Permit 1, u CITY OF T GARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00313
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/30/2007
PARCEL: 2 S 109 D D -0 7200
SITE ADDRESS: 12784 SW REMBRANDT LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 002 JURISDICTION: TIG
PROJECT: CARLSON
Project Description: Install 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
CARL & JEANINE CARLSON Description Date Amount
12784 SW REMORANDT LN
TIGARD, OR 97224 [MECH] Permit Fee 5/30/2001 $72.50
[TAX] 8% State Surcha 5/30/200'i $5.80
Total $78.30
Phone:
•
•
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -5014
FAX 503 -557 -2990
Reg #: LIC 71878
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: l /�/ Permittee Signature: / ) //( / 7 jy/ y 4i / /� / r
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
Is 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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."...-t• ' . ....- • -.. . • •,•,, • ,. - • .. • - , • ,. , • , " .• • • • • - • - :
...' 1 anical Permit A • lication •
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3123 SW Hall Blvd., Tigard, OR 7 in. 4. .. 1 ' 1 -3 . Plan Review
Permit No.: 1 I
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..::: Phone: 303.639.4171 Fax: . .121Pt, '*-- i4, t . .,...tjteoh, '; )1 ';'-. Dans/13y; ()char Permit:
'.. Inspection Line: 501639.4173 'i E-l/ 4 4
.10 ' ,_: .4 i Date Ready/By: awe: Sff See Flip 2 far
, —
Internet: www.ci.tigard.or.us Notified/Method: -Tie StIpplemenhtl Infurrnestion
• •
• " • 7'4. *IRK . :: i - - - • • . ' .. '': - . ' •ONFftlERCIAL FEE" •SCATEDT.:TLE - USE•CF1IECKTIST •
0 New construction Mechanical MIchdloitTrtjg
__. OgtmiatiN: Mechanical perntit tees' are based on tho value of the work
2 .,
performed Indicate the value (rounded to the nearest dollar) of all
''''''\-; Il Z ' ' •
E] Demolition Illi 40(7f ,I, f - • , , I - mechanical materials, equipment, labor, overhead, and profit
•
Ott CO lue: $
. •
: • . • ••• • •••••• . .. • " " CA ' ' CsriSTRI/CTION
• • • • -••• •• •••• -• ..... ..• - • - •• • • -• -• •• ' ifi.fiWENTIAL 0 .4 01 1 1 lidENT•iSYST.*IvIR'FR.P" -. . -- .. . ...
- and 2-family dwelling 0 Commercial/industrial El Accessory building - • •
For 8psrla1 Information fad eitecklmr.
• Multi-tinnily 0 Master buikka 0 Other:
Descriptiou -- _i_q ___IL _lLotal
....--...---...---
J::: ........................ .. 4 .... • '' . Heatin cog/±ft___________________
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Air conditioning or heat pump
Job site address: 4;1 7 8 4 ,5.6.0 /2. L Ai (requires sire plan showing placement) ( 14.00 1 i f
City/S'Ime/ZIP: ---ri i i... 4 ,- / ../) 6 1/2- 9 - 7)21' • Furnace 100,000 BTU (duels/vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17.90
• Suite/bldgfapt. no.: Prujaut name: ....._,..„ _, • . Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
.11ydruniu hot water system 14.00
it — caideritial hoiler(radiator or
. hydrade) 14.00
Unit heaters (fuol not electric).
in-wall, in-duct, suspended. etc. 10.00
Flue/vent for any of above
Subdivision: ........... Lot no.: 10.00
-
— , Other: ---_____—
10.00
'Fax map/puroel Ito.: . Other fuel appliances
-." - - - • - "
:::•"•• ..•••• ' .• .. .' • .. : •• - • •• • • DEscRien N OF • WO.itk .... , . .
0 0 1 b 46 1 4/ c.
/ - „ Gas fireplace_ ___ ___ , _____, _ )0.00 . _________
Flue vent for water teller or gas
fireplace 10.00
Lug lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10,00
, Chinmey/liner/flue/vent _10,00
.. - .: :. • •:;;,:e!gr;r•PCRERTY OWNER .
go.• • 0 TENANT .
