Permit C ITY OF TIGARD MECHANICAL PERMIT
,' DEVELOPMENT SERVICES PERMIT #: MEC2005 -00418
`�I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/12/2005
PARCEL: 1S134AB-00300
SITE ADDRESS: 11304 SW IRONWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 002 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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
LASCINK, GARTH V AND RUBY E Description Date Amount
11304 SW IRONWOOD LOOP
TIGARD, OR 97223 [MECH] Permit Fee 7/12/200f $72.50
[TAX] 8% State Surcha 7/12/200 $5.80
Total $78.30
Phone: 503 - 590 -4343
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: O , / ` 52,4 „, ' Permittee Signature: -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.
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.Nleehanical Permit Application., 11111111111111=811=1111.11.1111.
City of Tigard 11 ' E -a
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in imLic v _ Received ,...., '■''
. 17— Perm" is" V i Nktr-r2a).3 - 06 e i / d
13125 sw Hall Etivd„ Tigard, OR 97223 - Plan IttostleW
Phone: 503.639.4171 Fax: 503.598.1960 1 CAI= Permit
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Date/Br
inspection Line: 503.639.4175 4,,,,vki, v t .ii).
JUL . • I 2 20Pirll Date Ready/By; !uric VI See Page / for
'memo: WWW.Ci.tigard.or.us CITY OF TIGARD Notified/Method: 1 / 6 suPplementai Information ....-7,....,L.,..z,.;: 7'4 ',',!!),!;‘..,..I.
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: 1 7 1 7.M. i, " '';.:* '1R!.*Allhicif,',1-il .. if",1411:,n1)., . SetirtXtak.'iErEtiSCFIBIlltitE:' . •! : t3Stl . :B.t anfs •
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0 New constructiOn Addition/alteration/replacement
Mechanical permit fees"' are based on the value of the work
, .
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition D Other: .. mechanical materials, equipment, labor, overhead, and profit.
''.' w i,4;:::ROTIVIA,Igtir Value: $
1 ,,,,,,44,-,•:•ii.,; .,,„,I ,r1, ..,, - •.:i .0 ,..;..1...,,,:.. 14,........., , ..1•;.•:•!: 1 '°k,,...oHi. ,•:.•::. . . ,.- :.: •A . . - - • . . • ..• ...: • • - .77-7 ' 7 7 • • ' .
FEES
':•••ABSJEtritl&••EQUfintENTIt'SYSITNIS
• 1 - and 2-family c..; ening 0 Commercialliudustrial 0 Accessory building
For special information use checklisi.
1: Multi-family D Master builder ID Other -.
Description I Qty. 1 Ea, I Total
i! 1;h4. 1.:0, ej,., lAnionce.t g.:k ,... ,;'::?', ..,' ' ,.; .,:, .: .:, „ 4 ,, . . -
'.■;,i!1!: Hen ": " -....,— • • -..- ,.#--. eo,
Job site address: I (o Li c svo "V ofbaD i • Air conditioning or neat pump
re uires_situlikacetnont) i 14.00 i
City/State/ZIP: laaArD / 0 ( 9 32•Z'l Furnace 100 000 BTU (ducts/vents) 14 00
Furnace loo,000tyru (ducts/vents) 17,90
Suite/bldg./apt. no.: ,.._) Project name: ,
14,00
_
Cross street/directions to job site: Duct work - . 14.00
....
H. (Ironic hot water system _ 14.00
Residential boiler (radiator or
h dronic) 14.00
unit heaters (fuel-type, nut electric),
in-wall, in-duct, suspended, etc. 10.00 .
.....,—
-
Flue/vent for any of above _ 10.00
Subdivision; L -
ot no.: ---'--
.______, • other - 10.00 ,
_—.-
Tax map/parcel no.: • ,.,Other furl app
! ljf<Y9W,ii ■44itk
0 i1
114 , Vir ."--7- 7 1 7 ----1275- 7 Water heater
4: „ ...,..,- , , 111 i, Gas fi re vent for water beater or gas
. fire i lace 10,00
_,.
.— Lo: li;.hter _asi 10.00
-,.
