Permit
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2010-00060
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/10/2010
Parcel: 1 S135CD04800
Jurisdiction: Tigard
Site address: 9785 SW LONDON CT
Subdivision: LONDON SQUARE NO. 1 Lot: 1
Project: Vallejo
Project Description: Install single head ductless heat pump.
Owner: FEES
VALLEJO, ARMANDO & SANCHEZ, IMELDA Description Date Amount
9785 SW LONDON CT
TIGARD, OR 97223 Heat Pump 02/10/2010 $61.06
12% State Surcharge - Mechanical 02/10/2010 $10.80
PHONE: 503-839-4440 Minimum Fee Adjustment - Mechanical 02/10/2010 $28.94
Contractor:
A-ACTION HEATING
18245 SW TV HWY
ALOHA, OR 97006
PHONE: 503-649-3524
FAX: 503-649-6095
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 952-001-0100. You may obtain a copy of the rules
or direct uestions to OUNC by ing 503.246.6699 or 1.800.332.2344.
Issued Permittee Signat
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
0/29/2015 13:45 FAX a1001/002
. Mechanical Permit A t f li ._;2, ED
City Tigard � a v . g PermitNo.:
i 131 SW Hall Blvd., Tigard, OR 97223 Da R Q U la ���
Phone: 503.639.4171 Fax 5Q .1 `1 01 2O \O Date/13y: Other Permit
Inspection Line: 503.639.4175 DBy:
T 1,-, :� r. n Date Ry
ReadyBy: JyW" HI Sir Page 2 for
Internet: www.tigard of T Notified/Method: ���
C1 Supplemental Information
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Mechanical permit Fees• are based on the value of the work
❑ New construction Addition/alteration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ er. mechanical materials, equipment, labor, overhead, and profit.
�. i ^ to Value: $
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and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
4 ` -` gy ° ' £S ' s =- .;.;,;::.%•.::..?-...:.:
Multi - family ❑Master builder For special information use deecklist.
❑ �� Descrip ' I Qty. I Ea I Total
`x!_,= ;'r" SIDE :1P1)�ORM!>FTb1Y :, :,.'. �" +r'' Heating/cooling
lob site address: ' Q ' y �1 Air conditioning or heat pump •
t7 / / ` (temmev site plan showing placement) - 14.00
City /StaterhlP: T 9 Q. rd ( 7 223 Furnace 100,000 BTU (ducis/vema) 14.00
Suite/bldg./apt. no.: I Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pip 1 14.00 ) j-- '
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: I Lot no.:
Flue/vent for any of above 6.80
Other: 10.00
Tax map/parcel no.: Other fuel appliances
;- _ i � `!'� 4 - fi • aer heater
,, . . .. . : :.�, ,.: :... . _ .. _ ._ ,;.., - .... :.._, � , , >o
Gas Wt ht 10.00
10.00
fireplace
S n ' Q • Flue vent for water heater or gas
t X C I .Q . � �� L l igh 10.00
1 �TT ))) (� Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. +, „ r . .: r q,�.F,, - Chimney/liner /floe/vent 10.00
:� " :f.f , : :.: :i , other: 10.00
Name: Q r\ fl O V I 0 Environmental exhaust and ventilation
Address: • `, Q� S l � �� 1 ` V C al other kitchen 10.00
City/State/ZIP: -` - 11 A od - ri el ? -I 22 3 Z Clothes dryer exhaust 10.00
J -�° -�
Single-duct exhaust (bathrooms,
��� Phone: y t . q �T Q Fax: ( ) toilet compartments, utility rooms) 6.80
=1," "'i' 3 ° r ` Attic/crawlspace fans 10.00
Business name: A-A TION H •. TI/+
Other. ul 10.00
F
C A N1i$ A/C Fuel piping
Contact name: 18245 S.W. T.V. HWY $5.40 for first four; $1.00 for each additional
Ate: ALOHA, OREGON 97006 Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
•
E -mail: Range
CO(� :•.: ; j c�s:J3�. ;?,,.' ' ; Barbecue
- A AC11ON HEX ING & ji / Clothes dryer (gas)
Business name` 18245 5 S.W. T.Y. HWY Off
ALOHA, ORFGON 97006 .7 . _ r ` r �y „ t �
City/State/LIP: "O• Subtotal
Phone: Lp 3 5a 4 I Fax:503) `p • (O Q s Minimum permit foe ( �
��1 e,
9 Plan review (25% of permit fee) -e-
CCB 1k.: -7213310 . 9 State surcharge (12% of permit fee) l • 9
TOTAL PERMIT FEE ■
Authorized signs This permit appti adan expires ua permit is not obtained wi ' 180
days after it has been accepted as complete.
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