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Permit C ITY OF TIGARD MECHANICAL PERMIT l DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00342 _Ai. �•��i DATE ISSUED: 6/15/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112BC-04900 SITE ADDRESS: 14860 SW 83RD AVE ZONING: R-4.5 SUBDIVISION: LA MANCHA ESTATES LOT: 002 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: REPAIR NIT GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS 10000 cfm: AS OUTLETS: Owner: FEES WELLS, ROBINS A TR Description Date , Amount 14860 SW 83RD AVE PORTLAND, OR 97224 [MECH] Permit Fee 6/15/200f. $72.50 [TAX] 8% State Surcha 6/15/200f. $5.80 Total $78.30 Phone: 503- 635 -1604 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: � J��� Permittee Signature: SL-1_, 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. Jun 14 05 02:42p Co,u i ,, , 5035980270 p.2 type. • Mechanical Permit A Application P FOR OFFICE USE ONLY City of Tigard r iv i L110 Received 0 �.. 13125 SW Hall Blvd., Tigard, OR 97223 t Date/BY: Permit N /� �r i �Q �� / 7 A P la n Review Phone: 503.639.4171 Fax: 503.593.1960 `' U 7 0� - Tl A�G.sr•M' r� D ate / B y Cuter Perrrti l: Inspection Line: 503.639.4175 Qt' .',' y` Internet: www.ci.tigard.or.us CITY , -, ... • `dm Date Ready/By: =cri+ ®Sa Page 2 for all BUILDING DIVIS Notified/Method: /U Supplemental Information p'lr r y�' 3"e •GSt� ' w. lJ '1.� ' s� .rL �.:i 'l F . � * = n1 .I ,. E.. i l. '# t ... s ' Et``S Dial - '� US EOHECKLIST ❑ New constriction `ddition /alteration/replacement . Mechanical permit fees` are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ( ❑ Other: j� 61 mechanical materials, equipment, labor, overhead, and profit. fi'.Y.i : :J 'M ; � _.M `i !�% .. �4f' N l - � T �. A' S ..lL :: ' i:' . i r .,, �. 3� - L'e S : ..{� 1��..e. .: �',+'R C') G !1 j�.y L 31 i !,+ ��� r h tr RC 41. -+.,. ..tom ��:�'t Sw+, d + a •a •r �'�•r 'r..• V3I dwelling ❑ Accessory building h c.. 3 . _. . .a . :f S' ,F EES • 1 - and 2-family g ❑ CommerciaU)ndustrial Accessor buildin ❑ Multi-family I:3 Master b Iild r For special information use checklist. 0 Description I Qty Ea. Total 's;'.?i.. a ,,.a1]c. e rl ao ®ZOI& '� u'c+g�• \t1 Q ;a.� :A��d'�''' :�'�r�5i Seat inp.Jcoolins Job site address: / / ffa (/ (� 6 -' �J3/! Air conditioning or heat pump I . (regeires site plan showingplaeement) 14,00 ; City /State/ZIP: Furnace 100,000 BTU (ducts/vents) 14,00 Furnace 100,000+ BTU (ducts/vents) 17.9C 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 (radia :or or hydronic) 14.00 Unit heaters (fuel -type, not electrc), in -wall, in -duct, suspended, etc. 10.00 . Subdivision: Lot no.: Flue /vent for any of above 10.00 ' • Other: 1100 Tax map /parcel no.: t Other fuel appliances r., 'a y Ik r {� Y�I 0 0�) a .rte .a L t�' �f F1 P P- P i1D a : M ^`r t c. : r te �. F k ' ,iSC f�yi.B�tY..r9a,:£ i �� L �� � :L � '�" .'ri o-r: " ` Water heater 10.00 � ' . A Gas fireplace 10.00 //1/1 S 779// A Flue vent for water heater or gas fireplace IC- ' 00 Log lighter (gas) 10.00 Wood/aellet stove 1C.00 Wood fireplace/insert 10.00 ? 'O e .