Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
8 • COMMUNITY DEVELOPMENT Permit#: MEC2020-00597
Date Issued: 9/10/2020
FLGpdL} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439111
Parcel: 2S104DA07100
10" n /i1' Jurisdiction: Tigard
Site address: 13054 SW RAPTOR PL
Project: AC Replacement Subdivision: QUAIL HOLLOW-WEST Lot: 57
Project Description: AC Replacement. 9/29/20:REPRINTED permit to change from NC to heat pump replacement.
Contractor: WATTS HEATING &COOLING INC Owner: COLBURN,ANTHONY
580 PORTLAND AVE. BENSON, ERIC
GLADSTONE, OR 97027 COLBURN, MAUREEN W
13425 SW 61ST AVE
PORTLAND, OR 97219
PHONE: 503-786-2858 PHONE:
FAX: 503-786-2807
FEES
Specifics: Description Date Amount
Heat Pump 09/10/2020 $61.06
Type of Use: SFA Minimum Fee Adjustment-Mechanical 09/10/2020 $28.94
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/10/2020 $10.80
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: - Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicationk..7f II FOR OFFICE USE ONLY i
t I,.. •
Received
City of Tigard Received
Permit No.: M- +�,� �y
sl 13125 SW Hall Blvd.,Tigard,OR 97223 f:.�' 2i� 1.�' y / '� � � / 7
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 HaTdmy: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/gy: run: Ed See Page 2 for
Internet: www.tigard-or.gov )Votiilcd/Method: Supplemental Information
Mee202O bCi
t a'� .. .., 'fe.c a ' r �- x �w� ,�. Cg7YI1_ B,- `„,�cr$EDULE--..USE CI1E
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���. -Z " �i�',E -'�px ..�i �`,rf:�...� }.�. �� ` #-'' 1'�. ". ",:,.�. �Ra�� ,... -�`� - : !�Wt
Mechanical permit fees'are based on the value of the walk
D New construction Addition/alteration/replacement performed,indicate the value(rounded to the nearest dollar)of all
0 Demolition ]Other: mechanical materials,equipment,labor,overhead,and profit.
- ,4<u o ly c,,,t`- < f {?s�., X-u e,v m E r( 7.T �,g .{ r fre n%r Value:$
1-and 2-family dwelling ❑Commercial/industrial eeessory g For special information use checklist,
❑Multi-family []Master builder Description Qty. Ea. Total
• r` r'J3A S1'i'1 7 Fg� j - fr6j ',r t - Fa^ z Heating/cooling:
-m . ` .. Ws.}t.v ,r `^` '4I .4`'''Y'"-.'4O ', '-- �.;.t• `£ :a- .. 3,
Job site address: , sq e V R R..., Air conditioning 46,75
�11` Furnace 100,000 BTU(duets/vents) 46.75
City/State/LUP:'Ti G a'Y"/f t 0 CI 1 2, 3 Furnace 100,000+BTU(ducts/vents) 54.91
llll....�,,,1111 r- Heat pump I 61.06
te i.( ,D
Suite/bldg./apt.no.: Project name: Duct work 23,32
Cross street/directions to job site; Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23,32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
`' k 'x Gas fireplacenser[
Y .€ .. ,.ti . ., i.r SCRX1 riliEt. Q t P 1`".,, ;au . ._. G €u, ' 33.39
r n, p l I j Flue vent for water heater or gas
leo i e 0LI-L7 e pre-vas/p^(4( �`U,-f- `"p/ /� fireplace 23.32
{ i t k 2 0 -0-D D ! i 5 t-i 15 1 {)t U) I tk� W` Log lighter(gas) 23.32
1 fn�s D be -k pomp
} ` li Wood/pellet lstove 23.32
"t Y.. Woad fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
". ..x. . ,' g.tOkk XJOk VO «f . n Other. 23.32
s"```'�'" I'�' - k^' Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Other: 23.32
❑ AI'PLICIY'I' . � CONTACT IERSOi`1
Business name. /l 1 `tiy f�� „�... COO Lf Fuel piping:
VVV ttt/// 444 1114'l�E ay
lJ� 1 $14.15 for first four;$4,03 for each additional
Contact name: `5ct Furnace,eta
�`�''u���
Address: 3 �Dr an .�'f Gas heat pump
- WatUsuspended/unitheater
City/State/ZIP: Si ill }A I D2 q '/y/�v a."7 Water heater
Phone: -7 258 Fax:: 76[P-Z8o7 Fireplace
E-mail: 15 @watts Barge
v� E�J t.t>-�' � t� Barbecue
a mine { � � GOea n,,,{ 'I . a . .,ts Yt A,..-.-s Other:� � i� 3_' ' "a�ia"..o"'. �' t''
,b n4""}i':2 5Y R y x k ,... s r 'G Krr�F Ra ••,(nu�iUR.ero � `i}x:, s'ty
Wati.
'3 -,�.cs ,x,�€ � ,-F�z'Es�''�v, 4`iTQ "��,r �s �I Clothes dryot(gas) �
Busrnessname ,j� ,(� ,,,-fg �l,�ng 4 ,
Address: 586 J Oar_-! ` (i t+�,�t a fry,
Subtotal
City/State/ZIP; Minimum pelmii fee($90.00)
� r �� �a Plan review(25%of permit fee) II
Phone:(Z3) 6I�� 6p.- pp Fax:ES -'7 (0-2
s;�V p � 6-7 State surcharge(12%ofpennit fee) 1(�.
CCD lie.: /L L� wV,. TOTAL PERMIT FEE L(O 4C)
Thin perndt application expires If a permit is not obtained within 180
/� ) days after it has been accepted as complete.
Authorized signature: Gt i, ,, ! .C./ l y T ' Fee methodology set by Tri-County Building Industry Service Board
Print name: LISe? ��urfaC Y ��••�/� Date:c/12 ./2.O
I:I3uildinglPonaks\MCC_PcrmitApp 040113.doc 440-4617r(I 1/02/COM/WEB)