Permit F
4 � 4
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00319
I DATE ISSUED: 7/13/2006
` ' --' 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171
PARCEL: 2S103AB -03500
SITE ADDRESS: 12064 SW 113TH PL ZONING: R -4.5
SUBDIVISION: MEADOWGLADE LOT: 004 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:
GAS PRESSURE: 50 + HP: C WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS LO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
STEVE ANDREWS Description Date Amount
12064 SW 113TH PL
TIGARD, OR 97223 [MECH] Permit Fee 7/13/200€ $72.50
[TAX] 8% State Surcha 7/13/200€ $5.80
Total $78.30
Phone: 503- 968 -1335
Contractor:
CARSON OIL COMPANY INC
3125 NW 35TH
PO BOX 10948 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97296 -0948
Contact #: FAX 503- 227 -8521
PRI 503- 224 -8516
Reg #: LIC 8388
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: i
ii.-/A:r Permittee Signature: __Lek, Q(
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jul 13 2006 8:18 carson oil 503 227 8521 p.1
Mechanical Permit . i l a i t i n i t 1•01z (l l (, l : I NI: 0 \ 1 N'
City of Tigard � 'tL -' • t R ei ...7 / O r
• P- ,,,4 416C JQ6 - "
13125 SW Hall Blvd., Tigard, OR 97223 ��
Phone: 503.639.4171 Fax: 503.598.1960 , . ,; ; . �. Other Permit:
Inspection Line: 503.639.4175 J U L 1 r 00 L U U t I I i Date Ready/By: I Suris I a le El See Page 2 far
1
Internet: www.ci.tigard.or.us NotifiedlMetirod: 11 ( t� mental7nfotmation
4 „•' vY .',, .3•- q - + c' r 1. g . N i , x � v.' ✓`. , � MT , it Pit 4; t i y car y + . K
,. uF .. ... � �1.,. j t �..j ' x:, _ . a A ,f,, i 1 - w - �'i.. 4' 1 ; .q ' 7 .J111121 h '.g
- ', z2.3L %8!�^ix�u. 4L4:3:,ki.•r4'+- a-,'9. ¢?ra ,•�. w.t e. . 2,x, -a$:ie'.�lGA7Fa'4.�..: -• . 3v, a +l`w�..Mu'• ??z.t' .r,:.dL`
❑ New construction ® Addition /alteration/replacement Mechanical Permit feesb are based an the value of the work
❑ Demolition ❑Other performed- Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
. ,-; A 4 •. ?si aia t rV au .. M •• t Vii, "' " % 377 Value' $
it it I' z°a $ 4 k e v^a . i s 'r r `•�°'. ;i'' j • : yi ;L _
?, >`r:_. a:. x.x zsr. '
hra. ' !,,.7:a.,' ' 24 . 4 : .v : -66 - 5 w' 'i&('dtS'>"• .` r•i" -R
0 1- and 2-family dwelling ;' s-<�
y g ❑ GommerciaUindustrial CI building
❑ Multi- family ❑Master builder ❑ ether Description special irlfonnauon use checklist.
Description I Qty. I Ea. I Total
OOP"' ,4.-4 �` viVt`s r 'v r n ' .. r . ` `# f-4 rwt a ` :' "*',z�"`
�. _fir +• ��'' ��� � ���acb�itk?e� •xW #.,3a� "sk.a ',-�f ���.'+;is; ll eatinpfeool6l$
Job site address: 12064 SW 113"' PL Air conditioning or heat pump �
(requires simpler: showing placement) ' 14.00 1 T• 00
City/State/ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts/veers) 14.00
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt. no.: Project name: ANDREWS Gas heat pump 14.00
Crass street/directions to job site: SW TIGARD ST Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.: Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water
.. L} j F K 't� ' i a 3'�i € 8 $ -1 +.'i; 4 i' `i ii m� f. •- • t: heater 10.()0
.:�` �. .''�r'�' >.; � X °� '{•:S��; af�""i+` -.. Yua7F.?' i7,+ � �ti���t� .:&x''�`.'✓.Y.: +�af'�. .0 f. b�4
INSTALL NEW A/C Gas fireplace 10,00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert l0:00
44i, 4 ',S�" F ; , ; E .c+ Chimne /liner/ttue/vcm 10.00
x - , "9. i k' { '' , ? i . i. Y , , � . ,,,, ! .. in ; : " ,- t� ' ., 'd �. r i i- ;r {{ �r t;�?S3,t4 y
,`.- � X..�,. ?, r$; ��ti -,iii 1 '1 ,1 ' 4 other 10.00
Name: STEVE ANDREWS _ Environmental exhaust and ventilation
Address: 12064 SW 1113 PL Range hood /other kitchen
equipment 10.00
City/State/ZIP: TIGARD, OR 97223 _ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)968 -1335 Fax: ( ) toilet compartments, utility rooms) 6.
