Permit • e:
• � CITY OF TFARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00412
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/10/2007
PARCEL: 2S 102BA -03800
SITE ADDRESS: 12037 SW 96TH PL ZONING: R -25
SUBDIVISION: DUBLIN PARK LOT: 008 JURISDICTION: TIG
PROJECT: FITZ
Project Description: Install 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:
GAS PRESSURE: 50 + HP: WOODSTOERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
DAVID & HEATHER FITZ Description Date Amount
12037 SW 96TH PL.
TIGARD, OR 97223 [MECH] Permit Fee 7/10/20W $72.50
[TAX] 8% State Surcha 7/10/2007 $5.80
Total $78.30
Phone: 503- 620 -8203
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 B • y ii.//Z /ILA Permittee Signature: 4frrafoo
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.
1echaniL11 Permit Applicatio II c ._ rout (Inlet. rsI ONI.\
City of Tigard • f—• r Received
• • 13125 SW Flan Blvd_, Tigard, OR 97223 Date/By: 6 CM
I. Phone: 503.639.417I Fax: 503.598.1960 JUL 1 0 2007 Plan Review Other Permit:
DalelBy:
GARlJ Inspection Line: 503.639,4175 ^ Of r~���y D
CITYs 0l'7 ®See Page 2 for
Internet: tvww.iigard -or.gov BUILDING �������� l'oti6ed/ktethod: Supplemental Information
TYPE . OF I WORK : ` :': t:• . ':'Si:: j.." : COMMERCIAL FEE* SCHEDULE - USE CFIECKZIST- l
New I Mechanical permit fees* re based on the value of the work
3 ew construction ❑ Additiotlialterationlreplacetnt nt Mhil i f* bd l f h
I
performed. Indicate the value (rounded to the nearest dollar) of all i
] Demolition Other: mechanical materials, equipment, labor, overhead, and profit. '
CATEGORY OF :CONSTRUCTION • -. - I" " ` Value: $
:• RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Al- and 2- family dwelling ❑ CommerciiaVindusirial ❑ Accessory building
/ ] ` Multi - family [] Master builder For special information use checklist.
Other' Description ) Qty. 1 Ba. Total
' JOB SITE INFORMATION AND LOCATION i ._ Heating tooling
)13 site address: /� () 3 7 5 t J 9 G f ? P Air conditioning or heat pump
(requires site plan showing placement) 1 14.00
ity /StatelZ[P: 77 G ,4 it 9 7 3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
uite/bldg.lapt. no.: Project name: FI 4_ � Gas heat pump 14.00
mss street/directions to job site: Duct work . 14.00
Hydronic hot water system 14.00 i
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric), '
in -wall, in -duct, suspended, etc. 10.00
ubdivision: J Lot no Flue/vent for any of above 10.00
Other: 10.00
ax mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK ' • • Water heater 10.00
Gas fireplace 10.00
�.iPf „...41- Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER • I 0 TENANT •
Chimney/liner/flue/vent 10.00
Other: 10.00
ante: `' i7 ! I
V 1 " z, N j,(JVi / , f f1¢'1• Environmental exhaust and ventilation
ddress: /...2 d 3 7 5 J 9 G T" � toL Range hood/other kitchen
equipment 10.00
ityi StateiZlP: -77a A /Q 17 9722_3 Clothes dryer exhaust 1000
// Single -duct exhaust (bathrooms,
Slone: 3) CA�Q - c?.. Fax: ( ) toilet compartments, utility rooms) 6.80 .,
❑ APPLICANT ' 0 CONTACT PERSON . • Attic/crawlspace fans 10.00
usiness name:
Other: 10.00
/7"1 • Fuel piping
�
ontact name: t'/ r l lj $5.40 for first four; $1.00 for each additional
•
ddress: Furnace, etc.
ityiState/ZIP:
Gas heat j ump
/ [ I Wall/suspended/unit heater
l6
hone: c5 -13 ). L — >7 0 Fax: :,b 1 S", — (� ! -7 a Water heater .
mail: C Fireplace
•
i • Range
CONTRACTOR Barbecue
// 9 p L f Clothes dryer (gas)
usiness name:
[� Jli -o-wi 0„, i' ,,,, n al- � 1 i , i.Qr
.ddress: T / l Other:
/(� � J - �l D v MECHANICAL PERMIT FEES*
itylState/LIP : //� � Lp . op 9 7 / ; Subtotal I 4. c
�!li 1 Minimum permit fee (572.50) - 7. ,.�
hone: (5 Et f �-� � l Fax: ( , L-G� c - 6
!a 27b Plan review (25% of permit fee)
CS lie.: 35 State surcharge (8% of permit fee) 5,2
TOTAL PERMIT FEE - , f
,uthorized signature: t This permit application expires if a permit is not obtained within tall
�j i JJJ
days after it has been accepted as complete, / �
tint name: /� 1 .jy /1 Date: � 4 1 • Fee methodology set by Tri -County Building Industry Serv:ce Board
nuildin Permit10.CEC- Permitkoo.doc 04/06/06 !7 ITT (11 2 C04VWP]t)
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ar
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(593)624 -2704
SITE P AN
ADDRESS. 1 43 (3 7 J 7
c 0LZ0 869 - 809 DNI1V3H vv18WniOo d69:I.0 LO o Inr
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00412
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/10/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
,;(0, 'f �..
INSPECTION WORKSHEET FOR DATE: 7/20/2007 TIME: 7:03AM PAGE: 65
SITE ADDRESS: 12037 SW 96TH PL CLASS OF WORK:
SUBDIVISION: DUBLIN PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: FITZ
DESCRIPTION: Install a/c unit.
OWNER: FITZ, DAVID & HEATHER PHONE #: 503- 620.8203
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 - 6242704
Inspection Request Scheduled For: Date: 7/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 052426 -01 503- 624 -2704 Y
Corrections/Comments/Instructions:
a 0 - E672,CAL 1,1,1— 1 ,..aB 4- I.A -Le-L 71 5-4 1 3 3S' Redd Gcs� et.-, -i AL ��
PASS ❑ PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION L I ADDITIONAL FEES ASSESSED
Inspector:
A D a te: 7— ZU - "O> Ph one #: (503) 718- �Jt it l