Permit � CITY OF �����® MECHANICAL PERMIT
• ^ ° ;Ka.. COMMUNITY DEVELOPMENT
Permit #: MEC2010 -00136
f C,AAU 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/02/2010
wx aa„ Parcel: 2S112CC20000
Jurisdiction: Tigard
Site address: 15714 SW 81ST AVE
Subdivision: GAGE FOREST Lot: 7
Project: Labert
Project Description: Install heat pump.
Owner: FEES
LABERT, JEFF Description Date Amount
15714 SW 81ST AVE
TIGARD, OR 97224 Heat Pump 04/02/2010 $61.06
12% State Surcharge - Mechanical 04/02/2010 $10.80
PHONE: 503 - 348 -8285 Minimum Fee Adjustment - Mechanical 04/02/2010 $28.94
Contractor:
AIR PRIDE, INC.
18603 WILLAMETTE DR
WEST LINN, OR 97068
PHONE: 503 - 655 -0556
FAX: 503- 655 -0534
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 que tionsto OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued y: Permittee Signatur i I , , ,,_ �
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 Applicatioi FC11: ul 1 I( l: IJSF ONLY
City of Tigard APR 01 2010 Received IT �L�
Date/By: y i �o Permit No.: 10 /o - 404;4
11 01 • 13125 SW Hall T31vd.. Tigard, OR 97223 plan Review
Phone; 503.639.4171 Fax: 503.598.1960 Other permit:
Other
I' I c i A It f) Inspection Line: 503.639.4175 pare Ready/By: uria:
Internet: www.tigard- or.gov y V See tor
Notified/Method: /r Supplemental Information •
o .._ l 1 , 1 .i x'4y'`t., ,kti_ , ()L'Etr ` t azi1�;YI',:
Mechanical permit fees* are based on the value of the work
❑ Ncw construction ® Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CgT GQ!1iit OF (3gNSTik"vet1ii*' , /, , Value 5
P. iV ,!
®1- and 2-family dwelling ❑ Accessory building r ' ���� )(r *, i
Y g ❑ Commercial/industrial -••• - •� ° •.,, �i ,�.......
For special uformation ikse checklist.
❑ multi ft inily ❑ Master budder ❑ Other
Description I:)ty. Ea. Total
JOB' , lfil>t•'i3WMA'I*": 1.0 . 1 ` ... / ;.: ,,; Hearin coolin
Job site address: 15714 SW 81" Ave. Air Conditioning or heat pump
(requires site plan showing placement) 1 14.00 14.00
City /State/ZIP; Tigard, OR 97224 Furnace 100,000 STU (ducts/vents) 14.00
-
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt, no.: Project name:
Oas heat pump 14.00
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: Flue/vent for anv of above 6.80
Lot no.: _
Other: 10.00
Tax map /parcel no.: Other fuel appliances
u. `' / >` D rWOl ,,• " ;;, ;,; / Water heater 10.00
, .
Gas fireplace _ 10.00
Flue vent for water heater or gas
Adding Heat Pump fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove _ 10.00
Wood fireplace /insert 10.00
• 111 }Y�/ r < r • l F; �' r , Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Jeff Labert Environmental exhaust and ventilation
Address: 15714 SW 81 Ave. Rage hood/other kitchen
. tAment 10.00
City /State/Z1P: Tigard, OR 97224 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)348 -8285 Fax: ( ) toilet compartments. utility rooms) 6.80
2® A,1**.Ot`' ' . ;! 0 A rE (N" A nic/craw l p acer`ans 10.00
Business name: O ther: 1 10.00 1
Fuel piping
Contact name: 55.40 for first four; $1.00 for each additiona
Address: SEE BELOW Furnace, etc.
Gas heat pump
City/State/ZIP:
- Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E-mail:
Fireplace
Range
; , +,:■, ,, ::1 .... Barbecue
Business name: Air Pride Inc. Clothes dryer (gas)
�Addre __ ss: 18603 Willamette Dr. !�. Other ,.,� `, +.i yy , b ` n
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City /State/ZIP; West Linn, OR 97068 Subtotal 14.00 Q
Phone: (503) 655 - 0556 Fax: (503) 655 -0534
Minimum permit fee ($72.50) .50 / -
Plan review (25% of permit fee) 80
CCB lie.: 154359 State surcharge (12 %ofpermit fee) $.7U `V"
TOTAL PEW fXT FEE
A signature:. This permit application expires if a permit is not obtained within 180
_ days after it bay been accepted as complete- 00
Print name: Alicia Adkins Date: 4/1/2010 * Fee methodology set by Tri- County Building Industry Service Board ! vo
I: 1Quilpingu 'ermitsUv(FC•PermitApp.doc 01/19/07 4 /02iCOM/Wf.a)
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A/C, or H/P Site Plan
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Customer name :11 CI
Customer address f 4-(1e-
10'
3-5'+ -7 5 7
Home
Respectfully submitted by :
72 Degrees Heating & Air Conditioning
Air Pride Inc.
18605 Willamette Drive
West Linn, Or 97068
503 -655 -0556
CCB#154359
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