Other: _10.00
Name: 4 .ICWL:t A. . 'r A I Environmental eximuirt and ventilation
Range hood/other kitohen •
Addresii:
4.3 7° I / 3 7.6 --) ..,e16 equipment 10.00
City/State/ZIP: ir - ,„, .., - ,Jir clothes drer cabana _, 10.00
Single-duct exhaust (bathrooms,.
Phone: ( ) 0 Fax: ( ) tact com onto util room _
.. . ...IV.... •••
.: iitlitiEiitiT " . . . - - . . . : •• • • • • a t . " Attichrowtemice ems 1000
• . . . . . ... . . . .
Other:
Huainan' name: A-TEMP BEATINO AND COOLINO, liNf: . 10,00
, Fuel piping
--- .
Contact name: 16000 SE Evelyn St. $5.40 for Brat four, $1.00 for mach addltiosuil
Clackamak-OR-97015 «unlace, etc.
Address: 503450-5014
- Gas heat pump .
City/State/LU1: Wallhospended/unit heater , -
Phone:( ) • H-
: ) .5" - 5 - 92 'IO Water heater
. • . - , Fireplace
Z?---- .." .. . - T.. /7C._.... Range
KNOTT • I • .
--- - - •• ••••••-••• • - - •• • C
. . ., • , .• • .• .. It . . . Barbecue
Bus • s name: A HEATING min coo W. C ..s:ir,.the3 dryer (gas)
_ Giber:
Address: • 16000 SE Evelyn St. .-
ClaLiamak OR 9701S luggl.ANICAL.PERmyritowi . • •
City/State/Z1P: SO3-650-5014 _ Subtotal % / If
-,
Phone:( ) Fax: ( ) Minimum permit fee (172.50)
i ,
-, - 4
. . • . _ . Flan review (25% of permit fee)
CC13 he.;
State surcharge (14% of permit fee) ,.... A 9
•
, AI TOTAL, PERMIT FEE
, ••
Authorized , & 0 .,
....dp .' r 1 This permit application expires if a permit km nut uhinbusd within ,1110
‘ V.-le
• days after It has been accepted as complete.
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A-Temp-Heating & Cooling Inc.
SITE PLAN
55.5:1
Prepared by: 4/ o't A5 0 1 1 Date: -/F ' -
Customer Name: e .7 )410 eP 0 /A
- Address . / 27 it( sz) Pto<afa ca)
Customer Phone:
Property Boundary Line
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MAY 30 2007 t ie ,
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7 ,PITSION
House
Street
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CITY , OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00313
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30 /2007
Phone: (503) 639 -4171 1
L Inspection Requests (24 Hrs.): (503) 639 -4175 1 __..
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 89
SITE ADDRESS: 12784 SW REMBRANDT LN CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 002 TYPE OF USE:
PROJECT NAME: CARLSON
DESCRIPTION: Install a/c unit.
OWNER: CARLSON, CARL & JEANINE PHONE #:
CONTRACTOR: A -TEMP HEATING & COOLING PHONE #: 503 - 650.5014
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 050094 -01 503 - 747 -4917 Y
Corrections/Comments/Instructions:
fJ E1-E617 Lt' a St' 7
PASS ❑ PARTIAL APPROVAL ❑ CANCEL fAvRe4tess
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: >, Date: Phone #: (503) 718- Z44�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007-00313
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2007
Phone: (503) 639 -4171 li�
Inspection Requests (24 Hrs.): (503) 639 -4175 F ..
INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 60
SITE ADDRESS: 12784 SW REMBRANDT LN CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 002 TYPE OF USE:
PROJECT NAME: CARLSON
DESCRIPTION: Install a/c unit.
OWNER: CARLSON, CARL & JEANINE PHONE #:
O A - TEMP HEATING & COOLING PHONE #: 503-650-5014
Inspection Request Scheduled For: Date: 6/12/2007 Pour Ti -:
Code # Inspection Description Confirm # Contact # M- :s-ge / 5VNA
699 Mechanical final 050040 -03 503- 747 -4917 Y
Corrections /Comments /Instructions:
r)
V �
❑ -ASS ❑ PARTIAL APPROVAL 4. CANCEL ❑ NO ACCESS
❑ 'AIL — CALL FOR INSPEC o . ADDITIONAL FE -" ASS .SED
Inspect. • Date: Phone #. (503) 718-