Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00235
J 8 C Date Issued: 05/20/2010
TIGARDi 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112CC22500
Jurisdiction: Tigard
Site address: 15777 SW 81ST AVE
Subdivision: GAGE FOREST Lot: 32
Project: Denk
Project Description: Install NC. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
DENK, STEVEN G Description Date Amount
15777 SW 81ST AVE Air Conditioning 05/20/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 05/20/2010 $10.80
PHONE: 503 - 956 -9498 Minimum Fee Adjustment - Mechanical 05/20/2010 $43.25
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217
PHONE: 503 - 281 -0752
FAX: 503 - 282 -5722
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 or 1.800.332.2344.
Issued By:
AZillgarlorAt. Permittee Signature: 0Af- /2 -/'/— L f f -j /O,-■)
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 Application
City
p Rrter of Tigard � /G' YcnnitNoy��i O �n i0 X035
1.114 g 1‘/F0 Date /ivSyd . ��`'Y/ a 1325 SW Hall Blvd., Tigard, OF . Plan Review
w
Phone: 503.639.4171 Fax: 503 3 ',- ., Data/By: Other Permit:
T 1 G .4 ti D Inspection Line: 503.639 Date Ready /By: Surf; Ii1 See rage 2 for
-
Internet; www,tigarct- or,gov MAY 1 9 2010 Notified/Method: + Supplemental Information
d
d % r i a 1 n t, q;i" x ,. „ y • „-�,,. ,. r r .,,.. 71r I" ) u " r ..,.. . ,. ,1, { 4 r r n i�. ta b e� ,• '
; i'. , ' . ' II f � 1.. Et •l ��G� u;�'D�� '���' +,, er `rl I /!! = .l �. ..��r'� `::rY�er � �L.11��JJ1�1�% I � . . .
��-} 7777 1 � � y�erit i , L V � .... 'f ,!:
U Ncw construction El Addttior l 1'0 F I f I r r v Mechanical permit fees" are based cm the value of the work
performed. Indicate the value (rounded to the nearest dollar) or all
I ❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit,
, , i v r xa •', ,, � r?. � , Value: $
J 1 i Y r A4 kr v ' ' 1 c;Or ! TR ti •VAAI y ► N '1,16 ` I t Jrl x I r 1
:" a 1 n Y rG r �(r �� r � , . • ,.. J ,:. r I .;r Li t i e � " >': II t �
1
®
1 -and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
__ For special information use checklist.
0 Multi - family ID Master builder ❑ Other: Description Qty. Ea. Total
;' r ` . {, „r „ "r [I , JbI , Ski E O'It fkEtiO=N LdCAT.OIN ■•, .,: r ' r ilz :'. Healing/cooling /cooling
Y "�i-.y" 1
Job site address: 15777 SW 81 AVENUE Air conditioning
.u,.. (minims site plan showing placement) 1 46.75 46,75
City /State/ZIP: TIGARD, OR 97224 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54,91
Suite/bldg. /apt.no.: Project name: 428808 I feat pump ,_61.06
Cross street/directions to job site: Duct work 23.32
...,.._....._..,. ._,......_....,w.. -,,,.- —
Hydronic hot water system 23.32
M•• Residential boiler (radiator or
hydronic) 23.32
— Unit heaters (fuel -type, not electric),
in-wall. in -duct, suspended, ctc. 46.75
_.. T
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
- ,..,,. xn'"r'r, ;1 {FI �� ;r' ; I i* 'I:l'aN 15'kt' "OtHtlt ,. - I, , •,,.,?'iE :, "': u�',:m Water heater _..._....._� 23.32
INSTALL AC Gas fireplace 33.3
Flue vent for water heater or gas
fireplace _ 23.32
Log lighter (Ices) 23.32
Wood/pellet stove 33.39 •
Wood fireplace /insert 23.32 •
-~°-- - ---^ -r*•— � Cttirnney /liner /flue/vent 23.32
J r. tri " f .. , l it ; � ,'� p r "; 1r r i " I ! t v r . d.,.
�#tiP�r1i�Yr1�t41i? . i
s I ❑t 11A1�!?t1111 }i •n , tI ,ii, ,., * t Uthrr 23.32 -
Name: STEVE DENK Environmental exhaust and ventilation
Address: 15777 5�► SI AVENUE - -- - -° °•- Range hood/other kitchen 33,39
Ciry/Statc/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)956.9498 Fax: ( ) toilet compartments, utility rooms) 23.32
" , o a �� 3 "t a n tr> r J, } r Attic /crawispace fa
a
_, 6egfiP ' , o 1,V' /Y- �i0 t }� ti � 1 h 1 ;1 kai ras ai rd� lr Ct ,r.�
,� ,r �� 8 �1 _,. fans 23.32
_ ..... _ Other. 2332
Business name: ANCTIL HEATING AND COOLING Fuel piping
Contact name: CHRISTINE BARTON $14.15 for first four: $4.03 for each additional
Furuftcf etc.
Address: 4320 N WILLIAMS AVENUE °— - -- "" ' - w" - � -' °- "- "--
_
City /State/Z1P: PORTLAND OR 97217 Wall /suspended/unit heater
Phone: (503) 281 -0752 I Fax: : (503) 282-5722 _Water heater -
Fireplace
E -mail: INSTALL@ANCTILHVAC.COM RxJ ?arc .. L __. --_...
Business name. ANCTIL HEATING AND COOLING Clothes dryer (gas)
--- - - Othc
Address SAME AS ABOVE -- 1 i" !I Mule ; r; 1 t : ,, ; `
City /State /7.,1P; .,v....�� Subtotal 46.75
-- __. —_.. -- -.... ,.... -- Minimum permit fee ($90.00) 90.00
..-
L
?hone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lit.: 8897 0 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FF.F. IOO.hO r/
�� iti ) / ` r ,, fl T'htw permit appttcamon cxpYrca if a permit is not obtained *Mile [tl
AuthnflZCd 51{,+ndiW )� ,t f .1 T - Y I! 1� } l� I dRyr after it has been accepted as tomptete-
Print name: CHRISTINE BARTON Date: 5 /19/10 • 1.ee ■elh so by'rri ('ounty Building Industry Ser ice Board
1 Ruddily,. Pomp, N'11( -Prrmn A /9 dnc 10 51 .J40.41 !I 1 1 1 ('J) \1 WF}i
Id Wd92:t'0 OtiOZ 61 'FpW ZZLSZ8Z 20S : '0N 9NOHd 6ulloo0 '8 6u?1e 1IlJNb : WONd
N
•
E • . 0
r'
A/C -HEAT SITE PLAN
m
z. A
0 FEET T6 13'
tsCK OP' F PROPERT Y LNE 5 -
N .
N
N
in iiii . .
FEET'4- SID
IDS PROPERTY LIB
N
N
m -
Ln
O
Z
W
Z
O
S
FEET TO FRONT PROPER
ROPERTY LINE
c
U L _
. ADDRESS. I V) 111- 5 j S� �-�- -- -
.
_ m,.
J :ie•::r. ��: -.::
U
Z
Q .
Z . •
O
CC
L_