Permit CITY OF TIGARD MECHANICAL PERMIT
. a • COMMUNITY DEVELOPMENT Permit #: MEC2010 -00247
TIGARD 13125 SW HaII Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/28/2010
Parcel: 2S111DA15500
Jurisdiction: Tigard
Site address: 8990 SW PIPPEN LN
Subdivision: Lot: 0
Project: Smith
Project Description: Replace A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
SMITH, LEWIS Description Date Amount
8990 SW PIPPEN LN
TIGARD, OR 97224 Air Conditioning 05/28/2010 $46.75
12% State Surcharge - Mechanical 05/28/2010 $10.80
PHONE: 503 - 804 -9886 Minimum Fee Adjustment - Mechanical 05/28/2010 $43.25
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503 -538 -0165
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: /&��� �� L�R Permittee Signature: D/G ,f / / (' /9 v
���, "``���� % CaII 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.
re it
Mechanical Permit A r.. , a licatio E -, ,, 11+ 4 H ! 1( 1 :'
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City of Tigard . — .. .., Received ,...... .., ,,
Data/By -VG /17/0 )» Penult No./t/c ....00 , ;24 , 7
.7 .. 13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 7 2 Plan Review
i.r Pheine: 503.639.4171 Fax: 503.598.1960 Data/By Other Perrnit;
Inspection Line! 503.639.4175
See Page 2 thr
Internet; www.tigard-otgov CITY OF TIGARD Notified/Method: . Supplemental Itdonaidon
BUILDNG ONISIOI41 li CI
-- . — .'7' - • . - W PE OF *mit . ' • :' '. ' ' obefiegiiidox EE i SdintritiLE
EI New construction gAddition/alteration/replaccment Mechanical permit &es* arc based on the value of the work I
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition Other: mechanical materials, equipment, labor, overhead. and profit
Value: $
: 401017141.i,JORP6ffihite eipigritms FEwe ,
1- and 2-family dwelling p Commercial/industrial. 1:1 Accessory building
For special Wormation use checkfisi.
g.Multi-family 0 Master builder 0 Other; r
Description I Qty. I Ea. Total
, • JOB sat 11/4FORMATION )74111:111C01061 . : , . Heating/cooling .
Job site address: geigo sw . 9 - 7 )- t p pi op A LA li Air conditioning -- 'ep '
nim$ site len showin Imminent 46.75 l '
City/Stat 1-1
e/ZIP: - o K" ' -;-
1 Furnace 100 000 BTU (ducts/vents 46.75
suite/bids japtseifilt..sleili ect mow.. . %. ._ . Furner.e 100,000+ T (rh 54.91
U ietsivents)
Heat Rump 61.06
_ -
Cross gimlet/directions to job site: Duet work 2132
• Hydronie hot water system 23.32
Residential boiler (radiator or
hydronic) ,• 23.32
— Unit heaters (thekype, not electric),
in-wall, in-duct, suspended. etc. 46.75
Subdivision : Flue/vent for any of above 23.32
: Lot no.
Other; 23.32
Tax map/parcel no.: Other fuel appliances
0,00;170:4 k: .,,:.:,/,:i :. r '. '. : . . , : ' ::<. Water heater . 23.32
Ro aft, 4,
ti
t, Gas, li 1,....ace
nue vent for water heater or gas
flrcplac 23.32
Log lighter (gas) 2132
Wood/pclict stove 33.39
Wood fireplace/insen 23.32
iner/flue/vent 23.32
• ''''''..::;- :'''' ';:.• 71 *0901EY 'ONVINiii: • : : ,: :.. '; ,' ,: fa*EfirANT., ..:.... ,..:: : aninn8
I 23.32
...
•
Name: 'QW L-S i i Environmental exhaust and ventilation
R
Address:
g' SA) pr2AA Lct,vv-e. . Range hood/other kitchen equipment 33.39
,
' - • -
City/State/ZIP: TV 3 (I v.
---0( \ g 1 1 2-.
'2- 4
• Clothes cr exhaust 33.39
0 1 Single-duct exhaust (bathrooms,
Phone: ( f ix : 0 ' ... ''' 8.., , Fax: ( ) toilet compartments, utility rooms) 23.32 -
..-■':::.: .,: :: .;:'faiiiMICI-414T : ',. : . 7'. : 1 la t PERROi ;',:';:': ' Attickrawl5Pace fans 2332
. .
Business name: FOUR SEASONS HEATING Fuel Other: piping - — 23.32
Contact name: AND AIR CONDITIONING, INC. 514.15 for first four; 54.03 for each additional
1005 INDUSTRIAL PKWY pomace., etc.
Address: - NEWBERG. OR f)7139 Gas heat pump .
, .
City/State/ZIP: WidUsuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail: . i...• t ' • .* • 1 • 1.... ... 1. . A II 1 A 1 ‘ ■ Range . .
' : ,i : '. • • , ccirmut*AC: ' : : . ' Barbecue
—
Business name: FOUR SEASONS HEATING ClOthes dryer (gas) .. ,
AND AIR CONDITIONING INC. •
Add __ 1 =jCKLUIDUST_RjAL,_PKAkj_,____ Mg PfilbMr87114/3*
_ ,
City/State/ZIP: NEWBERG, OR 97132 . subtotal -
Mn_
Phone: (5153) 5?A.--ICI Fax; (5O3) ,S 0 i 6 S -- plan revicw (25% of permit fee)
/ CCB lic.: q i i ,s- .; 15 -0.......,
, • State surcharge (12% of pennit fee) - / 0 • KFE
'OLII eril ,./
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This prmit e apamentiou expires Ifs permit is rat obtained within 130
Authorized signature. ±4 . ci;,..,e1,4,,a`•0--- darn after it has bean accepted as templets.
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