t p ,i4 . r ,, . 9 a '''�� 4 .-4-ft, ) `{t.� r.„ i x r' _ ` e a ! 0 ( t to V rte• v • r nth-, Athe%raw a fans 10.00
Other: 10.00
Business name: CARSON OIL COMPANY INC Fuel piping
Contact name: JIM HARCOURT 1 TERI ZIBUISKY 55.40 for first four; $1.00 for each additional
Address: PO BOX 10948 Furnace, etc.
Gas heat pump
City/State/ZIP: PORTLAND, OR 972% WalVsuspended/unit heater
Phone: (503) 471 -4328 or 471 -4354 Fax: : (503) 227 -8521 Water heater
Fireplace
E-mail: ZIBULSKY @CARSONOIL.COM
f«i,: .. ? 5� fi} �. F ,*�` ' ` 4 " a . „,, r : c c^ a;,g " � Range .
.,,s- 4 • r , +� �i kiii...," . TM.? �• , i' v: its V. v 4 . 4 - 1 " Barbecue
. .ai.. - ,,.....,
Business name: CARSON OIL COMPANY INC Clothes dryer (gas)
Other:
Address: PO BOX 10948 . M . . . �a` y , ,. , . , s c .t� 4.
City/State/ZIP: PORTLAND, OR 972% Subtotal 14,00
Phone: (503) 224 -8500 4 Fax: (503) 227 -S.e21 M�im'rut permit fee (372.50) 7 . sn
Plan review (25 %ofpermit fee)
CCB lie.: 8388 State surcharge (8% of permit fee) •
' TOTAL PERMIT FEE f 1 w)
Authorized signature: / This permit application expires if a permit is not obtained within ISO
days Print name: TERI ZIBULSKY D sae: 7/13/06 I • Fee methodology by h �be accepted as camp S
SY by away Bnildmg Industry ervico Board
i\Bui .doc 12/00 4404617T(11/02/COAVWSB)
N
SITE MAP
N
N
OVER 10'
N
N
1'
H L )
a w ■
Andrews Residence
12064 SW 113"' Pt
Tigard, OR 97223
0
C
0
•
U
L
t0
0
FRONT
co
c .
SW113th PI
O
N
C
� z
m
CITY OF TIGARD_
BUILDING DIVISION PERMIT #: MEC200$-00319
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/13/2006
Phone: (503) 639-4171 . 1 :1 IA NW
Inspection Requests (24 Hrs.): (503) 639-4175 mmall
INSPECTION WORKSHEET FOR DATE: 1/12/2007 TIME: 7:04AM PAGE: 41
SITE ADDRESS: 12061 SW 113TH PL CLASS OF WORK:
SUBDIVISION: MEADOWGLADE LOT #: 004 TYPE OF USE:
PROJECT NAME: ANDREWS
DESCRIPTION: Installation of NC unit.
OWNER: ANDREWS, STEVE PHONE #: 503-968-1335
CONTRACTOR: CARSON OIL COMPANY INC PHONE #: 503-224-8516
Inspection Request Scheduled For: Date: 1/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 041971-01 503471-4343
Corrections/Comments/Instructions:
iAze7 ipair‘t qa 621 „4,42.i4/
fl PARTIAL APPROVAL n CANCEL I NO ACCESS
FAIL 1 ,1A CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: Phone #: (503) 718-