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Permit
CITY OF TIGARD MECHANICAL PERMIT t; COMMUNITY DEVELOPMENT Permit #: MEC2010 -00273 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2010 bs Parcel: 2S103CA00603 Jurisdiction: Tigard Site address: 13400 SW 121ST AVE Subdivision: Lot: 0 Project: Petitt Project Description: Install heat pump. Unit must meet 3' minimum rear and side yard setbacks. Owner: FEES PETITT, TOM Description Date Amount 13400 SW 121ST AVE TIGARD, OR 97223 Heat Pump 06/16/2010 $61.06 12% State Surcharge - Mechanical 06/16/2010 $10.80 PHONE: 971 - 645 -8413 Minimum Fee Adjustment - Mechanical 06/16/2010 $28.94 Contractor: ANCTIL HEATING & COOLING 4320 N WILLIAMS AVE PORTLAND, OR 97217 PHONE: 503 - 281 -0752 FAX: 503 - 282 -5722 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: ,oe, 4 1 Permittee Signature: OA/ 477/) / e1 -770A! `% Call 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. Mechanical Permit A li I �' ,i1 i•oR oF'hlt :'t: USI: ON1., �' R eceived / • City of Tigard Date /By: W %4 :® / t; t r, 7 / Permit No E`C�e -eV '7 I N -- . ' 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax 503.,598.1 Other Permit: Ins section Li 503.639.41'75 J"' ` � O Da TIGARD I Line: Date R e endyik: Joe s:. 9J Sec Page 2 for Interact: www.tigard- or.gov NoU(ed/Mctlwd Supplemental Information : i FI • • w _-- ..•. -.. p Tyttt i. 1...1 P et,C 1 1 H r ^ / "Jiibd i - ei:'J S A l, 4r,nr::(! '' .i'W m t 4, - tl °1 ' .. .. i gg )yy Q � ( 44 �. ,vn rv,. ... � 1 � , a fA tlr lN41 4 4 )p Vr G r a lYd jv, rt 4 ,};�p� p 4 7 r 'r ' I 1 +' o ` .I q� l�� • •. 6 191 4t 9. - '; 'Li'''''''.,,,,' •r,l'tY , en of J..:� d h f"l_A'1?XA... . �d _v'_1fi.Ilfy , __;'dery a47.,�y ,�:. ,�ow�l�7.�,a_ t/_J 9?bl�+,::1"1_ /11 41 .a 16' ,. v:6rt . J} 47,3M eAa J • cvv construction El Addition /alteration/replacement Mechanical permit fees' arc based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition ❑ Other: mechanical materials, cyuipment, labor, overhead. and profit. 3t 4 t 1 } (t"",q'�d'G kt (fir. 1 f-0 x, : I ,� ° , .T 7 A"' Jr9. v vnr t � L. li•+ Value: $ '!!. �,7'= i * ?,o/�', ,. P fIN. 0.'(0 �V 1 I l } .i l li�l` 9-! a,l ,, ii V et xe Ix li it .f roc 1 •yy s ® l - and 2- family dwelling © Commercial /industrial ❑ Accessory building For special infornrarion use checklist. 0 Multi family ❑ Master builder ❑ Other: Description- _ Qty. Ea. Total nf"•1ff11CSt rry rpt lylM1�try tt l � a ea 5/ r C' y'y t .," u ".(°'"��l J 17r, 4tV 11 '!Y ;,i ' y ii.1 ,; �x1 t i :.�,. ,�.t,r lAt ,;01 . 100 �f r lL� ?�ir {! {vnMl r r :'.e:,'h•,r d ,i.. ; 1 X , Heating/cooling, ST Air conditioning Job site address: 13400 SW 121 AVENUE (requires site plan showing p:aecmen) 46.75 City /State/ZIP: TIGARiD OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75. Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: Project name: #28852 Heat pump I 61.06 61.06 Cross street /directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 - 1.Jnit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: 1 Lot n0.: Flue/vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: j�p Other fuel appliances i r ,,1 e uw,K y v M i °r 1 n, t r5'. Fd 1(F Q �� ,' ' , hi - r„ i2ii t i'r r y r r* ar( 1 "?