Permit 1_ ..
rt* ,' CITY OF TIGARD MECHANICAL PERMIT
9!; L" Permit MEC2009 -00368
�h COMMUNITY DEVELOPMENT
TIG R 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009
0�, .Rfi, Parcel: 1S133AD06200
Jurisdiction: Tigard
Site address: 10935 SW SUMMER LAKE DR
Subdivision: Lot: 0
Project: Newton
Project Description: Install A/C Must maintain a 3' rear and side yard setback
Owner: FEES
NEWTON, DALE A AND LINDA L Description Date Amount
10935 SW SUMMER LAKE DR Air Conditioning or Heat Pump 07/22/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 07/22/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/22/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
FAX: 503- 691 -8556
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. •
Issued By: j ti Permittee Signature: Q
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.
07/21/2009 16:07 503 - 691 -8555 OREGON HEATING PAGE 01/03
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Mechanical Permit Application FOR OFFICE USE ONLY •
City o Tigard RECEIVED R i tt ' i -vv 3kg
II Aami Permit No.:
' 13125 SW Hall Blvd., Tigard, Olt 97223 Flan Review
Phone: 503.639.4171 Fax: 503,598,1960 d 21 2009 ()au15y: Other Permit:
TIGARD Line 501639.4175 � � Date Resdy /i3y: iwir: h7 See Page Z for
Internet; www.tigard - or.gov Notified/Method: Supplementallatbrmaflon
CITY OF TIGARD
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;i (' '• ''' ` , 1 ' •., ;,, T P4E at' kk ; . , , , t `'« , m , ' : , ,, •, ,, , .. ', '.* ;'0 *DU 'i 'Z JE C J C .t 0' ' ':
, ; . � + C01�� , : ,
0 New Mechanical pet7Dlt fees* are based on the value of the work
ew construction N Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, e.ui.... I labor overhead and .rout.
Value $
, i ^ , ° .#991:q, oP S ,..• . - 'not'
1 and 2 -famil dwellin Corr r1 r
y f p�y.7� y y c
7 Ii4.GS�1Sy "' 7.♦«7"a"� / EM.g �`F.>c q't• 1'..
y g C] merclal /industrial ❑ A ccessory building
For special information use checklist.
❑ Multi - family c 0 Master � builder ❑ Other: Description 1 Qty. Ea. Total
i 1 ''' ° t �n , r I 1 ( : iiili S1iT,t' v � cWb1NF ON s N ' Ikiti .TON I Y h +.',.. t( a Heating/cooling
q � Air conditioning or heat pump
Job site address: 1� l b c , � 2i... r YYI�'�` ll .o�ie_ 1 - (requi t s plan showing placement) 1 14.00 P .OQ
City /State /ZIP: ` ' \,Ure, O C -j 'Q Q 71 Furnace 100,000 BTU (dems!veots) 14.00 _
. Furnace 100,0001 BTl1(ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water sxstem 14.00
Residential boiler (radiator or
-
hydrunio) 14.00
Unit beaters (fuel - type, not electric),
in - wall, in - duct, sn pended, etc. 14.00
Subdivision: V Flee/vent for any of above 6.80
Lot
Ocher 10,00 _„
Tax map /parcel no.: Other fuel appliances
er e i° �, r',, t "�I� , 1 a t ir �' i 'rl + 1 : 1 r�1 ° iil�Mt"ra' °{ Water heater 10.00
: $� lit` i r�•,i t 1411. ${i6. aildE 0:_ei* ... • �� lii l,111 4 11 #+R'�It'ik�?'ifilii7 -
Gas i)ace 10.00
. 1 i r - e : QS` \ '
C -- Flue vent for water heater or gas
' l 5'enlace , 10.00
Log lighter (gas) 10.00
Wood/.ellet stove 10.00
Wood fireplace/insert 10.00
} p �, r, a l{ rn <y < i to r' d { i " , E, + Chimney/liner /flue/vent 10_.00
i't`��..Siai tal0M 0.teTi'Aiii :,.r'.l ,rv;10.0 igg ;+=�,+ x ' ftail,'El }.att'�hl!i Other. 1000
Name; aa`e C L:rrNf o, e_u_Y oY`1 Environmental exhaust and ventilation
Range hood /other kitchen
Address: `s . . ,t.s. *r .. . - - equipment 10.00
City/State /ZIP: "Tl and (\`R as Clothes dryer exhaust 10.00
I � Single -duct exhaust (bathrooms, .
Phone: �1 b a"t _ (-\ a Fax: ( ) toilet compartments, utility rooms) 6.80
I Y� } ti, Ep t�',' � I �. ° ,{.p, `,. Y I�Il t . r i; I+! ehF . ��. i,e,, l (f ° �' ] ri� `I I .4,:, 4 Attick.rawlspaee fans 10.00 F
t{,nl' I„Ig V Sr._., 11ri`!! . „�Na, e 3 t ..: i1' , ... • � ,- � . 1',i,.i f 1. �,,.
Other: 10.00
Business name: /'")y r� 4 (11 SCI NC. Fuel
. `+,
Contact name: �[� �. " � p. J $5.40 for first four; $1.00 for each additional
LS� Furnace. etc.
Address: 'Pt ,0,0 X - - -..
Gas heat pump
City /State/ZIP: 1l . .., ,. cA1 t Wall/suspended/unit heater
Phone: (56_5) e k l ., a� <219 Fax :: (5)6(3,_ J . j 5 � W.ater heater
Fireplace
. E -mail: Range
- ) L,q A) tr :.+ , r 1` ;:::; •,p ' i {, J ut:
, r „ ° i1 41.i 1 � : , Barbecue
,fm '1 � (, ^ -' ,, ;�} tip l ri 1,..., ti „ d. : p r d ;l � L �i T ! , , , , ,,, . , . ,o 1 i , I .,, ,,e I ,, G , . ,,.. , .., ! li .,
,i, ,,,
Clothes dryer (gas)
Business name: C)C e c � , i . - 1 4 i \r A. O t h er
Address • r pm,. ... ,I. i d :.,, l a ;.` EL J ,.'FE. ., ",r °i'� }.,: }:.,vii,,s ',+ '�
City /State/ZIP: DoxD (if e 91 1 l t Subtotal 1 4.o(°)
Minimum permit fee ($72.50) -7 Q, Q
Fhone: ( + O .• 1- cii ebb, l'.- (50 ,� Qn 1- 55Q _ Plan review (25° o of permit fee)
CCB lie.: V
, a State surcharge (12% of permit fee)
TOTAL PERMIT FEE T51 , 0101
This permit applicattoa expires 1f a permit is oot obtained within 180
Authorized signature:, day$ after it has been accepted as complete
Print name: F 1,P Q, �� Date: - 7-- @ t- OcA ` Fee methodology set by Tri County $nildisrg Industry Service Board
07/21/2009 16:07 503- 691 -8556 OREGON HEATING PAGE 02/03
.11..1110. -
First Floor
main floor
5' + -
` garage
5' +
N
Summer Lake Drive Summer Lake Drive • Job #: Oregon Heating & A/C scats: 1 : 95
Performed for: rage 1
Dale & Linda Newton PO Box 3971 992 Hwy 991A1 Right -Suite Resideratiai
10935 SW Summer Lake Dr Dundee, OR 97115 811119 R9R28588
Tigard, OR 97223 Phone: 503.538 -2953 2009 Jut 16:05:11
Phone: 503- 524 -5240 craig oregonheating.com CAW Oacu 1Wi'igt'tuft HVAC.-.