Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00251
Date Issued: 06/08/2010
T G ARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112CC18200
Jurisdiction: Tigard
Site address: 8418 SW DURHAM LN
Subdivision: Lot: 0
Project: Martz
Project Description: Installing A/C.
Owner: FEES
MARTZ, ERIC Description Date Amount
8414 SW DURHAM LN
TIGARD, OR 97224 Air Conditioning 06/08/2010 $46.75
12% State Surcharge - Mechanical 06/08/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 06/08/2010 $43.25
Contractor:
TOTAL SYSTEM SERVICES
1220 SW THIRD AVE B78
PORTLAND, OR 97204
PHONE: 503 - 227 -5955
FAX: 208 - 376 -1395
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: Permittee Signature:
Call �03. .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.
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0b/0•8/201k1 08: 80 5035981950 CITY OF TIGARD PAGE 02/02
08/02(2010 17;04 2083761395 TOTAL SYSTEM SERVICE PAGE 01/03
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olli,:mt city Of Tigard NE,V) ccci,.
Ir- 13125 SW 1-In 1 1 Rivd.. 'Tigard, otz 472kkEC,E Coluillyi • /
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at:voodoo Liras: 503.639 41 75 4
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0 Now construction g Addition/atter:0i - rep/accnicnt Mechanical perinit Ikea* are based on the yahoo of the work
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c ity/StateiZIP: Tigard, OR 97224, . Air conditioning
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Cross attentidinsetions w job sit;
— 11011 aFwailliMilliiiMMIMil 23 32 MIMI
,* hot ander 17 ni . 11 1111.110111111011111
Resident holler (radiator nr
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Subdivision; Lot tin.: hove -32
MIIMINIMIMI 23.3 MIN
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Install 16 SEER MC and Coil
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!.;.,;: .,,, ,....,, i. , i .:10.:, _ , . : , H Chitnneyner/finatyunt 111111M11.11
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Name: Eric Matto
.ti 1 ■ , mental on , ‘ 1 and ventIhnlo
' ringe notittfother kitencn
Addrcsa: R418 17nritarn Lane
ME
CiLy/Statc/ZTP: Tigard, OR 97224 alias d di' 4 i mrtst
Single-duet 127 1havit maavoorns,
Phew: (5113)784480S
eon, ; cuts, id r . pi :} 2.332
7 It 'It P. 6 AVNa ti', I ,,, i4)P 1. ...:::. ! M . ::.. j ' — ' 1 .'':.:IaIWXII I "tiA l .TkOt4tiP';,e.[... ,.. Allew j61• 3 2 a
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Easiness name: Total System Servieea
Contact. name: %Mt Kodesh
,4.1. dr , t fit r: 84 i. or each a/Winona
Address: P.O. fl* 2091
'as heat . um . MIIIIIIIIIIIIMI
City/SlatriVP: Bohm, 113 9.17011
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Phone: ans) S$4.7471 ext. 2 FaX! : 00012764M stor hooter 1111101=111111111
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Adthss: 1220 SW Third Ave 048
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C;tY/StAterrt Pomona, OR 97204
sobtotot —
'Phone: (5113) 227.5955 l'am OOP 3160134$ Aetna ■ . , it kill a 90.00
OMMESII=E5332=112/EMME
cc 11c.: 16310i
5inte aural (121$ of permit Ass 9 0.913
./ 4 , j TOT IL rEsiaor liEr 100.80
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06/02/2010 17:4 2083761395 TOTAL SYSTEM SERVICE PAGE 01/03
Mechanical Permit Application FOR OFFICE USE ONIA
Cit of Tigard c \\I VO Rc.cived
, No
Dmeray, , a rM Permii •
- — ,A 1
" 131 25 SW Hall Blvd., Tigard., OR 9722 '' '
Phut Review
Phone: 503.639.4171 Fax; . 503,598.19 0 . 0 Date/By Other Permit; ______
Inspection Line: 503.639.4175
TlCiAR.1) Dole Rearly/By: .Fur: Fil See Nee 2 for
Internet: www.tigard
r 16Nikp Notified/Method: ill i Supplemental Information
• Or 0
';';:.,:i :.:' , ':i , ''':::..; : • :';'_'::.; TYPE OF vco ili;: : ,:,,..:... ' ' :: . •• • cOlvth 1 40 tIngtil04A:'.t
Mechanical permit fees* are based on the value of the work
0 New construction El Addition/alterationYreplacement
performed. indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other; mechanical materials, equipment, labor, overhead. and profit.
l':,i':;',,' ::.:': :•::: ': 1 ' , Y c0tOitv,.:o*::Co■IstRiicirrotv:,.,_ ;:. i ,: . Value: $
RESIDENTIAL EOUtlitifINT / SYS'ItiVIS:EEES'":' ', • ' i': '
IZI 1- and 2-Family dwelling 0 Commercial/industrial (21 Accessory building
For special thformation USC checklist,
ID Multi- faini I y 0 Master builder 0 Other:
Description Qty. Ea. Total
:, '..:...,'''•• •?.:.-, 1 ', ; ! : .. .T . 0$ : Sitrt: . : 1 0*.c . -0MAtIO. 74' •-
OV. Job sitc address: 8418 SW 1/urharn Lane
0
1 4
City/State/ZIP: Tigard, OR 97224 Heating/cooling
Air conditioning
(requires site plan showing placement)
Furnace 100.000 BTU (ducts/vcnts)
6 75 46.75
46.
