Permit I YilFe;t:,4 ` i ' CITY OF TIGARD MECHANICAL PERMIT
` i 2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00228
Date Issued: 05/19/2010
T I G AR Li 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103CA05000
Jurisdiction: Tigard
Site address: 11530 SW TERRACE TRAILS DR
Subdivision: Lot: 0
Project: Long
Project Description: Install new heat pump.
Owner: FEES
LONG, CHERYL L & Description Date Amount
DELOZIER, PAUL E, 11530 SW TERRACE
TRAILS DR Air Conditioning 05/19/2010 $46.75
12% State Surcharge - Mechanical 05/19/2010 $10.80
PHONE: 503 - 443 -2190 Minimum Fee Adjustment - Mechanical 05/19/2010 $43.25
Contractor:
ABLE HEATING & COOLING
8900 SW BURNHAM F -5
TIGARD, OR 97223
PHONE: 503 - 579 -2250
FAX: 503 - 620 -3980
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 Notifi • � n�entes.�Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direc uesti to OUNClay calli.! 503.246.6699 or 1.800.332.2344.
Issue y: /I Permittee Signature: � �
_.......44 mod / "ter 1t�3` �rCT — `
Call 503.639.4175 by 7:00 a.m. for an inspection that buss • 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 A licatio t � , �=� ° t i ,,v,<4 �„ rr,, g 1 , :.;
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` City of Tigard fi l0 — OD a •
i ra Dat e i s .e. - �� Permit No..
] 3125 S Hall Blvd., Tigard, OR 97223
%t Phone: 503.639.4171 Fax: 503.595.1960 MAY 1 7 2010 Plan Review Other Permit
Date/By:
lIi� ry n I Ti( Inspection Line: 503.639.4175 Date Read /B �, ;s
?'it�a;� r(r r Internet: wwvv.tigard-0r.gov y y' RI See Page 2 for
S�t
��C����I��T��Y���� OF F TIGARD Notified/Method: Supplemental Information
BUILDING-DIVISION
TYPE OF WORK COMMERCIAL. FEE* SCHEDULE - USE CHECKLIST
❑ New construction - ddition/alteration/replacement Mechanical permit fies• are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
' and 2 - family dwelling CATEGORY OF CONSTRUCTION Value: $
{� 1 - Commercial/industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
�.
g ❑ ❑ Accessory building
For special infornra :rorr use checklist
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty, I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ` t C Air conditioning or heat pump
E rA is ' It . C l — (requires site plan showing placement) k 14.00 ,
CitylStateiZlP: ` Furnace 100,000 BTU (ducts/.ent_s) 14.00
` 1 � - � Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name LA IN � ,� , t �-_ {' Gas 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: Lot no.: Flue /vent for any of above 6.80
Other: I0.00 _
Tax mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
• \. 1 II Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
rf
OPERTY OWNER y;liner /flue /vent 10.00
❑ TENANT
Other: I 00
Name: 1
...AL ■ , �� , �' ,-. Environmental exhaust and ventilation
` jam' _ i Range hood /other kit :hen
Address
t\�J et\ li 1 {'Q \ua'iLczir % F equipment 10.00
City/State/ZIP:T ', ■■ C k i laf ∎--J Clothes dryer exhaust 10.00
Single -dud exhaust (bathrooms,
Phone: (-w, * _ 1 .i Fax: ( ) toilet compartments, utility rooms) t 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace tans 10.00
Business name:
Other: 10.00
Fuel piping
Contact name: S5.40 for first four; SI.00 for each additiona
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace 1 I
E -mail:
- Range
CONTRACTOR Barbecue
Business name: \,..1.1... ,, Clothes dryer (gas) 4. Lti
r/ ,V...,____ Other:
Address : ��Q( • \1 , A V *
Q�ft\ hY� �- - MECHANICAL PERMIT FEES
City /Statc/ZLP: ` i Q Subtotal
Phone: ( �� _ p Fax: (C G Minimum permit fee (572.50) t I c e \ 5" l 0 •
Q�5 �� - OO Plan review (25% of permit fee) ' --6'
CCB lie.: c ' •a__., State surcharge (12% of permit fee) '� j CO, Sre
TOTAL PERMIT FEE
Authorized signature: WI e , This permit application expires if a permit is not obtained Nythi
��d ,_ rjV +! � _ days after it has been accepted as complete.
1 Pr name: `l t �' G- Date: IS — `r \ _ \ 0 • Fee methodology set by Tri- County Building Industry Service Board b
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• ▪ ;: ` ` : TIGARD, OR 97223
• V (503) 443 -2058 Fax (503) 620 -3980
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