Permit CITY OF TIGARD
rlci G � AEI
MECHANICAL PERMIT
!4 ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00117
T 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 3/7/2008
PARCEL: 2S114BB -05300
SITE ADDRESS: 10075 SW PICK'S CT ZONING: R-4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 015 JURISDICTION: TIG
PROJECT: SIMMONS
Project Description: Installing gas furnace and A/C.
CLASS OF WORK: ALT 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
RODNEY & JUDY SIMMONS Description Date Amount
10075 SW PICK'S COURT
TIGARD, OR 97224 [MECH] Permit Fee 3/7/2008 $72.50
[TAX] 12% State Surch 3/7/2008 $8.70
Total $81.20
Phone: 503 - 624 -0504
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 261 -9915
FAX 503 -261 -9814
Reg #: LIC 122424
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 1.800.332.2344.
Issued By: � Permittee Signature:
Call 503.6 .'may 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.
. 03/06/2008 THU 1.3:46 FAX 503261.91.84 (0001 /003
• �_- � akgt�, )- d s wT_ Iri," rlT � FF 1 nF'y ' n�`�'� 41 -., �F� , ill .e 0 ' '
Mechanical Permit A c��',:t � . , n4
,i FOR OFFICE�USE011LY a]+ l.. r s
/ X ; • ;l,rl . 1'� , ,;!,;rui'ix •,;�s -fu. ai. �, env *�Ni �; ,a;, uaw.,M k�. �r. 1, �� .h � 9!.6SS.,+i ia y� 1 tF.W�4.
Ci of Tigard g p e,gy .1 9' Op Permit No.: in C ar�F -- uv , ! 7
13125 SW Hall Blvd., Tigard, OR 97 6 ZO D
7pp pp Plan Review
Phone: 503.639.4I71 Fax: 503.5986 _ Other Permit:
1 Date/By:
TIGARDi Inspection Line: 503.639.4175 Date ReY /B : ad' 1u�:
x Internet: www.tigard -0r.gov Y S See Page 2 for
CI OF TIGARD Notified/Method: Supplemental Iformadon
_ I k I ION _ -
-' afir .,.a ' .r- �" 6 3; ' 'f o � . -� . ,z.'-+� �°YiKIER i ai "E
r n
=-7` S - CIcri§i_
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit.
7, +.
... �� '' '1:tedtO,e fgrN " r r � Value $ . _ —
. �i� 9nr� 17 stir
/ ., — and 2-family dwelling AT T Q S Y ,.N. ES Q -
y g ❑ Commercial /industrial ❑ Accessory building
i Iti-family For special information use checklist
y ❑ Master builder ❑ Other: .ti _} Description , Qty. I Ea. I Total
y" .P `y. ,t 6 : ' ti iBi '16 '" t ` e ` frti.
.�_ ''''.:4,.,.::M.''. '. Heating/cooling
Job site address: 1 b t r 1S SW u�S c4- Air conditioning or heat pump
_ (requires site plan showing placement) 14.00 4 (., at
City/State/ZIP:71 bwp Q`2_ el1- T Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) ._ 'Ai
Suite/bldg. /apt. no.: I Project name: S(0.0.4-3S S , Aivj Gas heat pump I4.00
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 I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.:
Other fuel appliances
i.. ' ' .W?4 ` 'x x "* ..� 4 ' '�9 ti 6 '? `_ 6 ,�°, e ` . zxa Water heater 10.00
[ ; /� Gas fireplace 10.00
- " S lk G( , `� , t L 4 A ° IS � T Y (C 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
'° , - A.w 4 ''. x7 11. :esl:- Chimney/liner /flue/vent • 10.00
Other. 10.00
Name: d1 " r t a n,
t1�> Qr�S Environmental exhaust and ventilation
Address: l � Sw C(Cs LA— Range hood/other kitchen
equipment I0.00
City/ State/ZIP: '\'1 Q U e. r ad(..( Clothes dryer exhaust 10.00
�� ^^ r � Single -duct exhaust (bathrooms,
Phone: ( ( ) C`a�. VSO Fax: ( ) toilet compartments, utility rooms) 6.80
1K 3 ' l 6 1` ' ' 1 4 f . 6 t s� Attic /cmwlspace fans 10.00
trk; ?x.Alni.�' .1:n_......nta:i.��.�4 k.� k.. 4Z= w • tt� it '; ' - .
Business name: HEAT RELIEF Other 10.00
Fuel piping
Contact name: MARK DEFRANCISCO $5.40 for first four; $L00 for each additional
Address: 13122 NE DAVID CIR DR # 800 Furnace, etc. 1 1 5.40
o
Gas heat pump
City/State/ZIP: PORTLAND, OR 97230 Waltfsuspended/unit heater
Water heater
Phone: (503) 261 -9915 I Fax: : (503) 261-9814
Fireplace
E -mail: L Range
• .r��'" =- .2. ..C',: .s �„ a f 6 i tl G � 6 R - i a+,xr i, .�, 3 & -- � '` Ba[becu
- �
..�+ ..rr. >..��� _. - >. om- � .>ti »� - Clothes dryer (gas)
Business name: HEAT RELIEF Other
Address: 13122 NE DAVID CIR DR # 800 :" � �' 4 k�' � - • P 5 e.�'y k a,;
City/ State/ZIP: PORTLAND, OR. 97230 y Subtotal 37.
Minimum permit fee ($72.50) - ,
Phone: (503) 261 - 9915 Fax: (503) 261 -9814 Plan review (25% of permit fee)
CCB lic.: 122424 State surcharge (12% of permit fee) , 7()
TOTAL PERMIT FEE (, a0
This permit application expires if a permit is not obtained within 180
Authorized signature: 2��a1 . s after it has been accepted as complete.
i��� �C/t h L _ i/f / /LLt days P P
-
) 8 I ' Fee methodology set by Tri-County Building Industry Service Board
Print name: MARK DEFRANCISCO Date: r Q
I:\ Building \Pemvu\065C- PermilApp.doc 04/06/06 440- 4617T(11/02/COM/WE8)
A/C-HEAT PUMP---UNIT SITE PLAN •
FEET TO BACK OF PROPERTY LINE \-A) - - e
f ) .
• 1%4
00
DC'C
1--■
01=.
FEET TO SIDE PROPERTY LINE
62,
NA,
FEET TO FRONT PROPERTY LINE
1 ADDRESS: 1C1D15 P\C-CS •
PLEASE REF AX APPLICATION7WITH SITE PLAN
2
=