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Permit q CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2010 -00227 T.(GARI? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/18/2010 Parcel: 1 S 134C D05000 Jurisdiction: Tigard Site address: 12010 SW SUMMER CREST DR Subdivision: Lot: 0 Project: Christensen Project Description: Installing air conditioner Owner: FEES CHRISTENSEN, DARIN S Description Date Amount 12010 SW SUMMER CREST DR TIGARD, OR 97223 Air Conditioning 05/18/2010 $46.75 12% State Surcharge - Mechanical 05/18/2010 $10.80 PHONE: Minimum Fee Adjustment - Mechanical 05/18/2010 $43.25 Contractor: SKY HEATING & AIR CONDITIONING, INC 1637 SE NEHALEM ST PORTLAND, OR 97202 PHONE: 503 - 235 -9083 FAX: 503- 235 -0454 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 0 NC by calling 503.246.6699 or 1,$06:33-2 4. Issued By f HS3 9. Permittee Signature: �j' C .4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • Mechanical Permit A licafiio + Tr- % ^ µ I 1 FA = , # lu n„�,, ��� a.w tz t)l l It I. tltil c , �� 3:'6 7,40 Cl ' Of �A$AI'(� p � ' Received / a,aeon.rlt tarrs,av: + ii, an N. ; ¢ -' 13125 SW Hall Blvd., " OR 97223 IVIQY 1 !4 20 Da /1 y ir P er m it N u. : y ... ... r , _ do ' • \ 1� W + Phone: 503.b39.4171 Floc 503.598.1960 Platt Kuview a,:4C Inspection tine: 503.639.4175 Datellay: Other Permit: i i �f' ei' K't9 I. ,o,�.;raiy; p $ Internet: w'ww.tigard- or,gov CITY O F TIGq�D IO Dale Ready /By; /uriy; fQ Sue 1•' • 2 fur �_ DUILDING DIVISION Notified/Mara _ � Supplemental tcfurmat 'TYPE OF WORK COMMERCIAL • FEE* SCHEDULE - USE CHECKLIST ❑ New construction ' Addition /alteralion/replticcmcnt Mechanical permit fees* are based on the value ulthe work performed, Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Ot____ mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ 1- and 2-family dwelling ❑Commercial /industrial RESIDENTIAL EQUIPMENT /SYSTEMS FEES' m ❑ Accessory building ❑ Muhi -family Fur special irformatron use checklis/. Y ❑ Mister builder ❑ Other; Descri lion _ - .._ p Qty. 1 1 a. 'rural JOB S1TE INFORMATION AND• LOCATION fleatit�cooling Job situ address: l'0 0 l0 564.) Ste ' �, P� .— Air cunditiottin (royuires s ite plan showing placeinem) 40.15 c ty /SluterLIP: 7igee.rl 01► y z, Furnace 100,000 BTU (duewsrveins) 46,75 _.__ Suite/bldg./apt. no. Project Hume: / / / L �. / Furnace 100,000+ BTU (duets/veins) 54.91 +✓ ' �lsv" Hcac 61.06 Cross street/directions to job site: ~ Duct work 23.32 Hydronic hut water system • 23.32 -- _ Residential boiler (radiator or hydronic) 23.32 H - Unit heaters (furl -type, not electric), in -wall, in -duct, suspended, etc. .16,75 f Subdivision; l Flue /vent for any of above 23. .ot : — __- -.. _ no. Other: 23 32 - Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23,3 ^ 2 1 /�� / Gus fireplace 33,39 _. .,! *r/ 0 f J•. -e—. Flue vent for water heater or , tir place _ 2:3.33 Log. lighter (bas) 23.32 , Wuu�telkt stove 33.39 Wood lreplace /insert 23.32 ❑ PROPERTY OWNER Chimney /Iincr /tluc /vent 23,32 © TENANT Other: 73,37 Name: �r2, j// ye. ki`/ f1 � YY, _ S _ l Environmental exhaust and veining ion Address: l2 0 / 0 [ f' / ,,,,,,,,,,,,„7,:,—_— � I � Range hood /oth er kitchen c � �✓ cQUipnteu 3? 39 City /Starr /LIP: 2 — r -•� f C17-2-273 Clothes dryer exhaust 33.39 . - " ' (/ - - Single duct exhaust (bathrooms, Phone: ( ) Fax_ ( ) toilet t:ompurtntenls, utility rooms) _ 23,32 ❑ APPLICANT ' ❑ CONTACT PERSON Attic /crawlspace fans 23.32 )3usiness !ante: Other: 23.32 _ Fuel piping Contact name: A, _ $14.15 for first four; 54.03 or each additional 1 Address: hu,'na e, etc. Gas heat pump City/State /'LIP' • Wull/suspendcd/unit heater Phone: ( ) _._._�_ Fax:: ( ) �__ Water heate - Fireplace Ii mail:c — _, .. CONTRACTOR Barbecue Business n one: 5 \ in - Clothes dryer (gas) _. _ _ / , Other' Address' lt, '' 5 e .// 1 Yl te!, - �. MECHANICAL PE RMIT FEES* City /State /L1P: /7Or - f - rc , i frk G! , d 4: ', -- 7 All t Subtotal Minimum permit Ice ($90.00) 60 Phone: ( ) T . 2 . at nY _ Fax: 9 2.3 QG4 S y Platt review (25 % permit tcc) CCI3 lie.: u4C • � . State surcharge (12% of permit fee) ! 0 — -- TOTAL PERMIT FEE /00. 4 1'hls permit application expires if a penult Is nut uhtaiue within 1110 Autlturizcd Signature: � ' J days a(tet it has been accepted us comple, Print name: 6/.1. W (►r.e.✓ Dart:: 457 / G /� Fee methodology set by 'I'ri.Cuwry llnilding Indusir Set�ioe Board I'Aaddiny\amiIn: \UiiC.P rmitApp,duc IDIOT /U9 1 440 ITF( I1/07/COM/WI ) EO /T0 39Vd DV GNV ONIlb3H A)IS b5b05EZE09 9T:T0 0T2Z /VT /50 HOME LAYOUT /SITE PLAN 4 5 o E0 /Z0 30 d STREET 545 DV GNd SNIld3H A71S b5b05EZE05 9I:Ie 0t0Z /bt /50