Permit CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00282 •
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/21/2006
PARCEL: 2S 104DA -17700
SITE ADDRESS: 13270 SW KINGSTON PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - SOUTH LOT: 003 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
DAVE CROSSWHITE Description Date Amount
13270 SW KINGSTON PL
TIGARD, OR 97223 [MECH] Permit Fee 6121/200€ $72.50
[TAX] 8% State Surcha 6/21/200€ $5.80
Total $78.30
Phone: 503 -590 -5544
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: �� y Permittee Signature: 5 , .
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 20 2006 2:31PM CLIMATE CONTROL INC 5039687224 p.1
rf echanical Permit Application , FOR OFFICE USE ONLY -
Cl of Tigard Received // p ermit No
13I Hal: Blvd„ Tigard, OR ���� ® Date/ ty: 6 � �/ � `- �6( 2 IQ � -,
Plan Review
Phone: 503.639.4171 Fax: 503.598. Other Permit:
Inspection Line: 503.639.4175 ,� i 1 2 0 2006 1 11'�� Date Ready/By: luris: Ir ga See Page 2 for
/
Internet: www.oi.tigard.or.us -��� Notified/Method; 'I V Supplemental Information
CITY
ILDINr DIVISION .
BUILD
. TYPE OF ..Vs ORK: : .;:.: ,: -::_ .. COMMERCIAL FEES' SCHEDULE..::- USE:CHECELIS'
Di 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
,❑ Demolition • Other: mechanical materials, equipment, labor, overhead. and profit.
CATEGORY OF CONSTRUCTION -`
Value:
: RESIDENTL4L EQUIPMENT / SYSTEMS FEES"
►iolk and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklisi.
■ Multi- family ❑
❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION - Heating /cooling
Air :onditioning or heat pump
Job site address: 139,'"'10 5(A) 9
419 5 pt. • (requires site plan shotsink placement) 1 14,00 ) y-0
• Cit /ZIP: T1 6 �-- 9- Z23 Furnac 100,000 BTU (ducts /vents) 14,00
Suite/bldg. /apt. no.: Project name: s cc , `4 Furnace 100.000+ BTU (duets vents) 1 7.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
' Res boiler (radiator or
hydronic) 14.00 '
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no..: F1'e /vent for any of above 10.00 .
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' DESCRIPTION OF WORK . . . Water heater 10.00
n /� [ Gas fireplace 10.00
i /[� l � i (aY� �� Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.0p
Wood /pellet stove 10 - 00
Wood fireplace/insert 10.00
[PROPERTY OWNER ❑ • TENANT Chimney /linerlilue /vent 10.00
Other: 10.00
Name: 0 V CX'oSS w� t r Environmental exhaust and ventilation
+� Range hood /other kitchen
Address:
�J a 7 0 5 v..) 1C....1 �
a bft pi • equipment 10.00
City /State /ZIP: T( / q - 7 Z3 Z Clothes dryer exhaust 1 0.00
� Single -duct exhaust (bathrooms,
Phone: (-?j) S7a _ �t1L( i-(573) 1S-1g, 2 0 toilet compartments. utility rooms) 6.80
APPLICANT ` CONTACT PERSON Attic /crawlspace fans 10.00
Business name: c 1 t r ` 6-11- (i nn'1 6 I Other:
Fuel piping 10.00
Contact name: S5.40 for first four; 51,00 for each additional
Address: 1 ( ) 7d-t t� l Furnace, etc.
p Gas heat pump
City /State/ZIP: e) 1 t 7�a Wall /suspended /unit heater
Phone: 4 ? ..4.4-4,3,, _ Fax: . ( 553 / _ . ^' 7 a Water heater
t - �✓..! tu7 j Fireplace I '
E -mail: Range
CONTRACT R Barbecue 1!
•
Business name 4 C \ . Clothes dryer (gas)
f 3
Other
Address: 16560 ,1 ( E i 7 1 MECHANICAL PERMIT FEES*
City /State /ZIP: r ` U 97 a ' Subtotal t4-dd
'„)4 3 F ax: :5' t — -7,3 permit fee (572.50) a-,,f'�
Ph one: :�' C ( ( �
�'� 7 ^ �' 9 Plan review (25% of permit fee) I
CCB iic. V +� i n S surcharge (8% of permit fee) . 1 L � e(
TOTAL PERMIT FEE
Authorized signatur : iiiir /{ i This permit application expires if a permit is not obtained ithin 180
�I�� days after it has been accepted as complete.
Print name: M -'`�, t f Date: A � " Fee methodology methodology set by Tr- County Building Industry Service Board
{ i
i:\Huilding \Pernil is \EC- PermitApp. do 4 40-161'7T x111 ?iCOM/WEB) .
Jun 20 2006 2:31PM CLIMATE CONTROL'INC 5039687224 p.2
,
°..; '''' . :_ MATE 16500 SW 72nd Avenue Portland 97224
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Phone: 503- 453 -4922 Toll Free: 866 -463 -4822
HEATING S. AIR C O N D I T N I N G Fax: 503- 969x224
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SYSTEM DESIGN — INSTALLATION SERVICE MAINTENANCE
cl lmatecontrolinc.com
CITY OF TIGARD
BUILDING DIVISION PERMIT #: meGO
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ���Npl �� (�I+
Inspection Requests (24 Hrs.): (503) 639 -4175 � :_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 3.D...170 ) j y CJ S 1LV) 1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: Qp PHONE #61,3)453
CONTRACTOR: PHONE #:
Inspection Reques S heduled For: Date: (� r � Pour Time:
1 m �
Code # ns eefion Description Confirm # Contact # Message p p M 9 ,
CAS/ RV-)
Corrections /Comments/ Instructions:
n /�,
__ _PASS ❑_PARTIAL_AP_P_ROVAL _ ❑_ CANCEL _NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: s Date: 6 - Zr9 .00 _ Phone #: (503) 718 - -e