Permit C ITY OF TIGARD MECHANICAL PERMIT
���I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00386
� • °��-' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/27/2005
PARCEL: 2S112CA -08700
SITE ADDRESS: 07556 SW ASHFORD ST ZONING: R -7
SUBDIVISION: RENAISSANCE WOODS LOT: 013 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: . 50 + HP:
WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TAKASUMI, RICHARD C + DEANNE L Description Date Amount
7556 SW ASHFORD ST
TIGARD, OR 97223 [MECH] Permit Fee 6/27/200E $72.50
[TAX] 8% State Surcha 6/27/200E. $5.80
Total $78.30
Phone: 503- 624 -1183
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Phone: 503 -557 -2220
Reg #: LIC 72623
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 j' �, j Permittee Signature: c),11
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 23 05 07:O1p Tri Count Temp 5035570919 p.1
Mechanical Permit A; plication ...__ _ _ -
.orcvs�olvL
Cit,' of Tigard 3' Received _ q ,� Q
..2, $'':1 Hail Blvd., Tigard, OR 97223
DateBy: Kr,L 775) - t` PermitNo, : �.�. L7 �i,� s- ,-
Phone: 503.639.417! Fax: 503. 9819 W.t,
inspection Line: 503.639.4175 Plan DatetBy: Review Other Permit:
Internet: www.ci.tigard.or.us L ZOr^ � + I'' Date Read B 0 See Page 2 for
NotiEed/Method: "�7(/ I Supplemental information
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- - - ..- . ... ... - : .....,..'.1C'YP E ' - RK'�. : ss ::' , ?`` .,:::_;. `; '... <�; _•,,. r ;:.: r [.r -0014
�• t .Q t.- t 0.42C1AL : FE .SCHEDt}I E USE' CHECIQ IST
❑ New construct ionAddir a igr�alr `an�I�epi Mechanical permit fees" are based on the value of the work
: 'Cr ��1 GIV performed. Indicate the value (rounded to the neare "st dollar) of all
❑ Demolition ❑ Other
�t1a��G mechanical materials, equipment, labor, overhead, and profit.
_ -.- CATEGORY`OF :CONSTRUCTION : :' : : , . - - Value: S ‘
1 and 2-family dwelling Commercial/industrial , ,. T T •?EQtNIENT.../ SYSTEMS. FEES*
❑ Acces building
❑ Multi-family E Master builder C] Other: For special information use checklist
Description Q Ea
.. '::::.j-.1:7:, OB SITE = INORMATION.; AND LOC ATION.: ;,, t
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._ ma y ng
Job site address: 155(0 \A� i •� t r 71 Air conditioning or heat pump
Ci[yi$Ca[e'ZIP: ^ a( W �a� IY Y / Furnace (requires site plan showing placement) 1 14.00
Furnace 100,000 BTU (ducts/vents) 14.00
Suite:bldg. /apt. no.: v 1 Project name: • Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00 i
Cross street /directions tojob site: I Duct work
1 i 14.00
I
Hvdronic hot water system 14.00
Residential boiler (radiator or
hydronic) 1 14.00
I Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10 .00
Subdivision: i Lot no.: Flue /vent for any of above 10.00
Other: 10.00 ,
Tax map /parcel no.: Other fuel appliances
;. `AESCIZIPTION,rOE. :VIrORIC.,: - ; •. er heater I 1
Ih1 ' Gas fireplace 10.00
Flue vent for water heater. or gas
fireplace 10.00
Log lighter (gas) i 10.00
Wood /pellet stove 10.00 '
Wood fireplace /insert 10.00
PROPERT?Y: O WNER_;, 'r =` " : %,y ,,' <' [j :: :TENANT" -'. c` . :.: '= : Ot y/liner /fluelvent 10.00
Name: {(}� T r _ Other:
I'JS
` U 'ti I 1 10.00
t Environmental exhaust and ventilation
Address: m� Range hood/other kitchen
I
�+""� equipment 10.00
City/State. ZIP: Clothes dryer exhaust 10.00
Phone: (aet if21 190 Fax: ( ) Single-duct exhaust (bathrooms,
_
toilet compartments. utility rooms) ) 6 80
[ •'•.? .. :.' , - 0`.APPLI °: : -= :::1' : ,.:u r ';' ; :: s -; -1 COiNT ,PERSOiY:';.' : : : :: : .. , : . ..",:7. _ Attite!crawlsptaceerfans law Business name: Tr! Ctrl If1 COI/dip 1 Other: 10.00 -
A 1r Fuel piping
Contact name: bianc lyl 55.40 for first four; 51.00 for each additional
' Address: 1 00 6 0 a. k , l (s (RI \f4/ j uc) ' Furnace, etc.
`mil if IU Gas heat u
City/State/ZIP: CI'��?`' a e � C(70 `L � WalUsuspend d /unit heater
Phone: () G •
557` 7 -3 / (� Fax:: (62) 557-Ni (j Water heater I I
E- mail: 1 Fireplace •
::: :.i = - :> <•�,. / y : ' . =; . :' : u :e -- Range
V _ _ ^_ :': •r ? ./ �::^ :.. : VAS: ;' ? ^:C: - s Y �M . , : .`.�.
_ ... ._ ... ±....•x- ;r; = «. r rS,'. ,. . _ :�- � " :'i Barbecue 1
Business name: T n Rine Cj) Clothes dryer (gas)
l�'� �'r` l/ 'tt`
Other:
Address: \ ?) i 50 G t . c moos R► vrrt l� 1.. , _ MECH
/ ���ii`� // '' ry � - aNIGA'T'PEI2IYITL E' • •
City/State/ZIP: ore con U C'k_ q� Subtotal
Sub
Phone: (�•i) as-r.22-2n Fax: (..,,ca � • - (/T I
Plan review (25% of permit permit fee ($72.5 )
J �l �, "' f J mit fee
CCB Iic.. State surcharge (8% of permit fee) \
TOTAL PERMIT FEE T 0.
n . 2.1 - �
au1ltO:iZed Signature': This permit application expires if a permit is not obtain
� days after It has been accepted as complete.
Print name: DL - Le itil U� `'1 } / 1 Date: `Q/2 n.') // - Fee methodology set by Tri- County Building Industry Service Board
if \;PLC- PermixApp,doc 12/03 4404617T(1 l /02/COM/WEB)
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CUSTOMER INFORMATION
NAME • .
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PLEASE REFAX APPLICATION Wall SITE PLAN.
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CITY OF_TIGARD
BUILDING DIVISION - " PERMIT #: MEC2005-00386
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U27/2005
Phone: (503) 639-4171
1
1 1 1 1 1
Inspection Requests (24 Hrs.): (503) 639-4175 ,...
INSPECTION WORKSHEET FOR DATE: 11/18/2006 TIME: 7:17AM PAGE: 14
SITE ADDRESS: 07556 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS LOT #: 013 TYPE OF USE:
PROJECT NAME: TAKASUMI
DESCRIPTION: Installation of A/C unit.
OWNER: TAKASUMI, RICHARD C + DEANNE L, PHONE #: 503-624-1183
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 11/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021890-01 502-667-2220 N
Corrections /Comments/ Instructions:
...„ _ - 41 Ay _, 0 Ad - 'air ,..-.iiili //1 '
i I, e-■- a 3 •• 2
•
,,,--
PASS PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
FAIL
0 0 ALL FOR INSPECTION
A ri ADDITIONAL FEES ASSESSED
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Inspector: / Date:/// Phone #: (503) 718