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Permit " CITY 'O F TIGARD ' MECHANICAL PERMIT I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00571 + ��' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/23/2004 PARCEL: 1 S134CA -06900 SITE ADDRESS: 11750 SW BURLCREST DR SUBDIVISION: BURLWOOD NO. 2 ZONING: R -4.5 BLOCK: LOT: 009 JURISDICTION: TIG 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: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replacement of A/C unit. Owner: • FEES JURGENSON, NEAUMARSHA A Description Date Amount 11750 SW BURLCREST DR [MECH] Permit Fee 8/23/200 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 81231200L $5.80 Phone: Total $78.30 Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Final Inspection 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. Issued By: "J: � -o _ Permittee Signature: , v Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanicl'Per>riiit Applicatio �.,i A� FOR OFFICE iIsl: ON 1.1 City of Tigard �1 V► Receive. ��/1 V nate�y; 3 i y Permit No.: C.� ©O y - V V �'/ 13125 SW Hall Blvd., Tigard, OR 9722 ! Phone: 503.639.4171 Fax: 503.598.1960 X1°859 2 " 'u " +,v',,'„, Date/By: only pert: Internet o www.citigard.or.us 503.639.4175 AUG L U Date Ready/BY: See Paget for Notified/Method: ■1 Supplemental Information - 'a` -_ 1d ._.`.�1 i . 11 i (' i 1 � . T IGARD `•�' b __;[C:,. lr . ;� - . k . -t 0 n " , ... .._, , ..J a a:. . .�. +�... (1 l^ • .9ii5, Fdcs:c ^� 'Ii :.nom - +rU.nq ... , . _ vim �•. _ ... ., - s, .. � .. , ,., . ._ .� :u1m�� �!�: ..» , l.. � m1 fi:- .:!tr,..,,. °' �'.�� - ❑ New construction dition/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 ❑ er: ------- -�.� !?,ix :`'a �_ , �N ij� 0 k �in�o� T>ttL.. c ,>.�n %.t }� �� ' i:_ 1 1 - - mechanical materials, Value: $1 labor, overhead, profit. p 1. .; , _..• M _ "" Yu. fi a I ; -----=.,...., ' . -_ ah yu d ro s aorov a an 4 - and 2 dwellin ..,-` l P1.ii � §1 :901 t a`1, _ c 44 €. t „11111,9" S t. . , • Fc t H.= y g ❑ Commercial/industrial ❑ Accessory building • For special information use checklist Multi-family 0 builder ❑Other: _ Description I Qty. I Ea. I Total (' 1 1 Gdi - t ..._. Ima r t % . o � =' j t E. ; • •i•11 (�) mnu et•-- - =:Jni fir- 1 _a,, Heating /cooling Job site address: 1 I �� � - \ r e.. -1 \ - ( d site plan sl o p 1 14.00 114- City/State /ZIP: i t • , ,( Q -.- Furnace 100,000 BTU (ducts /vents) 14.00 / Suite/bldg./apt. no.: `� `Y ` Furnace 100,000+ BTU (ducts/vents) v I Project name: Gas heat pump 14.00 Cross street/directions to job site: J r- G _ -s Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronicl 14.00 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/paroel no.: • Other fuel appliances - s ,li ' • - = ', 3 Mil) ii'.? r l ' 1"r. �'�; l W ; t Water heater 10.00 A n } ♦ (- Gas fireplace 10.00 / " , eik-0 �► f' (O 11 a 1 i-t ©� j Flue vent for water healer or gas • UL� ---�•- fireplace 10.00 Log lighter (gas) 10.00 f,N \@ L• ,�� Wood/pellet stove 10,00 Wood fireplace/insert 10.00 '' r y m tuat � [ Fr et ^'{k - 1 