Permit �! w
CITY TIGARD MECHANICAL PERMIT
r� � DEVELOPMENT SERVICES PERMIT #: MEC2006 -00184
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/5/2006
PARCEL: 2S 103CC -12800
SITE ADDRESS: 12068 SW WHISTLER'S LP ZONING: R -4.5
SUBDIVISION: WHISTLER'S WALK NO. 2 LOT: 075 JURISDICTION: TIG
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
NIKSICH KEVIN & DENA Description Date Amount
12068 SW WHISTLERS LOOP
TIGARD, OR 97223 [MECH] Permit Fee 5/5/2006 $72.50
[TAX] 8% State Surcha 5/5/2006 $5.80
Total $78.30
Phone: 503- 685 -1898
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
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 or 1- 800 - 332 -2344.
Issued By: , ` Permittee Signature: \p 49
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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Mechanical Permit App lie o � � ��' !I � I� FOR OFFICE l SE o pt
City Df Tigard Received - -- / ' � . - V
+�J
Date
13125 S W Hall Blvd., Tigard, OR 97223 P,( ;of Plan Review
Phone. 503.639.4171 Fax: 501598.1960 • 1 -u: „
Date/By: 1 y: Othor Remit:
Inspection Line: 503.639A175 _ '. 1' Date Realy:13y 1ur[s
lili Sec Page 2 fur
Internet: www.ciligard.or.us C' Notified/Method: Supplemental Information
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T iPE - OF 'WORK d `- COAMMERCIAL FEE* SCHEDULE ". - USE CHECKLIST
Mechanical permit fees* arc based on the value of the work
❑ New construction ❑ Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
$
- CATEGORY OF CONSTRUCTION Value:
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Information use c/iec61)sr.
❑ Multi - family Q Master builder ❑ Other: Description I Qty. I Ea. I Total
• JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / / Air conditioning 01 heal pump /
C Zs. g : srje` / % / ', j/ 4 L ,o (regimes site plan showing placement) 14.00
City /State/ZIP: Furnace 100,000 BTU (duets vents) 14.00
Furnace 100,000+ BTU tduets;vents) 1 7.90
Suite/bldg./apt. no.: I Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14,00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10 00
Tax map /parcel no.: Other fuel appliances 1
DESCRIPTION OF WORK - Water heater 10.00
_ Gas fireplace 10.00
7/f- 779.7/ Flue vent for eater heater or gas
fireplace 10.00
Log tighter (gas) 1000
Wood/pellet stove 10 00
Wood fireplace/insert 10.00
Chimney/liner /fluevent 10.00
OPERTY OWNER . 1 " - - ❑ TENANT .
Other. 10.00 _
Name: 4V,<, ,r / /cif 'i 57 e. 4 Environmental exhaust and ventilation
Address: •' v / // Range ltood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust limo .
'3) �� if J
Single-duct exhaust (bathrooms,
Phan `y ( ) t Fax: toilet compartments, utility rooms) 6-80
Q APPLICANT .2 "CONTACT PERSON Anidcrawispace fans 10.00
Other 10.00
Business name:
Fuel piping
Contact name: /� /) .4 /, y S5.4D for first four; $1-00 for each additionadditional Address: CJ Furnace, etc -
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone 3 ) t2 y .
Fax : (543) ..... D.�7() Fireplace
eater
E -mail: Range
- CONTRACTOR Barbecue ._
Clothes dryer (gas)
Business name: ( f1f el A COn C� G� Other:
Address: ,, /9 OX 30 3 qq J - MECHANICAL PERMIT FEES*
City/State/LIP: y q 49 a 71 Su brow/
'f Minimum permit fee ($72.50)
Phone: ( 5 6. ; ) G R e / ,77U s Fa x: ) ) J 4 7/) Plan review (25 %of permit fee)
CCB lie.: 7/. 35. State surcharge (8% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained 'within 180
Authorized signature. dais after it has been accepted as complete.
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Print nam 4 O� f ; �r,` J ate: • Fee methodology set by Tri-County Building Industry Service Board
■ 1Bu11d'uW\PrnnitslMEC- PennitApp doe 12103 4.5646171 (1 1NwcomiwES)
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HEATING & COOLING, INC.
Q.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
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ADDRESS: / 7# L j fa/ A. 46,p
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CITY OF TIGi4 J BUILDING DIVISION PERMIT #: MEC200S -00184
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/5/2006
Phone: (503) 639 -4171 At
Inspection Requests (24 Hrs.): (503) 639-4175 ' it
INSPECTION WORKSHEET FOR DATE: 6/23/2006 TIME: 7:16AM PAGE: 64
SITE ADDRESS: 12066 SW WHISTLER'S LP CLASS OF WORK:
SUBDIVISION: WHISTLER'S WALK NO. 2 LOT #: 075 TYPE OF USE:
PROJECT NAME: NIKSICH
DESCRIPTION: In:4.aII NC unit.
OWNER: KEVIN & DENA, NIKSICH PHONE #: 503605.1890
COLUMBIA HEATING & COOLING INC 36 ?_A 2704
CONTRACTOR: PHONE #: 50
Inspection Request Scheduled For: Date: 6/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 032206 -01 503-624-2704 N
Corrections /Comments / Instructions:
iLel'-erp d %
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ‘ Phone #: (503) 718- ��(