�7'.,rr' r n yr Water heater 23.32 •.Fi�U r AEI i Pih },;.{.it :...'ku� % �1 " 4�'Zldi'bf fAfFt'dt;,niT(� ,w,, ;Nr'a� +,, , 11,... n�e”, i,,,,,,, vn4 Gas fireplace 33.39 INSTALL HEAT PUMP Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23:::32 Wood/pellet stove 33.39 -- Wood fireplace/insert - 23.32 w s t {� ' ��- t „ Chimne /liner /tlue/vent 23,32 i Ar aPb a, �r A.;W! , r. r<(4ttJam /5/4fZ( {ir,d,. +r(u!, r i}i;; rc Y (uJir�, .(i i °Irin i� !v 4•,i it I 19 r 1 r 1:i. Ja rhnv' ,• „{fie ••y other: 23.32 Name: TOM PETITT • Environmental exhaust and ventilation Address: 13400 SW 121 AVENUE Range hood/other kitchen equipment 33.39 T City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39 Phone: 971 645 -$413 Fax: M � - , w w~ _ . ,_,., -- Singles -duct exhaust (bathrooms, ( )6 ( ) yy�� � y toilet compartments. utility rooms) _ _3.32 , lei , t t . l±�e " ItAaPa¢, 9 '' r { , l i t, Ir∎ 1�1 „'r v}1 r .' L F F7i''LL}� :�:�. 7 eV rW A . rlry l? L +IJ + r • �r' +, •1 net n + 4 Attic /ctAwls a 23,32 „ 5,., rin,. . „.. „ ,��. { .. �l�r,. a Jr . � ..... r „r.,rr � �, J.,� , . . ��,��� . y ..,�r.rn -, ( r�lr(', . ,r�ll , n., Business name: ANCTIL HEATING AND COOLING _ Otite _ r. .._- . 23.32 Fuel piping Contact name: CHRISTINE BARTON $14.15 for first four: $4.03 for each additional Address: 4320 N WILLIAMS .AVENUE Fumace etc, Gas heat pump . City/State/ZIP: PORTLAND OR 97217 Walt/suspended/unit heater Phone; (503) 281 -0752 Fax: : (503) 282 -5722 Water heater - -_ _,- - Fireplace E-mail: INSTALL@ANCTI VAC.COM Range ' a, irr.i�T r I �� � ., :,.::•r ,. •`•:,�:l i i t "?�41 r '� �' , tf r I enw.•.. 11 J r,, t ;. v VIIIt:0.1 Etarbecu I �Cx'bR ,,,' . .- Business name: ANCTIL HEATING AND COOLING Clothes dryer (gas) ^ ^- - - _... .- -. - . - Other _ Address: SAME AS ABOVE _ tC iiI*% ,'`),0*'St)1i"It 1,`k')F013 v'"'f ' "' ' City /State/ZIP: Subtotal 61.06 • }tone: ( ) Fax: ( ) - - r` >aw.M in unum permit fee (590,00) 10. < / - ... . / ', ' #e .7w°bof permit fee) CCB lie.: 8897 if State girt e,(12% f pennil fee) _..._ . \---------- y t Z TO' AL y'RMIT FEE 1 )0.� 0 _ ._ „ ...a. J P complete. _...., ...... 7 1'htx permit application expires i't fi permlS is not obtained within t da p Authorized signature:, A� r' -T� _._ .._. ter after if has been accepted 715 Print name: C•HRISTiNE BARTON ( Dale: 6/11/10 I ' Fcc methodology set by'I (`uunly !NM inl; industry Service. Board i xr:dv!nq. l' niln MT(- PCSnLApp.dnc 10'01'09 440.4(171( 11107 Td WdPI :SO OTOE TT 'unf ZZLSZ8Z £OS : '0N BNOHd 6ut IooO '8 6utlpaH 1IlDNd : W0e1A . m 0 3 D . Z • n • A/c-HEAT P J1VII' -=== SITE PLAN - cu o FEET TO EACIC OE PRoPERT'Y UNE :_ LD N . o 0 0 • z FEb f TO- SIDE PROPPERTY LINE z . o m W N 00 j rzi NJ • • . l FEET 1 FRONT PROPERTY LINE � qy� . ..' i1.JptJS 3 �1� eru J a r^- 0 . - �swresraae avc A . A . '. � - 3 • -u