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Permit I A CITY OF TIGARD MECHANICAL PERMIT tr COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00289 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/18/2007 PARCEL: 2S 103BC -02100 SITE ADDRESS: 12235 SW ALBERTA AVE ZONING: R -4.5 SUBDIVISION: CANOGA PARK LOT: 005 JURISDICTION: TIG PROJECT: SITZMAN 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: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES SITZMAN, DEANE D /ANNA L Description Date Amount 12235 SW ALBERT ST TIGARD, OR 97223 [MECH] Permit Fee 5/18/2007 $72.50 [TAX] 8% State Surcha 5/18/2007 $5.80 Total $78.30 Phone: Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -453 -4822 FAX 503- 968 -7224 Reg #: LIC 62196 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: L IfI L' // _4.■■ Permittee Signature: yc�, i j I��'�C'.�/ 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. .Mai 18 2007 12:OOPM CLIMATE CONTROL INC 5039687224 p.2 Mcchanica1 Permit Ap ;ijcation city f Tigard -- 4 R '° 1' -- - n F . r - 4 . Reui,ee }, v t _ ' Date/By: CJ :Permit No : r. i .131;25 SW Hall Blvd., :Tigard, OR 97223 Plan Review • Phone: 503.639.4171 ' Fat: 503.598.1960 • a:., *, i: i' Date/i3y: Other Permit: • • Inspection Line: 503,.639.4175 . l _._rat. .4 Internet: wv<vv.oi - m Ay Iy :: --• DateReady/By: Jona :- 10 SeePage2for . Notified/Methoch G Supplemental Information • . v T.:-n-•'cr, :' -- ..f- y d - • Tl E E IZ,I. s 4:x4 = . W`'c _ , . ..... ;- . ' .:...: : ; °.: • :. COMMERCIAL FEE!` ,. S SCHEDULE :USE CIIECI{L I El New construction_ ditton/alteration/replacemen ' Mechanical permit fees are based'on the value of the worst performed. Indicate the value (rounded to the nearest dollar) of ❑ Demolition • . • . Other: • : mechanical- materials, equipment, labor. overhead, and profit. . • -. - CATEGORY. .OF CONSTRUCTION ",.: - •_`. _,. ,::; :: ":., ,.'`; Value: $. ... RESIDENTIAL EQUU'MENI•! SYSTEMS FEES"', . igl► • arid 2- .family dwelling 0 Commercial /industrial ❑ Accessory building = family .. El Master builder' • • For special in wmarron use checWisi MI Multi ❑ :Other: .Description I , Qty. .I Ea: Total ..> 1 „;;.. -: JOB. SITE ;INFORMATION:- AND' LOCATIONt:_ . `--:':; :' : Heating /cooling • Job•site address:_ / . Air conditioning or heat pump / (requires site plan dhowinp.placement) . 14.00 .City /State/ZIP: 7_E7i4/. Li Furnace 100,000 BTU (ducts/vents) 14.00 . Furnace 100.000+ BTU.(ducts/vents) "17:90 ' • ' : Suite/bldg./apt. no.: . ' 'r-Project name: l+ ma kk Gas heat pump' 14.00 ' • Cross street/directions to job site: . • • - Ductwork : '14.00 . ..Hydronic hot water. system • •14.00 . Residential boiler (radiator or . itydronie) 1 "4.00 • - - • Unit heaters (fuel - type -not electric) . _in -wall: in- duct,' suspended etc. . • • 10.00 Subdivision: Lotno.:, a r. a . :Flue/vent nt fn any of . above.. ' 10'00 • - - Other 10:fl0: :. Tax map /parcel no - ' Other fuel appliances . -' .. . .DESCRIPT'ION:,OF. WORK-.-'- . : , Water healer... - : 1000 . . _. Gas fireplace , Flue vent for water heater argas -:. � . _ ', treplaie' 1000 ,. •.: . , Log l fighter (has) 10 00' ' Wood/pellet stovt 1.0:00 , .. _ ' - . _:... .. Wood :rrepla nsen - .. 10:00'` PROPERTY OWIQER _ , `., . : CI TENANT . ,. ;:= . -C Nam - .. .. . _. _ Other: naynirter711udv = ` ;• .:: ...