^ t . i. 1 i ri p }r, r 'ms - W" ' : �� 1 Chimney /liner /flue/vent 10.00 � � - ��� v - ti Other: 10.00 Name: d k/11 �_ /e //5, Environmental exhaust and ventilation / � (�/ / :9 Range hood/other kitchen Address: � � equipment _ 10.00 City /Sate/ZIP: -7-377.rr� # Clothes dryer exhaust 10.00 exhaust (bathrooms, Phone: ( y ) r Fax: ( ) toilet compartments, utility rooms) 6.80 ,,,, ;_ tu .�i iTh�'t�r , ? = iAlfiFe o m Attic /c-aw ace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: /. A ,Qj). /* 1 / $5.40 for first four; $1.00 for each additional Address: / Furnace, etc. I ' l Gas heat pump , City/State/ZW: Wall/suspended/unit heater • Phone: 3 • �D b.,2 el �,. d _[ I Fax : : (� Jl ?er a.� �D Fireplace heater I E -mail: Fireplace I t s,ic tF a� F s r y r Range ,c r. 5�.2 '`.Fi �, .� • z� , 9:t1. `�.i . f• t' ;g ' i Barbecue Business name: f u /`'f b ia.. 77 �� .4- a jt'4 Clothes dryer (gas) I Other: Address: cR 34,...5 i}f " ., City/State/ZIP: 7/ /4. . 4 GVa— g 'aa`:.; i Subtotal Phone: 1 ) G a p ee' � 0 3 ) � �. as � a tiii m permit (25% n for permit fee) f Fax. Plan review (25 /o of pmit fee) I CCB tic.: 7C-9,5 9' State surcharge (8% of permit fee) TOTAL PERMIT FEE I Authorized signature: & L /.!1 Pi i4/ This permit application expires If a permit Is not obtained within ISO days after it has been accepted as complete. Print name: ja .4ifA 4 .,v 76 Date: ,6j//t5/ • Fee :methodology set Tti-County Industry Service Scam eaC-a6 44C-4617T (1 1 /07 /CGM v. B) i' BuildingtPcnniuV�C- PertnicApp.doc 12/53 j CITY. OF TI 4 .,. c 6uto- 6-L/P--- 1.2.)--e/LAA _ / / c2,,..,..2 0 , BUILDING DIVISION PERMIT #: MEC2005-00342 13125 SW Hall Blvd., Tigard, OR 97223 C- DATE ISSUED: 61512005 Phone: (503) 639 -4171 ����r�p4�� I ' f 3 P Inspection Requests (24 Hrs.): (503) 639 -4175 -1E . � 6171-62"1/ INSPECTION WORKSHEET FOR DATE: 7/14/2005 E: 114t8ANI PAGE: 8E1 i SITE ADDRESS: 14860 SW 83RD AVE CLASS OF WORK: SUBDIVISION: LA MANCHA ESTATES LOT #: Q02 TYPE OF USE: PROJECT NAME: WELLS DESCRIPTION: Installation of NC unit. OWNER: WELLS, ROBINS A TR, ' PHONE #: 503 -635 -1604 Cam) CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 501 �! - /0 70 (//) Inspection Request Scheduled For: , Date: 7f14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 011350-01 503 -624 -2704 N Corrections /Comments /Instructions: (66 Cle 61 C) Mat • KZOAO — c-/A � I. I C s • • . 4.> • ►'j PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED inspector VOt `° v Date: 7 / IL/ /� Phone #: (503) 718 - p ... --.'.,, '''-' - L) . '2%. ''''' - _'':'' ' . 5035980270. .n:':' -' . .‘,-, L ID Jun 14 05 02:42p .._: N ,Hqating. -•. -.•...., . ,.. - , ..,• ..:-. - „• . , . ,,•_.,. ,-..- ' ,,:-,.,„- --_,6- - , , • ....-..-•:- - • . . -,,..,. . % - .:. -,,' , -. , -.: r, ,:,,, ,- ,:'...•,..... ,,,,,, ,. ' • -' , '. •- i .-,... :, . - : •,, ;:.,_,:,-- -., ;:',- : -._ - • .., ,. .::‘, '... ,,- . -, .,-, ‘ -f... , ;,,„,,,, , • ,,;,,:: :. 4p ,,,..,..._ •,, ._- 'HEATING'&COOLING ,...- R•ii BOx C)47'. CARD, OR 9781 (603)624-2704: • . ,.!.. ;,!.,..! 1.; • ';,.:. ' i , :..: . .. , , . , , .. . „ . ,-.;,--: . ,..-: , - . - • • : `)..- ''... " '... :'' ,_ .. ,.. , . . ... . -.= .. 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