Permit 7 ���l la �f,� CITY OF - �°��+�� MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00217
u Date Issued: 05/12/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103AA03800
Jurisdiction: Tigard
Site address: 12295 SW 106TH DR
Subdivision: CLYDESDALE Lot: 20
Project: Abraham
Project Description: Replace furnace and add heat pump. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
ABRAHAM, DARCIE Description Date Amount
12295 SW 106TH DR Furnaces < 100K BTU 05/12/2010 $46.75
TIGARD, OR 97223 Heat Pump 05/12/2010 $61.06
PHONE: 503 - 430 -8742 12% State Surcharge - Mechanical 05/12/2010 $12.94
Contractor:
CLACKAMAS HEATING & COOLING LLC
15115 SE PENNY LEE CT.
CLACKAMAS, OR 97015
PHONE: 503 - 658 -4808
FAX: 888 - 500 -2912
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $120.75
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.
1
Issued By: ( Permittee Signature: e7A/ //z70,Z_/ e_47-- 7-7cA
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.
May 09 10 11:20p Clackamas Heating &Cooling 18885002912 p.1 la • MLBCh9>IIIiCAl Permit Apphc S.1 w 'l f 4 ' . a ,.,, , ( � ' ,., r ,:i lF Via .4 r
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" l iw I Rtw 11 4. .�a.a�i,.ea�mM r „ g n1 a r.,,
j ejt CIEs of 'Tigard � � Received a //4 - Permit No:
i 4 Date/By: l Z / /Gl �j A /� 7
1 3125 SW Hall Blvd., Tigard OR 972.1 /
e / / l�C��a ~ /!C� Ai
r Y 11 2010 Di g
.../ii P hone: 503.639.4171 Fax: 503.598.1 .0 p ly. Other Permit
°I: Ins Line. 503.639.4175
�o l t � Internet: ,.ww.tigaril- or.gav CITY OF TIGARD Noah Ready/By: j ; S Pen I nn
BUILDING DIVISION
Sentimental Information
. TYPE OF WORK COMMERCIAL FEE= SCHEDULE - USE CHECKLIST
❑ New construction ® Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed_ Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials,
equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
Eg I- and 2-family dwelling ❑ Commercial/industrial RFSIDENTIALEEQi1IPMENT/ SYSTEMS FEES*
❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12295 sw 106th Dr Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 _ 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name:
Heat pump 1 61.06 61.06
Cross street/directions to job site: Duct work 23.32
H ironic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, eta. 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other: _ 23.32
' Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 23.32
Gas fireplace 33.39
Furnace replasemeal & Heat Pomp Add -On Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 ,
Wood/pellet stove 3339
Wood fireplaee/tnsert 2332
® PROPERTY OWNER I 0 TENANT Chimney/liner /flue/vent 2332
Other; _ 2332
. Name: Abraham, Darcie Environmental exhaust and ventilation
Range hood/other kitchen
Address: 12295 sw 106th Dr equipment 33.39
City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)4308742 Fax: ( ) , toilet compartments, utility rooms) 2332
® APPLICANT ❑ CONTACT PERSON Attickrawlspacc fans 23.32
Business name: CLACKAMAS HEATING & COOLING LLC
Other: 23.32
Fuel piping
Contact name: VLADLVIIR MIKHATS $14.15 for first four; 54.03 for each additional
Address: 15115 SE PENNY LEE CT Furnace, etc-
Gas beat pump
City/State/ZIP: CLACKAMAS, OR 97015 Wall/suspended/unit heater
Phone: (503) 6584805 Fax: : (888) 5002912 Water heater
Fireplace
E-mail: CIICLLC@COMCAST.NET Range
CONTRACTOR Barbecue
•
dryer
Business name: CLACKAMAS HEATING & COOLING LLC Clothes (gas)
Other:
Address: 15115 SE PENNY LEE CT MECHANICAL PERMIT FEES*
City/State /ZIP: CLACKAMAS, OR 97015 Subtotal 107.81
A (303) 6384808 Fax: (.'::)5002912 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 165630 S tate surcharge (12% of permit fee) 12.94
TOTAL PERMIT FEE 120.75
This permit application expires if a permit is not obtained within 180
Authorized signature: / / /y44i/ //f" /-----
days after it has been accepted as complete.
Print name: VLADIMIR MIKHATS Date: 05.10.2010 I • Fen methodology set by Tri- County Building Industry Service Board
1. 1nuildingl PermitslMEC- Pea.it4pp.doc 1 0101/09 441:1-44171r p
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May 09 10 11:20p Clackamas Heating &Cooling 18885002912 p.3
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