�' " _,,_, ' : - '0,i . T4 ' ..; `..: : : �:. ; . � .::;:. '....', . .r.- _ Environmental.exhapst and`vcntilation • '.'_'..:` - ... Ran ge: hood/ tch Address: • / � Z- 3:� : ScJ,'• . . ;�L`!.�� -. equtpmen : 10:0' : .. , • ..City /State /ZIP 776,, Y L �3.: ' Clothes'dryer.ezhaust • ` I0: I0 Single -duet exhaust(bathrooms, . • :Ph one : _(.. . 1' . -. /9 : -Fax: ( • - .-. -):' • . . .. toilet compartments, utility rooms) °' 6.80 ;::: • .. PPLICANT • .. : / Atticcraw ace •Busi .: '�•:A :. ., �L CONTACT PERSON Isp fans _ 10.00 ness name: . --‘1.•1: ...: .- , . j ( 'Other; : �1 : t .s 1�" 1 : • Fuel piping . . . • • Contact name: 04 - f 4 "" ` .. • • S.40 for first four; SI 00 for each additional • `Address: • i( ( /' , !'' ` • • !A e - F urnace: etc. . • i. t C k1t -7 . c '. `�` ° �` G a s h pump . -City /State /ZIP: -.: � il t: «.,: .•76144' . % ralVsuspended /unit heater • P t 77 Water heate hone: -� . Fax: ... t E -mail: . • • • . • . • .. . Fireplace . 'Renee.. . . . • f : CONTR4CT RR • Barbecue • . . • Business name , # I. - f 'f )(..J� � • b i . T \ .. . . • I • Clothes dryer teas) C , t �-� Other: • ,Address: I ( (t 05'57 1 , r k `\ `-) 0 . • ' . MECH LAICAL PERMTCFEES* • City /State/ZIP:' ' r� . iJ (]wry , ��� t � -f ' (� O� Subtotal. l / t- �� • . Minimum permit fee (572.50.) I7d. - f 7J Phone: � 1 �. Fak: ( � — — Plan review. CCB lic.: jj y permitfee) � . , I r��.' � (25% of State surcharve (8% of permit fee) t} . TOTAL PERMIT FEE 3, Authorized signatur ....... 4762",c4..e.2 This permit application expires if a permtris not obtained within 180 'days aRer. it hoe been accepted as complete.. 114.111',._ ; Da[e:� Fee metladologyset by.Tri- County Building Industry'Service Board • i:,Buildin ermitoWJ ._C- t'crmitftpp.do. ”, _ 440 -4617T it 1 /024COMIWEBi' : . ' • May 18 2007 12:00PM CLIMATE CONTROL INC 5039687224 p.3 • . ame Layout,. � ` "� \ H • k Ill -;7 • o .• ... . 4 . '.1. ..... .• 0 .• .. . . .. ... . . . • . .. • . . . , • . . 1 . i . . . .• . . . . . . . .. • .. . . . ... ..... ....• . .. . ... . • . . . . ....... . . . •,,, . ... . . . • . •.. . . • . . . . . ., ... . .• . . . . . : . . . . . . . . • .• . • . . . . . .. . . . . . •. . . . . . . . .......... ...... ....... .. .... . ..... ....... •.•• . ..• _ lbw . • 1 . ...... .........:. . • . ' . U . •. W . Windows • Windows Doors Walls Roof • Floors • • CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007- 002139 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/18/2007 Phone: (503) 639 -4171 /� Inspection Requests (24 Hrs.): (503) 639 -4175 �� � �� INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7 :01AM PAGE: 80 1rLtu c Lt SITE ADDRESS: 12235 SW ALBERTA AVE CLASS OF WORK: SUBDIVISION: CANOGA PARK LOT #: 005 TYPE OF USE: PROJECT NAME: SITZMAN DESCRIPTION: Install a/c unit. OWNER: SITZMAN, DEANE DIANNA L, PHONE #: CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 - 453 -4822 Inspection Request Scheduled For: Date: 6/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Me 699 Mechanical final 049495 -01 503 - 453 -4822 /41---4 - Corrections /Comments /Instructions: , • ❑ PASS 'ARTIAL APPROVAL CANCEL I I NO ACCESS ❑ FAIL r/, ° LL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: y� 0 7 Phone #: (503) 718- `-