1 . Wood/pellet stove
-..- 10.00
----- Wood tire I lace/insert _ 10.00
, .
j 0,00
,i-,,will,._400.t,:7•77•171747.77,31777,,i ='.0..7,f1^1 , 01 , 449,.. , e.0 , 1„,,s.4. ,4 40 Chimne /liner/flue/vent
• 1 :5 • ''''''' Gen" %Ur i i4 r., Oi• ',
•-„.„••' ,,,'•••••' `,,,„ oit 1. IS 1411 ... • s, i ..,--... .,,...., P.A2,2, ..:24' , • . w..... .4 .,,,.., ,,,,!, . .,,i,,.... _ 4, ;1411 $ A..'....'14,14)1., ' . I Other; 10,00
Name: 0 I h i.c...., Environmental exhaust and ventilation _
aange hood/other kitchen
Address: 10,00
equipment
'''''"' — •
City/State/ZIP: Clothes dryer exhaust 10.00
.•
. Single-duct exhaust (bathrocims,
Phone: ( ) •e 5 - 1 0 - VS ( .. . 7 Fax: (,,e.' ) toilet sumpartments, utility rooms) 0.89
i
Vzfptil,Vaiart", Tar% 61,fiti:.1■ ti,.iii.iiEtvii!, 1 1 4 1g;:l Atti2/cta wISpace tans 10,00
ITI '•Fii0 • TI..= ..W=1•Vigi:0,104tii,k4J. ;10,,.:,:,.- ;.,..,k
Other: 10.00
_
8,,in., wine: itl MLitt, — C171{) CONITO 1 Fuel i in. -
.__
Contact name: $5,40 __for first four; $1.00 for each additional
, -
Furnace, etc, • __,
Address; i'ql F.1 0 • ClaCkan Ri i 7 ( 1.1 0 Z) Oaa heat pump -
.._
-.-.
_
CCity/State/ZIP: OrtgOrl CI 1\1 OR q70z,ri Wall/suspended/unit heater _
' ( C 7
Phone . ) ,,, , -- 2220 Fax: : (62) 55-Fcclg Water heater
.... _
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E-mail: . RATI• e _
V.: I
• , 151K :k ' • ,., " krf ,.• • . , ,,, ..,1 .r.;, .!!,310,..1.11r• ,Le ., ,t,;i!n' "i. t. M
Vilti i t' V117„:F. A 1 ,... „ ct . v , i .,„ „.11.. ■ g.. r 44 ■ ..?.,, ,f,,Pi , ,k!, „ .,..., 1• Barbecue
Business Cl
ess name: Clothes Caln D #i ti) — Other
othes dryer (gas)
Address: t?)FX) G. .r\f,,K4 a,c_ 111/615 g — ... r bri IrC, _ '-'L7' ' - -:' • • • "4E*9 • • " .• •
.••ild' • : •,,E,PNIFI. - .
City/S tate/ZIP: OrTon (,)- ___._ci _ . „, subtotal
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--,....„., " Mintinum permit fee ($72.50)
Phone: (t 19b -2220 I Fa :
x' (.") • . . 7 •
' 0 F5c . -(1,1'4 - .---,
pian review (25% of Permit fce)
CCB
lie.- -
721123 ... .....
_...., _ State surcharge (8% of permit tee) --i
TOTAL PeRMIT FEE
,:›x •7 -Le /274,0C • " permit appiii;tioa expires if n permit is not nbtaine w n "L
Authorized signature: days after It has been tick:eyed MI CUMPI
Print name; bial ptou
, , I A., i, A Date: 1 1 /06'. 4 ' Fee methodology set by Tri-County Building Industry 90
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Service 8ard
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.004 °f8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2005
Phone: (503) 639 4171'j ° 4Unq�iiigf %'j�l'�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/9/2005 TIME: 7_05Am / ' PAGE: 70
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SITE ADDRESS: 1.304 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 002 TYPE OF USE:
PROJECT NAME: LASCINK
DESCRIPTION: Installation of A/C unit.
OWNER: LASCINK, GARTH V AND RUBY E, PHONE #: 503 - 590.4343
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 -657 -2220
Inspection Request Scheduled For: Date: 0/9/200 Pour Time:
- Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013150.01 503 - 557 -2220 N
Corrections/Comments/Instructions:
Cth /tot- kw/ nta 44 ,5`2- qd
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL 111 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: Phone #: (503) 718-