Permit _ w , µ 4 414, CITY OF TIGARD MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00140
,� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/23/04
PARCEL: 2S103CC -10000
SITE ADDRESS: 12220 SW WHISTLER'S LN
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 047 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: Install a/c unit
Owner: FEES
JOE & MARY MASTON Description Date Amount
12220 SW WHISTLER'S WAY
TIGARD, OR 97223 Permit [MECH] Permit Fee 3/23/04 $72.50
[TAX] 8% State Surchar€ 3/23/04 $5.80
Phone: 503 - 524 - 3444 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 No = ' Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 -0e' -0100. Yob mayo.tain opies of these rules or direct questions to OUNC by calling
(503 246 -6699.
Issu- s By: i 9 P artilli Permittee Signatu _ „Ira
Call (513 6 . -4175 by 7:00 P.M. for inspections needed the nex business day
Ma: 23 04 10:27a climate control 503 968 7224 p.1.
ti w
Mechanical Permit Application QI F.1Cis USE ONLY
� _ ii ' ± City of Tigard RECEt� Date received: " �, d Permit no.: -212! ,
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 972 Project/appl. no.: Expire date:
Phone: (503) 639 -4171 0 Date i ssued :
Fax (503) 598 -1960 MAR 2 3 By: Receipt no.:
CITY OF TIGARD Case file no.: Payment type:
•
Land use approval: IVISION Building ►3UILDING D g permit no.: /
TYPE OF PER - ii/�iii
R 'ITT
sal & 2 family dwelling or accessory 0 Commercial/industrial
0 New construction 0 e f. +] Tenant improvement
0 ❑ Other
JOB SITE INFORMATION
COMMERCIAL VALUATION SCHEDULE
Job address: 1 ...a. - D-0 SW iVJh( -iiurs �.
Bldg. address: Indicate equipment quantities in boxes below. Indicate the dollar
Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.:
Lot: profit. Value $ _
Block: Subdivision: * �
Project name: See checklist for important application information and
X014 05 - m c tv .-) jurisdiction's fee schedule for residential permit fee.
City /county: �
T" yc _ a I ZIP: q 1 �3 I & 21 A DWELLING PERMIT TEE SCHEDULE
Description and fecation of work on premises: ANI COMMERICAL/INDUSTRIAL I;QUIPMENT SCHEDULE I
1r\5 l 0.
Est. date of completion /inspection: Fee (ea.) Total
Tenant improvement or change of use. Description Qty. Res. only Res. only
HVAC:
Is existing space heated or conditioned? U Yes 0 No Air handling unit CFM
Air r ati o n of existing (site plan required) I
Is existing space insulated? 0 Yes 0 No
• MECIiAI\�ICAL CONTRACTOR • teration of existing H VAC system
Business name: C I1.
State boiler
�a CU (v0 ( State boiler permit no.:
Address :11.4500 �w - jD_tie-t. Ave_ HP Tons BTU /H
City: PO r F t � Fire/smoke dampers/duct smoke detectors
State: OR 1 ZIP: 17aa Heat um
Phone:5c,3 `453 - y FaX Install /replace ce (site plan required)
� �tn E -mail: I nsta l l /replace 1'umace /burner BTU /H
CCB no.: C �1 �� Including ductwork/vent liner 0 Yes 0 No
City /metro tic. no.: f 4 l� Install /replace/relocate heaters - suspended,
Name (please print): wall, or floor mounted
ti I. "1.t, ... - Vent For appliance other than furnace
CONTACT PERSON Refrigeration:
Name: Absorption units BTU /H
Chillers HP
Address: Compressors HP
City: State: ZIP: Enviromrtentai exhaust and ventilation:
Phone: Fax: Appliance vent
E -mail: Dryer exhaust
OWNER Hoods, Type 1/ IUres. kitchen /hazmat
Name: �V f 1\116..v Mw4wl hood :ire suppression system
Mailing address: 1 a Exhaust fan with single duct (bath fans)
a 3w uv )i- 1 1 5"i- p V" J Exhaust system apart from heating or AC
City: T ■ a v C,1. State: -j a s Fuel m (up outlets)
ZIP: piping i p g and distribution (tr to 4 outlets
Phone:•• 2y3�4y Fax: E - mail: Type: LPG NG Oil
ENGINEER Process .Ping each additional over 4 outlets i i
i Process piping (schematic required)
Name: Number of outlets
Address: Other listed appliance or equipment:
City: Decorative fireplace
State: ZIP: Insert -- type
Phone: Fax. E - mail: Woodstove /pellet stout
Applicant's signature: ) Other:
lA_ : i 6 I Date: ,g - Other:
Name (print): A G f - 1
Nat all jurisdictions accept credit cards. please call jurisdiction for more information
❑ Visa 0 MasterCard Notice This permit application Perini[ fee $
Credu curd it u mbel' expires if a permit n; not obtained Minimum fee $ �j a, c7-)C1 within ISO days after it has been Plan review (at %) $
Name of cardholder as shown on credit card State surcharge (890) $ 5.75 0
TOTAL $ i F, - 3
acce as cotnplett:
S n
Cardholder signature Amount /
4411 -4617 (6 /00UCUM)
Mar 23 04 10:28a climate control 503 968 7224 p.2
CLIMATE CONTROL 3315 NW 26th Avenue Portland, OR 97210 -1839
A&B HEATING & AIR CONDITIONING 503- 223 -4393 FAX: 223 -4494
Ms FP
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SYSTEM DESIGN INSTALLATION SERVICE - MAINTENANCE
TIGARD • 684 -3355 ST. HELENS • 397 -2501 VERNONIA • 429 -0707 VANCOUVER • 254 -3063
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received Date Requested —04 AM PM BUP
Location /2- a .54 S Le) • Suite (V 171 — N
Contact Person Ph ( ) 5 3 — V — PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner�C
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear i 4-06
Framing
Insulation I
Drywall Nailing L -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
-
Final
PASS PART FAIL
PLUMBING r , _
Post & Beam
Under Slab
Rough -In
Water Service `( C
Sanitary Sewer fi 4. ' 0 I S � b
Rain Drains y
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: •
Final
£S RT FAIL
MECHANICAL
eam
Rough -In 4 � A/1-
Gas Line
•• a Dampers
T FAIL
CTRICA
Service
Rough -In
UG /Slab r r
Low Voltage {p
F' rm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date u Inspecto I Vg - ' ' Ext
Other:
Final 1 DO NOT REM • VE this Inspection record f om the Job = - te.
PASS PART FAIL v