, Furnace 100,000+ BTU (ducts/vents) 54,91
Suite/bldg./apt, no.: Project name:
.. _ Heat pump —, 61.06
Cross street/directions to job site; Duct work 23.32
' Hydronic hot water system 23.32
Residential boilcr (radiator or
hydronic) 23.32
• - Unit heaters (fuel-type, not electric).
in-wall, in-duct, suspended. etc. 46,75
Flu/vent for any of above 23.32
Subdivision: 1.01 no.:
Other: 23.32
Tax map/parcel no.: Other Nei appliances
' '.,.:,:',.',':;:',••.... ' BESCittPTION. OF Woi*: : '::' :' ,..;: Water heater 23.32
— Gas fireplace _ 33,39
install 16 SEER A/C and Coil Flue vent for water heater or gas
.
• fireplace 23,32
- — I Log lighter (gas) 23.32
woodipcIlet stove 33,39
—
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'1,;:' OWN :779 . ; : : .. : : . ';: : I: :# .. : . : :.: , :
Other; 23.32
Name: Eric Martz Environmental exhaust and vendla ion
Range hood/other kitchen
Address: 8418 Durham Lane equipment 33.39
City/Statc/ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms.
Phone: (503)784-6808 Fax: ( ) toilet compartments, utility rooms) 23.32
''.I:111,.1.'.:;••:; #11 : i1. :, :.:::,. :.• :' ::: . . •: • : :! 1 . ' ' CbtvtAct. rElikiN:. .:: . . Attic/crawlspacc fans 23.32
Other; 23,32
Business name; Total System Services
Puel piping
Contact name: Susan Kodesh $14.15 for first four: $4.03 for each additional
Address: P.O. Box Furnace, etc, 2091 -
Gas heat pump
City/State/ZIP: Boise, ID 83701 Wall/suspended/unit heater
Phone: (208) 854-7471 ext. 2 I Fax: : (208) 376-1395 Water heater
— Fireplace
E-mail; skodeshgtsslivac.com Range
::'.:.,:1,,ti=.;,:j,f : •:: : :, : :: : . 1:': :: .::,• :'..,
CONTRACTOR ... !..,•1. : ' ,!, : :•.:. - : ! :•,. ' : .,.: 1 ,. l3arbccuc
Clothes dryer (gas)
Business name: Total System Services - —
. Other:
Address: 1220 SW Third Ave 13-78 ::• . : !:,: : :MEekiksite*ittintirtitt$
City/State/Z11'; Portland, OR 97204 Subtotal
-- ,
Minimum permit fcc ($90.00) . 90.00
Phone: (503) 227-5955 Fax: (208) 376-1395
Plan review (25% of permit fcc) _
CCB lic.: 153181 State surcharge (12% of permit fcc) 10.08
TOTAL PERMIT FEE 100.80
This permit application expires if o permit 11A not obtained within 180
Authorized signature: days after it has been accepted Ilk complete.
Print name: Susan Kodesh Date: 6/1/10 +— Fee melI0E1010gy 0 11 hy Tri-entmly Building Industry Service Board
1:Suilding\l'alni1S1901T-PermitApp.doc 10/01/09 110-1017T (11/02/COMME17)
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o_ 20 ft to back property line
Air Conditioner Site Plan
8418 SW Durham Ln
Tigard, OR 97224
Total System Services, Inc.- Contractor
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20 ft. to front property line
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8418 SW Durham Ln
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06/08/2010 11:08 2083761395 TOTAL SYSTEM SERVICE PAGE 01/02
eras rr.sr Le110 08' 3R 5035991960 CITY OF i 1GARD
PAGE 01/02
City of T,g
23125 SW Hal 18Ivd.
Tigard, OR 97223
Phoxac: 5023- 639
jT L G \R' .
FAX TRANSMITTAL Il ry k
Date June 3 2010
Number of pages 'i c rig covu sheet
Al Sr 4 h1
s
To: From: ���;
CO: S 5c Co: COLOilig
pout #: gQS_37671395 Fax #: 503-5984960 _
Ph #:
SUBJECT Eric Martz mechanical permit application.
MESSAGE:
To Whom It May Concern:
The mechanical permit application for ,Eric Matta, is missing an "authorized signature." Since the
permit applicant, Susan Kodesh, is currently out of tae office until. Monday of next week (we are
closed on, Mondays), any employee can sign the application so that we may issue the permit. Once I
receive a sigrnituxe, I can process the pconit immediately.
Thanks.
3randen Taggart
Pciynit Technician \ d
1 13r6
1, I B aftdi �g1 'orm % \r• 1 /18/n; ,_