4477 a 4 Chimney /liner /flue/vent 10.00 :' r . ra,. -- dri er � �� i . r l •'•-- :id Other: 10.00 Name: me.:. -6 Mars IAA_ \ v�r e)n7‹, e) `n Environmental exhaust and ventilation Address: ' t� V t Range hood /other kitchen �� 6 �•� lc ` equipment 10.00 City/Slate/ZIP: -- 1 -- -- - , 1, cx 6 q ` L� - • Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, Phone: 3 ) i ) (5 V� Fa x: ( toilet compartments, utility rooms) 1 i (t ii i -9. ,i -� ry 71 , 51901 viii = . 1 ,a� "1 Attic/craw fans 0 .00 0 1111Glipi -i^. ,.�� �u= „ ::cr,a.. � 1 _ ,� 10 .,. �Ya -. ar " t_ -� � a � . i .�. r - • - , Business name: / 1 Other: 10.00 Gi tw s - ©V "k7` 0 Fuet i in Contact name: { ` j ` • P p g ��` -t l v $5.40 for first four; S1.00 for each additional Address: I (0500 fu....) & IN j,p ` Furnace, etc. 1 v �- Gas heat pump Q r City/State/ZIP: 4 I ail/I d q D 1 7.4 1 W alUsuspended/unit heater Phone: ( ) L S 3 - J 1 l Fax: (503) C76,. I - 721-1. Water heater `'1 I Fireplace E- mail: `: "' l'l{ {il - ' °„ o U t* la _ age j r: . �, .W t �� °DES - F- Ii(I': �. •: � i Barbecue Business name: (1 [ 11VVI. ce 4<__ Clothes dryer (gas) I �.� s -7k(-14 1 , p Other Address: L U.� CD c -. �� AA1_., fl l 1 li Pr.-7 "a �'. ,-; EANIPP ....: ``'ft� � yt � 1 1 f Rte City/State /ZIP: PA r `l-1 n�Jl/t_� / t 7a 'a Subtotal . I -�G Phone: (i�d?S) If t -, >- Fax: (93) c 76,2 4 3 - 7 � a Minimum permit fee($72.5 77, 77, S(� / Plan review (25% of penult feee ) CCB lie.: (o t c ( P • State surcharge (8% of permit fee) 5 , B 0 TOTAL PERMIT FEE '7 4 2, , ' 3 0 Authorized signature j This permit application expires if • permit is not obtained within 180 _ days after it has been accepted as complete. Print name: K K-R e t�V L / i / Date: 1 / 5 11 * Fee met odology set by Tri Building Industry Service Board i:\ Building \Pcnits\MCC- PanetApp.doc 12/03 � _) 1 440- 4617T(11/ OM/WF ) T ' cl t722LB96EOS 3W I 102I1WO3 31E11.1113 WUL2 : G t'002 02 2nd r • i. tLIMATE CC,11101. 16500�'Y 72nd Avenue Portland, OR 97224 503- 453 -4822 FAX: 968 -7224 HEATING i AIR CONDITIONING 503 453 - HvAc pa4(2.2 4-25' aZ -1-25 1 cPr1 2- 117SO 5 t (AC IC #2.s r SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE PORTLAND • 453 -4822 VANCOUVER • 360 -254 -3063 2 d 1722L89GEOS 3WI 102IIWO3 31bWI10 WEL2 :6 17002 02 2nd CITY OF TIGARD . BUILDING DIVISION PERMIT #: MEC20Q4 -00571 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2004 Phone: (503) 639 -4171 4,44 NGiil'1 Inspection Requests (24 Hrs.): (503) 639 -4175 .,.' INSPECTION WORKSHEET FOR DATE: 4/18/2005 TIME: 7 :14AM PAGE: 41 SITE ADDRESS: 11750 SW BURLCREST DR CLASS OF WORK: SUBDIVISION: BURLW {.SOD NO. 2 LOT #: 009 TYPE OF USE: PROJECT NAME: JURGENSON DESCRIPTION: Replacement of NC unit. OWNER: JURGENSON, NEAUMARSHA A, PHONE #: CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 - 453 -4822 Inspection Request Scheduled For: Date: 4/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 004731 -01 503.4553 -4822 Y Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: it' -I F - °C Phone #: (503) 718-