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Permit CITY OF T GARD MECHANICAL PERMIT li COMMUNITY DEVELOPMENT Permit*: MEC2010 00306 TidAAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/06/20 10 Parcel: 2S 103BD03400 Jurisdiction: Tigard Site address: 12920 SW' 1 STAVE- Subdivision: Lot: 0 Project: Sanchez Project Description: Install mini - split heat pump. Unit must meet 3' minimum rear and side yard setbacks. Owner: FEES SANCHEZ, RICARDO NAVA Description Date Amount 12920 SW'' 121ST AVE Heat Pump 07/06/2010 $61.06 TIGARD, OR 97223 12% State Surcharge - Mechanical 07/06/2010 $10.80 PHONE: 503-679-7886 Minimum Fee Adjustment - Mechanical 07/06/2010 $28.94 Contractor: FOUR SEASONS HEATING & A/C INC. 1005 INDUSTRIAL PARKWAY NEWBERG, OR 97132 PHONE: 503- 538 -1950 FAX: 503 - 538 -0165 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: • Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180.days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001- 0010.through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: 0/ G i . �— PermitteeSignature: OW i3'f/o6. /C f_ 7d,V . Call 503.639.4175 by 7:00 a.m. for an inspection that,business day. This permit card shall be,kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. rc>t��tll$ liege n • City of Tigard a p e, n s ..r Pe rmit No./ f z? o / f� -0030 : ; 4 ' . e 0 , ' 13125 SW Hall Blvd., Tigard, OR 97223 0 2 2010 f 503. 639.4171 Fax 503.598.19 Ptan Review Other ermt r. ,- Phone; �� � Date/By; Oth P i aC elo.3 -. Inspection Line: 503.639.4175 /+ y -� / T Date Ready/By; ii... la See Page , 2 for IW A,• :,I. " Internet www.tigard- or;gov CITY 1 OF 1 IGARRiD Notified/Method: /I ( Supplemental laforwatioo BUILDING DIVISION O TYPE :OF:VItO Addition/afterdtion/rcplaCement COMMERCIAL FEE' SCREDULE -, USE CHECKLIST [] New construction / �y' Mechanical permit fees* are based on the value of the work performed. indicate the value (rounded to the nearest dollar) of all Q Demolition ❑ Other: mechanical materials, equipment „ labor, overhead, and profit. Value: $ CATEGORY. OE CO NS - 'ante u - . RESIDENTIAL EQUIPMENT /SYSTEMS FEES* • 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi- family _ ❑ Master builder 0 Other: Description ' Qty. I Ea I I Total - 1OR SITE INFORMATION AND LOCATION Heating/tooling Job site address: \ . . l — Air conditioning N • t, (requires site plan showing placement) 46.75 City /State/ZIP: 3 . 411111 Furnace 100,000 BTU (ducrs/vcnrs) 46: ` ' { Furnace 100.000+ BTU (ducrslveuts) 54.91 Suitelbidg, /apt. no.: Project name: Heat.t n p 1 1 _ ]_ 0. ,_IpI . , Cross street/directions to job site: Duct work 2332 Hydronic hot water system 23.32 Residential boiler (radiator or tiydmnic) 23.32 Unit heatcts (fuel -type, not electric), , in•wall, in -duct, suspended_ etc. 46.75 Subdivision: Lot no.: Fl uet vent for any of above 23.32 Other: 23.32 - Tax map/parcel no.: Other fuel appliances — _ DESCRIPTION OF WORK.' .. Water heater 23.32 • Gas .fireplace 33.39 lik 1„. 1 t! 6 0.. , : ; Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 2332 I Wood /pellet stove 33.39 Wood fireplace/insert 23.32 - Chimncy/lincr /tluclvent 23,32 :I. PROPERTY OWNER O TENNtN1l Other: J 23,32 Name: ` _ Environmental exhaust and ventilation a 1 Range hood/other kitchen � Address: call_ -/� 1 \ , _ equipment 33,39 Cit /State%ZIP: I - r Clothes dryer exhaust 33.39 y � � - N \ © f Q � ^ S Single-duet exhaust (bathrooms, Phone: ) 711 •j Fax: ( ) toilet compartments, utility rooms) 23.32 E rj [p CONTACT PERSON V Attic/crawlspace fans 23.32 Other; 23.32 W AIII Business mane: 4 \), _ ■ ` ” a ' _ ~ ► Fuel piping 1 A h • ,,...„,„..71., .a 4 314.15 for first four; $4.03 far each additional Contact mine Furnace, etc. Address: ..., . P_ � armillp � C)ss heat pump 41 City/State/ZIP: `�+, '0_1' �y WalI/ uspendcd/uniaheater • sz Fax:: ( 'j' «_ /�1� Water heater Phane:'(�') S 4 � �+ Fireplace E W4% cyii'gg0.9 t'w ' /ir" Range CONTRACTOR. Barbecue . r.; • C + Clothes dryer (gas) { � L - a:. ► Others: Address: i Y' "11. MECHANICAL PERMIT FEES* City/State/ZIP: 1 • . _ y O - — Subtotal b 1 ^ • i y Minimum permit fee (S90.00) 9() • lb IM Phone: (5' j) _. _ i - • M " ° s : M .:�w Plan review (25% of permit fee) - 1 _ c ' State surcharge (12% of permit fee) t,[) . •• t� TOTAL PERMIT FEE �( Authorized si store'/ This permit appbcatioa expires it a permit is not obtained within 160 days after it his been accepted as complete. Print naive: Date; 1 ■ a�► ° H' methodology set by Tri County Building industry Service Board \ . s _ �-� r� , 1A8uildi+>gWem�MEGacrnaApv.doe 1 11(09 440.461 Tr(11/02/cowi.va5) E00 /8001 99108E.9E09 XvJ Bb 80 OIO.Z /ZO /L0 • - 1 pi V o o i 1d ` o , , • . 6BEAT PUMP—.UNIT S 's • . - o FEET TO BAC' -' Y LINE 1 OF (PERT v, ' :F e � E i Y . S • l FEET TO SIDE PROPERTY LINE s _ . t , • i � B ry y . CO ° - B ,A FRONT PROPER O L1 • , .App 5.12920 Ste' 1ZI.4 Alm X ; f. rep• t t M • PLEASEREFAIC PPT.CTI P r, c, O • ) \ J O J '•