Permit I , ti: ;,, w
A CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00468
+�I1� DEVELOPMENT H BMENg Tigard, ) 639 -4171 DATE ISSUED: 8/6/03
PARCEL: 2S1 04 B C -03700
SITE ADDRESS: 14363 SW WINDSONG CT
SUBDIVISION: HILLSHIRE WOODS ZONING: R -7
BLOCK: LOT: 048 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: 1 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of a/c unit.
Owner: FEES
KENT MOCHIZUKI Description Date Amount
14363 SW WINDSONG CT [MECH] Permit Fee 8/6/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 8/6/03 $5.80
Phone: 503 430 - 7525 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 - 624 - 2704 Cooling Unt Insp
Final Inspection
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 -00
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sued By: LA( i � ' Permittee Signature:
Call (5 1 639 -4175 by 7:00 P.M. for inspections needed the next business day
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•
' ' _` - ''Mechani+cal�Permit Application
,. Al on
\ 1� G p 3 Permit no.: ►1�c�a .00� lo g'
Date received: g 1 ..d'
. 1! City of Tigard 3
a � Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR u7"
Phone: (503) 639 -4171 Auk) V Date issued: By: Receipt no.:
Fax: (503) 598 -1960 G ay o F TIGARD Case file no.: Payment type:
Land use approval: v t2y t1I�IG DIV Building permit no.:
'fYl'1•: OE l'1•:1t11111
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
O New construction Addition/alteration/replacement 0 Other:
JOB Silt INFORMATION COMMERCIAL VALUATION SCHEDULE,
Job address: / ( !0 3 ski , A,2s 9 C . Indicate equipment quantities in boxes below Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: Block: ISubdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: I & 2IA11111.V DWlG :I.I.ING PERMIT FEE SCHEDULE
Descnption and locatio of work on premises: AND (• 0511111:1t1('AI.IINIHIS7•RIAI. EQUlPA1l•:Nl'SClll?DULE
/■v. s 7 /9-c-- Fee Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling u CFM /
Is existing space insulated? 0 Yes 0 No Air conditioning (site plan required)
Alteration of existing HVAC system
1111:('IIANI('Al. CONTRA(' FOR Boiler /compressors
State boiler permit no.:
Address: HP Tons BTU /H
p 0 ox . � 0 .9 7 Fire/smoke dampers/duct smoke detectors
City: 0_4- • State: `. ZIP: - Heat pump (site plan required) I
Phone: L 2e f. ,2 7 4 y FaxS4f... 02.7 _ E -mail: nstalllreplace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 94 3 S 9 Install/replace/relocate heaters- suspended, ■--
City/metro lit. no.: LArg_7_,7 floor wall, or floor mounted
Name (please print): , G is , L ( a s O 4e.A L ' ent or a. • lance o er an urnace _
('ON l A(' l' 1'I:ItSON ' b e' gera on: ■ --
Absorption units BTU/H
Name: PAM 9A /b y eqN DeaffAekl/ Chillers HP —
Address: Compressors HP
Enpn event exhaust and ventilation:
City: I State: I ZIP: I
Appliance vent
Phone: - p Fax: • , A,.. E -mail: Dryer exhaust
OWNER Hoods, Type U lures. kitchen/hazmat . .
�/ hood fire suppression system
Name: ki�NT /l cA,,' ate /4.4 ' Exhaust fan with single duct (bath fans)
Mailing address: , , 6e. Exhaust s stem a • art from heatin : or AC
State: p2: ZIP: e P P ' g an. 't • art on up to • out ets ■--
'r 22 T pe: LPO NO Oil
Phone: ' ;511 Fax: E -mail: ue •i•in: eac a.Iitiona over • out ets NM
ENGINEER 'rocessp p 'g schematic require.) IIM�
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: . I State: I ZIP: Insert - type
Phone: Fax: E -mail: Woodstove/pellet stove
Applicant's signature: Date: _ Other:
A
PP g /�II __ -O Other:
Name (print): , i / s MI
'Nor
all jurisdictions seeps credit cards, please call jurisdiction for mote information Permit fee $
O Visa 0 MasterCard Notice: This permit applicatio Minimum fee $
Credit card number / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount
' 440-4617 (60001C OM)
-A
HEATING & COOLING, INC.
8900 S.W. BURNHAM ROAD, SUITE E110
TIGARD, OR 97223
(503) 624 -2704
FAX (503) 598-0270
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JOB ADDRESS: /173 (p 3 56 CJiNc&fyi (y
SITE PLAN FOR AC OUTDOOR UNIT LOCATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
_ BUP
Received /OA F5e Date Requested Z AM PM BUP �1
Location /4 2 J (0 3 (A,) d Sv/i? G Suite 41P 3 — 0( /d
Contact Person 'E&,V'' /1/0c ►' ) O(3 — 7 535 PLM
Co 1014_ tPt PFi SWR
BUILDING Tenant/Ow er 3 —2.70 ) N (7\i-5L_
Footing
Foundation _ ELC
Ftg Drain Access: t / V M � 1 l. _ w� ✓ 0 t ELR
Crawl Drain 2J�
Slab Inspection Notes: 57 - 70 5 SIT
Post & Beam
Shear Anchors
51-74 e e l i e
Ext Sheath/Shear ll`'
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
pampers
PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1O- 2/
"► - 0 Inspector c ) Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL