Permit /� p ® MECHANICAL PERMIT
� � CITY _ CTY ®F TIGARD ` r COMMUNITY DEVELOPMENT Permit #: MEC2010 -00329
TIGAD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/14/2010
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Parcel: 2S109DD09200
Jurisdiction: Tigard
Site address: 12658 SW REMBRANDT LN
Subdivision: Lot: 22
Project: Allen
Project Description: Install A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
ALLEN, LAURA Description Date Amount
12658 SW REMBRANDT LN
TIGARD, OR 97224 Air Conditioning 07/14/2010 $46.75
12% State Surcharge - Mechanical 07/14/2010 $10.80
PHONE: 503 - 544 -5290 Minimum Fee Adjustment - Mechanical 07/14/2010 $43.25
Contractor:
TRI COUNTY TEMP CONTROL INC
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503 - 557 -0919
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: 0/V ��/e'G/1r/51— j �0/\-/
...Z..4ZVe.,.._ 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.
JUL -13 -2010 02:10P FROM: '/ \ TO:5035981960 P.2
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Mechanical Permit Applicat c� .§ l I; r i l )1 i ,t ,, i
City of Tigarrd \s\,.... r \) Y - /.i :- wi. n Hd ECO2O // — #0 r1
13129 $W 11411 illvd., Tigard, OR 972
Phone: 503.639.4171 Fax: 503.3'' 4T y 7 Oth.rPaognt:
Inspection Line: 503.639.4175 ' tawe , a
Internet: Www,tigatd -nrgov t .__ ��_. Kati, • S apem t ab! I�afenrtadrta
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.::,:- ,4.:, _ ;, .. . .. y . . .:, . . PrQR�0,: _ , . .. - , 0 ;fX47�t1T��"�l'3Ci,;�`s� '
0 New construction ® Addition /4lteration/replaccment .Mechanical permit Bea* are batted on the value of the work
performed. Indicate the value (rounded to nte.nearestdollar).of all ,
❑ Demolition [l Other
• ,..- ._._.w. , ,, .. ., ,;�,,.;.,,; ,.., � mechanical materials, abor�ovo fit
FannF- 29'x.::. �_ 2'''�i l � M ? 14. {. '*!' t f rh
. �} �.. Value: s
..... ., +� non
®1 -and 2-family dwelling C3 Commercial/industrial ndustriol 0 Accessory building ; -, ! flf1,,' i3O,0* Ak ". � Va 0-014n gl t
0 Multi- tinnily [J Muster build r 1 r
��' Description 1 Qt J
builder 0 Other: ( Total
L k 0. - CeiC, NA0, f 1V'R :.g) ,`1 ' ' '` Heatiagkoeling
' Job site address: I , 5S r W RanbifrAnk (} r " �/) air conditioning
`,r`^ ^ ' (requlmaiit� tan showing atacemem) , I 46.75 i
City /State/ZIP: 6 Si • (4112,4 Furnace 100,000 BTU (ducm/vennt 46.75
ti Purnacc 100,0001.OTU (d c tdw,uil 54.91 `•
Suits/hldgfapt, no.: Project name: Neat pump 61.06
I Cross street/directions toJob site: Ductwork . 23.32
Hydronic hot water system 23,32 a
Residential boiler (radiator or
hydronic) 23.32
Llnit heaters (fuel -type, not electric), .,
tn4wall in =duct, suspended, etc. 46,75 l
Flue/vent for any of above ` 23.32 .
Subdivision: i Lot no.: Other. 23.32'
•
Tax ntap/parcel no.: �q - • Other fuel appliances 1
V a A d'y `_ - ill � 'Y2x' '' r _ , r.1� tl'� 4` �v Water heater 23:32 1
i t ,., ...,, Gas fireplace 33,39
4 y�-/� l L L / � � ni p
Flue vent Ibr Water heater Of gas 1
4! tlJt14 i �/1
I I
t COr � V f Il r - firoptace 23.32 .
Lop lighter (gas) 23;32
Woodl ellet stove 33.39
Wood Theplace mscrt . 23.32 r
w F�?a ? ,fa`na '-3 . Chimney/liner/flue/vent 23.32
il
•i-7 :g. Y7: :': rTttT..'.IKp�t."�"F 1 ,11�r st-�� 3IZ. -h� 5,{K , ,:i '.l.:NUgi � ,,72rt ;. :- d r.. ... ....
Other: 29:32
Name: 4 d/ Aid l Environmental exhaust and vent nation
-Range hood/other kitchen T
t l.1 1 t�
Address: equipment 33.39 •
City /State/ZIP: Clothes dryer exhaust 33,
'Single exhaust (bathrooms , a
Phone:( 4 4 -*DE! 0 Fax: ( ) toilet compartments, utility rooms) 23.32
Atm
;
t , il " ` ' ` 1 r` a 7 `, ; tl .. _... , Attie/ rawtspate fans 23,32 1
:_. Other: 23,32 ' t
Business name: Same as contractor
Fuel pipintt •
Contact name: Diane Manna 514.16 Rnr first fuartS4.03 for each additional
Furnace. eta R
Address: has heat cutup [
City /State/21P: WaI1/ruuspended/unit heater '¢
Phone: ( ) l Fax: : ( ) Water heater
6.0811: Range. 4
h it i • e -4;'e _ 1 " ; a yw ',,, , -! ..at,. �, ; : '0,...44,1,7 a,4 " ... Y 4 .. Mii 0% a: Barbecue
litigious tame: Teri county Temp Control Clothes dryer (gas)
Address: 33160 S Clacltsmna River. Drive Other ' '',U, r ' :L , EWS' t';'�' " . ` :
IP
City /Statq/Z Orison 6.4Y• OR 97045 1►hbotRi: i li
.:'Pbotroi (503)1157422 I Fax (503) 557.0919 Minimew (25 mtt f be t ( 0) ' . 14,714;
. _ Plan mwtew {259'5 of pn this} ✓0 r =4 ikd
C CB ItU cy2 State aUtr har (i2%ot rink AA /60 +/
TOTAL ricomrr For, ivu
/ i ' Tbta penult appli ecptr�sira person It sat sainted' Man !0a
Authorincd signature: / days Oar it Mss bean tietapted gannet**
moon 3'rmt maw Dale' 7 `/ • tko matbodnloay tot by 1'ri.County building Wintry Service Ronal s
. IQT1 r
t:1nu hi hault*a41'wetgaggdoc )WOtaV 440461f(Iiitrux dnv n)
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