Permit n''' , . MECHANICAL PERMIT
CITY OF TIGARD
I , . c COMMUNITY DEVELOPMENT Permit #: MEC2010 -00275
���'� Date Issued: 06/16/2010
JTIGA.RD? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 109AD 11800
Jurisdiction: Tigard
Site address: 14982 SW LOOKOUT DR
Subdivision: Lot: 0
Project: Prowse
Project Description: Install A/C. Unit must meet 3 minimum rear and side yard setbacks.
Owner: FEES
PROWSE, MICHAEL S & Description Date Amount
14982 SW LOOKOUT DR Air Conditioning 06/16/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 06/16/2010 $10.80
PHONE: 503 - 998 -1586 Minimum Fee Adjustment - Mechanical 06/16/2010 $43.25
Contractor:
OREGON HEATING & AC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 -691 -9699
FAX: 503 - 691 -8556
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: � �- f ,e /69-7-7—to/N/
"`CCC 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 Application, 3 4, 1 ()12 ()1'E 1(:E USE CINLI'
City of Tigard . ", D Received
y: / /d / Pe No - N
7,4 Eegei ► = 00
• • 131 SW hall Blvd., Tigard, Olt 97223�ri r p RcvieW Other Permit:
Phone: 503.639.4171 Fax: 503.598.19 `` `` 1 J D y;
T 1 G :, z D Inspection Line: 503.639.4175 Jv Date Ready/By: curie: E] See Page 2 for
Internet: www.tigard -or.gov �NatifedJMcihod: e SapptementalInformation
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`
,.u� ,a lY � fi = / m °T ''� 4r a J r r '� ter
'1, .r.: r. { : F4 ■.. . V i. r : i; `T 1 7 4k�,.1 ,;' H f .. „ ;�.� .:', / ,, f1 P ,, ..( r ' iC �' i �` q.**00(4 r/% '�1 .�.,, 04:0^ ,
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 A ., . M '� Other: r�� � y mechanical materials, equipment, labor, overhead, and profit,
l • , 1 YeP " '„ r ., I 1 IV Nf`n.i,i �/ 1(Y .i' ,,;' 1 '�.
Value:
1 /PP",,,,, 4 y / r
! �
�e ... P . % -' ,, ,' , •; „' . r , . . ' : "ds ,R raP�use col *
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
special l 1st.
Multi family Q Master builder 0 Other: Description I Qty. Ea. Total
: 1 '4Q ISITE,:IINF)YZd4. Rf 4 A . A 1 ,� .:." 1,.i`7.1 neahnpfeoolrng
1 L4 n „ o • � � Air Conditioning
Job site address: d b (,� (requires aite plan showing placement) 1 46.75
City /State/ZIP: - T4'e _y r i � a,
- i J-1 Furnace 100.000 BTU (duc&v nts) 46.75
'"' 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 boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended, etc. _ 46.75
Flue/vent for any of above _ 23.32
Subdivision: Lot no.:
-• Other: 23.32
Tax map /parcel no.; Other fuel appliances
I)) S hiss i* bJ W(? ti ,, , , /, r1 Water heater 23.32
` eat o 33.39 33
c�q'-/ Flue vent for water heater or gas
fireplace 23.32
Log lightertas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chi mney /liner /fluchcnt 23.32
! 0.' r r r w l 4! 1 f r t 7 dr , r ,, ,0
tiy D 1prRU 1" oi1!IER a *, ` Ic a , : '. ,� Other J 23.32
Name: A ` ; V, A C� r Environmental exhaust and ventilation
t qg a Loo 1 Range hood/other kitchen
Address: _ - equipment 33.39
City /State/ZIP: " Clothes dryer exhaust 33.39
1 71 ` j single-duct exhaust (bathrooms,
Phone a (1 a 6- : • Fax ( ) toilet compartments. utility rooms) 23.32
,/ ".; �0 AP"PX,.t.ek "% �:,; !sl M a C4*.i74 'P Qlv a , % Attic/crawis a a fans 23.32 !
., . . r-t I `+" ! Other 23.32
Business name f ` � I ` e}r A le y Fuel piping _
Ali Contact name: l 1 11� I Igo $14.15 for Gust four; $4.03 for each additional Furnace. etc.
Address: ¥, a • K p�`-C ` Gas heat um
P P
City /State/ZIP: Wall/suspended/unit heater
Phone: 3) t GI 4- i Fax: : k5 ' ( t 1 t %(.s Water heater
Fireplace
E -mail: Range
r 1��1,` « 7w / ,�'(.! v , O '� s� {r ,T } Burbocud
� Clothes dryer (Ras)
Business name r ( `-� ' 1 a .. rZ � �
` r . r Other „> .:, r° " ' {
Address= (� e e ,� mgr , r
t V . ( � . �� fir^ n+ � t' 14iJF,i'+n7" M
City /State /ZIP: b ilih CkI. � a,`� LLB - Subtotal l
f 9 ( -f. � n.9 4 � t �, s r Minimum permit fee ($90.0 CM t
Phone: `{ / F �' � �•i' �' plan review (25% of perntit fro)
B lic.: / #7 A / o £ v State surcharge (12% of permit fee) j 10. O
/ TOTAL PERMIT FEE ) pp . �G
it �� 1l'� l This permit application expires it a permit is not o ptained within 180
Authorized Si afore: ‘ days after it bet been accepted at complete-
....�..,
Print Warne: firdi : L 1 i 0 Date 1 , " Pee methodology set by Tti- County Building industry Service hoard
t•t nl, aair °1D.rmi,a{MFf.- PermiLAan.dac 10/01/09 440- 4617r(11/02/coM E13)
EO /t0 30dd 9NIIV3H NO93M0 9SS8- T69 -Ea9 5t :60 0T0Z /ST/90
10"'0153
First Floor
5'+
5'+
4 - --.
5'+
Great Kitchen
f�i
Garage
Entry Dining
Office
/ ;I
Jurisdiction - City of
SW Lookout Dr -- Tigard
Job #: Oregon Heating & �►!C scale: 1/8" = 1'0
Performed for: Page 2
Jill Nancy and Mike Prowse PO Box 372 / 992 Highway 99W Right -Suite Residential
14982 SW lookout Dr Dundee. OR 97115 6.0.90 RSR28586
Tigard. OR 97224 Phone: 503- 538 -2953 2010 - Jun -14 12:54:15
Phone: 503- 998 -1686 CADocumenta and settings\lanoe \...
kirsten@oregonheating.com
80/60 39Vd ONIld3H NOSB O 9958- T69 -E05 9T :60 0T0Z /5T/90