footnote 1,2 9.65
5) Vent not included in a Dpliance permit 4 75
Cnylslatc Zip Phone Check all that apply: 'Boiler Heat Ali-
For Items 6-10,see or Pump Cond Oty Price Amt
J Noma for name or smessl footnotes 1,2 Comp
6)<3HP.absorb unit to i
100K BTU f_ 9.65 , �a
Occupant Mailing Address V 7)3-15 HP,absorb unit
00k to 500k BTU 17.651 _
CnylState zip Phone 8) 15-30 HP,absorb
unit 5-1 mil BTU 24.15
_____ 9)30-50 HP,absorb
Contractor Name unit 1-1.75 mil BTU 36.00
(',-L/�� CD,f/j�ol_ _ 10)>50HP,absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15 _
issuance,a copy 1 6 SZ)o S� r7� 11 Air handling unit to 10,000 CFM
of all licenses CA /State z p Phone _ 7.00
are required if q OR- 97zzzr 1 -YK1Z 12)Air handling unit 10,000 CFM+
expired in COT Oregon Const Con Board Lica Exp 11.85 I
Z Q /O OG 13)Non-portable evaporate cooler I
database 7.00
Architect Name
14)Vent fan connected to a single duct
or Melling Address '-----
15)=Ventilationsystem not included in
Permit 7.00
Engineer cnyfState Zip Phone 16)Hood served by mechanical exhaust -
7_00
Descr be work to be done 17)Domestic incinerators
12.00
New O Repair O Replace with like kind Yes*No O 1B)Commercial or industrial type incinerator
48.25
ResidentiaCommercialO
l
19)Repair units 8 4U
Additional information or description of work �' , � 6 -20)Wood stove/gas Mother units/clothe cryrudetc
t4 e Aj&4'r // I -AI/ A 1,�CG�I/LVT7�1//q/� _ _--_ — 700
NOTE: For Cor)lmercial projects only,Units ove:400 lbs require 21)Gas piping ene to four outlets
structural gas talcs See footnote 1 375
Typo of fuel oil n natural gas— LPG O electric O 22)More than 4-per outlet(each) 75
Minimum Permit Fee$50.00 SUBTOTAL 45'2 tri f? OG
I hcreby acknowledge that I have read this application,that the information 8%SURCHARGE i'"> r1`
given Is correct that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL
the owner,that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits onl
TOTAL
Signature of Owr erlAgent, D to - --- ---
Other Inspections and Fees:
1. Inspections outside of normal business hours(mininum charge-two
Contact Person Namep One hours) $50.00 per hour
.IJP `1 2. Inspactions for which no fee is specifically indicated (minimum
zi/_3 - tc�z� _ r�harge-half hour) $50.01)per hour
F000tes for commercial projects only: 3. Additional plan review required by changes,additions o,r:visions to
n
plans(minimum charge-one-half hour)550.00 per hour
1 Provide full schematic of existing and proposed gas line and pressure
2 Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units — ------ "Residential A/C requires site plan showing placement of unit
I Unechperm doc rev 7/1;1,'99
Home Layout
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