Permit li_ w CITY OF TIGARD MECHANICAL PERMIT
: :;- COMMUNITY DEVELOPMENT Permit #: MEC2010 -00171
1.GAR)3 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/19/2010
Parcel: 2S102DC04100
Jurisdiction: Tigard
Site address: 9252 SW HILLVIEW ST
Subdivision: MCDONALD WOODS Lot: 14
Project: Allison
Project Description: Air Conditioner Must maintain a 3 foot rear and side yard setback
Owner: FEES
COMMUNITY FINANCIAL CORP Description Date Amount
PO BOX 1969
LAKE OSWEGO, OR 97035 Air Conditioning 04/19/2010 $46.75
12% State Surcharge - Mechanical 04/19/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 04/19/2010 $43.25
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503 - 538 -0165
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 questions to OUNC by calling 503.246.6699 f or 1.800.332.2344.
Issued By: (J4 �(� Permittee Signature: e j�
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.
Mechanical Permit AnDlicatikE CEWED I l: I > I h l+ I l . +, .
City of Tigard may: Permit No.: C - 02) 11 1
13125 SW Hall Blvd -, Tigard, OR 97223 6 Plan Review Other Permit:
' ' Phone: 503. 639.4171 Fax: 503 - 598.196, PR 1 6 2.010 Datefly:
i s ; . Inspection Line: 503.639.4175 Date Ready/By: D See Pape 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
1 k 1 1►
TYP. : OF W. , ... ‘...c0 Ili" . SCUEDULi - vsE comeagr
✓ ❑ New construction Addition /alteration /replacement Mechanical permit fees are based on the value of the wort
performed. Indicate die value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials. e•ui.ment, labor. overhead. and .rofit.
CATEfii(tY -O)p CQP11t`liC)'1Nl1)i .. a`, ;: Value S
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building £ /
For special information use checklist. SYS*PAS FEES*
Q ulti- family ❑Master builder 0 Other: Description Qty. Ea. Total
JOR BerE • INFOL 3 tTI 1,.A1NiD 'L 1ON lleadn: cool!
Job site address: / c ( l Air conditioning MIEN tires site .Ian showin_ .lacemem) 46.75 ME
Furnace 100 000 BTU ducat/vents 11111111 46.75
city/staterLlP: — r - v c] b� { . 0 (p, 67-7---
I Furnace 100,000+ BTU (ducta/veais) 54 -91 MIIMI
Suite /bldg. /apt. no.: Project name: a `, L it t sl9 V\ Heat . um. En 61.06
Cross street/directions to job site: Duct work 23.32 ME
H d&Onic hot waters stem 11111.111M1
Residential boiler (radiator or
h ironic 1111 23.32
Unit heaters (fuel -type, not electric), -
in -wall, • • . sus. n. • etc. 46.75 MI
Subdivision: I Lot no.:
Flue/vent for an of above MI
Other: 11111 23.32
Tax map/parcel no.: Other fuel a .. fiances •
:ITION. 0I? 'wt Water heater lIgIn
AM �� 1 1 t Gas fi • lace NE 33 NEIN
�a► .. .L Flue vent for water heater or gas
fi .lace 23.32
-- - en - " = : 23.32 ME
Wo. cllet stove 33.39
Wood .lace/insert _ r ■111
23 -32
- : i!$Ql►�'iFY :OWNER �'P,p�Lt1,Ai'I' : •.. :.; _
` Other: REM
Name: U-`2'1 . ( 1' (n -- _ Environmental exhaust and ventlladou
Address: `7 2.S j 1 SO I4 Y12. \ / e ) &+ Range hood/other kitchen
..ui.rncnt 33.39 MI
City /State/Z1P: �l q d pa ( . DP C "7 2. Clothes d r exhaust _ 33 -39
(S'3 4%7 Lio Fax: �— toilet corn artmentss (bathrooms,
rooms
I -�
Phone: 1
ace fans
_ LTA � . , NI 23.32 NM
• Attic/craw : .
Business name: Other _E
IlnIT
Contact name: FOUR SEASONS HEATING $14.15 for first four; $4.03 for eaca additional
Address: AND AIR CONLJI 1 IUNINCa INC. Furnace, etc. MN
1006 INDUSTRIAL PKWY —
City /State/ZIP: NEWBERG, OR 97132 Wall/sus • : ded/unit heater _ NN
Phone: ( I R s0 I Fax:: ( -6 f c5 Water heater _ ��
E -mail: tahf- Q -i'�QtI .5 4 ` kkt aCO WI . MEI
Firc.lace rer.1■1111111.■Mill ME
CONTKAcrea . Barbecue
Business name: l� Clothes . cr _ :) � �
P�u �a HUNG
Other.
+ �G INN
Address: AND AIA C � , i, 1 1. ktect ooti: mire rms.
City/Statc/ZIP: NEW 1 DUSTRIAL picky • Subtotal MIME
Phone: ( ) SAG ON FW132 ) Minimum permit fee (590.00) MEM
Plan review (25% of permit fcc)
CCB lie.: �y State sutra
�, . � � ergs (12% of permit fee) 0 .: 0
TOTAL PERMIT FEE Mg Ms
�.. T his permit a B
Authorized signature: �..GO.tiQ, PP>� m expires if a permit is not obtained within 180
days after it has been accepted as eomplete.
Print name: g u . , tk, Date: - 6 6, —/D • Fee methodology au by Tri- Ceenty Building Industry service Board
I;IBtildinaWerniU C- PermitApp. IN01/t19 440 461 71 - (11/021COM/w13B)
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MC—HEAT P NIP --- SITE PLAN -
FEET TO BACK OF PROPERTY ]LIB W
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- TO SIDE PROPERTY LINE -
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FOUR SEASONS HEATON
,... , , . FRONT PROP :9:' T AND AIR CUNaI' ONING, INC.
� � 1005 INDUS IlIAL PKWY
N EVUBERG, OR 97132
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