Permit 1
CITY TIGARD MECHANICAL PERMIT
,. I^, DEVELOPMENT SERVICES PERMIT #: MEC2006 -00529
epi DATE ISSUED: 11/1/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103DA -07700
SITE ADDRESS: 10980 SW MIRA CT ZONING: R -4.5
SUBDIVISION: MIRA PARK LOT: 015 JURISDICTION: TIG
Project Description: Install heat pump, gas furnace and gas piping.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
FRED BEST Description Date Amount
10980 SW MIRA CT [MECH] Permit Fee 11/1/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 11/1/200E $5.80
Phone: 503 639 - 3957 Total $78.30
Contractor:
MILWAUKIE HEATING & COOLING
PO BOX 220216 REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97222
Contact #: PRI 503 -557 -5562
FAX 503 -557 -0790
Reg #: LIC 104102
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -809- 332 - 2344:
Issue B 9,____
y: f '� ' at
i, zL� Permittee Signur_e:— ---- , ( ? / v
Call 503 - 639 -4175 by 7:00 a.m. for inspections 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.
Oct; 30 06 04:19p Milwaukie Htg a Clg 503- 557 -0790 p.l
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1Vlecha ica! Permit �,�.' :. !,' i� ,, T�.a .,, 4f .. FOR• 0 1 1 I . (1 1ISF 0 )1 =r .g 1 ,
City of Tigard ` ` R eceives
`�► b DateBy: /Q � e Permit No.: /'. / /;,, d , -06 - •
13125 SW Hall Blvd, Tigard, OR 97223 , L
Phone: 503.639.4171 Fax: 503.598.1960 L i 0 200 Plan Review
.fi+ � . Date/By: other Permit:
Inspection Li 503.639.4175 e 1,-- . ,.• for
interact: www.ci.tigard.or.us I I i
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Ntified/Metta edfMet y: t3 Supplemental In
CITY OF TIGAR " " "" ° '__ Notified/Method: Suppplemental nformation
BUILDING DIVISION
I TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CirF.CKLIST
❑ New construction Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
❑ Demolition Other
performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
)Z - and 2- family dwelling ❑ Commercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Multi-family ❑ Master builder For special information use checklist.
❑ Multi- fa
❑ ��� Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: f ,� 1 Air conditioning or heat pump
tog ijf/ v • rr , r , CA (_ 1 (requires site plan showing placement) I 14.00
City/State/ZIP: I \ A f Gi' l� {Z�1 �o7o�
Furnace 100,000 BTU (ducts/vents) 14.00
C�
Suite/bldg. /apt. no.: J 1 Project name: c S Furnace 100,000+ BTU (ducta/vcncs) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10.00
Subdivision: Lot no.: Flue /vent for any of above / 10.00
— Other: 10.00
Tax map /parcel no.: Other tiaei appliances _
DESCRIPTION OF WORK Water heater 10.00
;1 Gas fireplace 10.00
rl ( l 3 -..a , ..K c e _ A . S i. a ! / Flue vent for water heater or gas
fireplace 10.00
Log lighter Vas) 10.00
Wood /pellet stove 10.00
W9od fireplace/insert 10.00
OPROPERTY OWNER i ❑ TENANT Chimney /liner /Sue/vent 10.00
Other: 10.00
Name: — r Q e J ,� Environmental exhaust and ventilation
Address: c Range hood/other kitchen
((4 0 ) LJ fV1 sc - C 4 equipment 10.00
/ State/ZIP: w
City/State/ZIP: J 3 Clothes dryer exhaust 10.00
ty I lLjc�!� � a Single-duct exhaust (bathrooms.
Phone: (yU3) 634i . 3 5- 7 Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT ' CONTACT PERSON Attic/crawlspace fans 10.00
Business name: i ((l (�Oy , t e Other: 10.0 •
Fuel piping •
Contact name: 11
e r r 1 C .1 r .'1 / $5.40 for first four, $1.00 for each additional
Address: R c.„) . , j ar x a) J , I Gas heat etc.
Gas heat pump
City/ State/ZIP: to n r (t,�G ti k i - e (,z- r1 7 p WaWsuspended/unit heater
Phone: Y r Fax:: ( � Water heater
( Z J) �� , S -)- I S� ) 7' 075 0 Fireplace
E -mail: Pi. i (1.4a.n it r G (, t..- 4, ^5l? --ii--- '-a. =-r Range .
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
r^ Other:
Address: I ,)(----
MECHANICAL PERMIT FEES*
City/State /ZIP: • I �i Subtotal ! ,
PP Minimum permit fee ($72.50) 7A, 3 L)
Phone:( ) I Fax:( )
Plan review (25% of permit fee) _
CCB lie.: )0 0 o2 State surcharge (8% of permit fee) 5 , 0
TOTAL PERMIT FEE 7$ , 3C
This permit application expires If a permit is not obtained within 180
�
Authorized signature: / r r � 1 �
. if-i}j ./�j��]/ `` ,\ days after it has been accepted es complete.
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