Permit CITY I CARD MECHANICAL PERMIT
of DEVELOPMENT SERVICES PERMIT #: MEC2004 -00413
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/28/2004
PARCEL: 2S 103CC -07900
SITE ADDRESS: 13705 SW HATHAWAY TERR
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 026 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: A/C Install, do not place within the required setbacks
Owner: FEES
DEVIN KOOPMAN Description Date Amount
13705 SW HATHAWAY TERR [MECH] Permit Fee 6/28/200 $72.50
[TAX] 8% State Surchart 6/28/200 $5.80
Phone: 503 - 579 - 6701 Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 624 - 2704 Final Inspection
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.
Issued By: (t�j77 Permittee Signature: CrYI
Call (50 639 -4175 by 7:00 P.M. for inspections needed the ne business day
Jun / 2`4 04 03: 10p PAM DALBY 503- 598 -0270 p.
'ti
App FOR OFFICE USE ONLY
Mechanical Permit App ���® Received Permit No. �2D6 -Od
City of Tigard rE D Receive
13125 SW Hall Blvd., Tigard, OR 972 3 Plan Review Other Permit:
200 �y A �I Date Ready/By: I ® See Page 2 for
Phone' 503.639 Fax: 503.598.19 ' i.,
�� .{ 0 I Dat e fEt y: S Information
Inspection n Line: 503.639.4175
igard r US .1M V "^ Notif•.ed/Method:
Internet: w'ww.ci.trgard.or.us i
_,-r./ nG TIGARD *:
... r . . ,• r { g :•; 1,.: ;, :;'. ^, ° ' =i t• ,' ' ':':> ' "'I ;COMMERCI F EE SCHEDULE - 'USE CHECKLIST 1
4 " � +` J ` "+, t' Mechanical permit fees' are based on the value of the work
puf` performed. Indicate the value (rounded to the nearest dollar) o' all
❑ New construction ' ,
• � ddittonialteration/ replacement I p ( rot
❑ O mechanical mater.als, equipment, labor, overhead, and p a.
❑ Demolition ., v �iu e ' $
: • O Y '.OF -` ^`'CON RT .CL LOIY `; ,,.. I: L,EQU.IP1YIENT / SYSTEMS FEES"
1 ` and 2 dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checkla;.
O ther: D escri tion I Qty. Ea. l Total I
❑ Multi family ❑ Master builder ❑ P
'IOI3 SITE' TNOlivIA ?Ql: `APID: 'CO Ctt1TLON' ' ? ::
; ia : ,,: Heatinp/eooling
/l Tj Air conditioning or heat • �' I
Job site address: / � 5J 24 �✓A.y �-tJVtA ALL. (requires site plan showing placement) l 4 00
I l 14 J0
Furnace 100,000 BTU (ducts /vents) {
City/State/ZIP: Furnace 100,000+ BTU (ducts /vents) I 17.90
Suite /bldg.lapt. no.: I Project name: Gas heat pump j {
14.00
Duc: work I I ' 4 ' 1 " 0 � l
Cross street/directions to job site: I 14.00
Hc work
hot water system
Residential boiler (radiator or 14.00
hydronic)
Unit heaters (fuel -type, not electric), 10.0
in -wall, in -duct, suspended, etc.
Flue /vent for any of above 10.00
. ,Lot no.: Other: I 10.00
Subdivision:
` Other fuel appliances
Tax map/parcel no.: ,•.,,, 10.00
_ Water hea
E C TiO.' p ` ' ..._. 4 ''% : ., ,, _. a. " ' .... u 10.00
;. r s:r; p S_ . Gas fireplace ` `
r Flue vent for water heater or gas I I 10.00
/A/ 5 G L — Gi fireplace `
Log lighter (gas) I 10.00
Wood /pellet stove 10.00
Wood fireplace /insert
10.00
Chimney /liner /flue /vent I I 10.00
.,' _,... 1 00
,� ;.;;,i i i; u T E Ahi'C. ...
`p, `.�.,,{/ • P .: LY'.OVhIEEt' .1 , •=,.: , .,...�a''i:...._ •i�:.I� ,..... Other:
E nv ironmental exhaust and ventilation
e
e
hood /other kitchen
Name: /K Range D O , R
o ��, ,� � � � —_--. g � 10.00
Address: 137 D S , J L P tL.) IS �l f �CAtteJt C i ., equipment
Clothes dryer exhaust 10.00 f
City /State/ZIY: �y
Single-duct exhaust (bathrooms, 6.30
_/ 1 toilet rooms)
( / Fax: ( ) 10.00
Phone: ,�e� S load oilet compartments, utility
a Attic /crawls. ace fans
;: ; i::• , ',t `. ti -.. . ;; .; r'..;�' - C. AC'L'iiiiiiC1 't'
:.,d '® AYEL ..._r ':, ? 1 Other: 10.00
T:;
Business name: Fuel piping
$5.40 for first four; 51.00 for each additional
Contact name: A9/ ! Ql� /�1 Furnace, etc.
Address: Gas heat .um.
City/State/ZIP:
Wall/suspended /unit heater
Water heater
Phone: Fax:: (3'03 ) ,5,-,1 O /1 j ) Fireplace
:v3 >lo �y ��a� � I I
Em ail: .e:�r... I I I
s �aa. ue
/,. �;�,. _ ;.,r.. .CON R� , _'. -,... • � ",',.•::•:...,, ...... I
,/ '4,4. Clothes dryer (gas)
Business name: �0/u M6 /a. ,i-� A- T7r�CF. ..,_ ° t I Other: 1
' .MVIECHANICA:l:'PERMIT'FEE
o f o x a 3 � � _ •:;:.::
Address: Subtotal I
City /State/ZIP: 7 � ,a-r . 02 9 7� /Z I Minimum per mit fee ($ 2.50)
an review (25% of permit
D3 o ? L{ ,2 '1 O f Fax: 03) . se Got • c, P l ee)
Phone: � 4 )
I I State surcharge (8% of permit fee)
CCB tic.: ,j ( TOTAL PERMIT FEE 1
This permit application expires if a permit is not obtained within days after it has been accepted as complete.
Authorized signature: � "�" � I • Fee methodology set ny Tri -County Building hid ry Ser:,ce 30:
Print name: . ),(:) , 42 Ai �� 4_ 4,-,7,,, �� V 1 Date: 4•4 ay�D
40.4613T ti 1 /0 ? /COnrlwEB)
iAduildm r
g \Pcaits,t4EC.?crostApp.doc 12'03
Jun 24 04 03:10p PAM DRLHY 503 - 598 -0270 p.
- .
etn Zl ve T 4
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUITE E110
TIGARD, OR 97223
(503) 624
FAX (503) 598 -0270
JOB ADDRESS: / 0 7 - a�
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503 ° -4175
INSPECTION DIVISION • Business Line: (5 v4) 639 -4171 MST
]� BUP
Received 3 3 r (2 M Date Request-d /w� 0 AM PM BUP
Location / ..gr �.�. ✓ Suite MEC Od £/ 40®x/:
Contact Person h ( '2)3) ( p
?.4 70f PLM
Contractor /3'I Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: Ret4‘i e n/
Ftg Drain �� `/ Sc4 ELR -
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear [\f w` L 68E 1/'/
Framing Y 1 / /
Insulation
Drywall Nailing 1L (j a
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post Beam
R � ] /
Rouu gh h -In f (
Gas Line
Smoke Dampers
PART FAIL
TRICAL
Service •
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 17 O ' 0 Inspector � Ext
Other:
Final DO NOT REMOVE this inspection recor • m the Job site.
PASS PART FAIL