Permit CITY OF TIGARD MECHANICAL PERMIT
i COMMUNITY DEVELOPMENT Permit #: MEC2010 00324
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/13/2010
TIGARD
9 Parcel: 2S103BA00135
Jurisdiction: Tigard
Site address: 11810 SW LYNN ST
Subdivision: LERON HEIGHTS NO. 2 Lot: 25
Project: Spencer
Project Description: Install gas furnace and A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: • FEES
SPENCER, MICHELLE Description Date Amount
11810 SW LYNN ST
TIGARD, OR 97223 Air Conditioning 07/13/2010 $46.75
Furnaces < 100K BTU 07/13/2010 $46.75
PHONE: 503-341-0090 12% State Surcharge - Mechanical 07/13/2010 $11.22
Contractor:
ROSE HEATING CO
9945 NE 6TH DR
PORTLAND, OR 97211
PHONE: 503 - 283 -5183
FAX: 503 -283 -5070
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $104.72
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 question to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: , / - Permittee Signature: en{ L / ( ,�/�d /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.
07/09/2010 14:23 5032835070 OSEHEATING #6667 P.001 /003
'
Mechanical Permit Application ,� ?' i (?.R!9. 1.± I C t L " O \ L
City of Tigard Q.,- �7 is Perm l eC 103 13125 SW Hall Blvd, Tigard, OR 97223 +1 �o
Phone: 503.639.4171 Fax: 503.598.1% 09
1.. Other permit,
'' , P. r i i Inspection Line: 503.639 0- WP , .. Ready/ By: NISI El Sec Page 2 for
Intcmct: www,tigard -or.gov c i�g� 4... supplemental Information
(i i,;/ Y i r Md.L....1 i�JJw J6kY tl r:.I Z J x ; a � a -L e 1'' , }: J+ s.,n 1 A.di E .w4 t o r v'r r te: y r b, -,. .., t; . •.. n , ti
, ��
r \a. . r. .. , � ' rr. r.. WC. l rr t'S„r N. r Y' V J "i.. G� ,li f..,..
❑ New construction Addition/alteration/replaccment Mechanical permit fees" arc based on the value of the work
• performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition r A Other: meohanicai materials, eympmeut, labor. overhead, and profit
C 'E' . K T t4PI''SI .i p Idle f lv 2 N @ F 7 #a d }v Valne: $ -
p ,
'! I - and2 f&rnil dwellin r �Os7 tk.w i.._SMfi1I 1 :v'y .t ,3 ./ d A ' N4 a. - �- b ,, ,,
w , .
A� �� + . / � � ''''''''''4711111,1
A
ullw Commercial/industrial ❑ Accessory building kA 6 ,_.. _y . ;> x (a ....._.,. 1rx -- ,.a1
For special Information use checklist.
■ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea_ 1 Total
. ' +' r j � F `I '_ 71�R1L'P.tASrCE FV`(pNr+N„8 808E 4. -.. if I )1
•V '.!.in.,it ,r .a.. tl: q ti . a ,r .,1 ;,r' I �� A i d. t i i ry 0 ''
1
ill ti.. w. . ..; �. ,Crl$91�C1A� a1 AYua^t 6'� . ra iL:L ....,:... . •i ^.t Heating/cooling
Air conditioning
Job site address: 1 1� c \ ,r„, (requires site plan showing p % 46.75 403
City/State/1,IP:-"- r R • 416. ( / • 1 1 Ftmeace 100,000 BTU ( ) 1 46.75 4%. At' 1
Suile/bldgJapt no.: oject name: Furnace 1000 000+BTU (ducts/vents) $4.91
( - • Heat pump 61.06
Cross sweet/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 cleerric),
in -wail, in-duct, suspended, etc. 46.75
-
Flue/vent for any of above 23.32
Subdivision; L I ' Ot no.; Other 23.32
Tax map /parcel no.: Other fuel appliances
Rift, ! ° "1 1=" i, nr Y - t , "A ` �° t a r t y 4 , a`.,�1 , rr f \F �. • , f x Water heater 23.32
,, fr, Yol6 ..E. , ,.. • - ,. air w k Jr+ + xlS s�G *� tha d' �ad . ,,g yh ;..: t .. i ^, , .:. -
eras fireplace 33.39
Ir iaMia :a• - tit LJ - Flue vent for watts heater or gas
fireplace 23.32
Log lighter (gas . 2332
Wood/pellet stove 33.39
Wood fircplaceinsert 23.32
�W Stu ;� 1 J� , , ry A h . r � ; ,, ,, � , ...,r i vl I Chimney/liner/flue/vent 2332
• ... .. i~.,`.,,... O t h er ` 2332
N
y. gS • ' _I ` .uL'a�.tru'Crl .141l� +1, FhA NFd' wx ...."� :,'. � vni Ie'.w�A .. ,
Name: [r 3 1 Q I o n Environmental exhaust and ventilation
Range hood/other kitchen
,w 1 1 to '
-. � s :tiii equipment 33.39 !,
City/Stare/ZIP: r . T 1-b Clothes dryer exhaust 3339
! single exhaust (bathrooms,
lhoIIe: ( ) . .-- all a - d i. Fax: ( ) toilet compartments- utility moms) 2332
F ps aw o sr x ` r ""r� r+� �, tl, , '. yTr ', Attic crawls fans 2332
r' w.1 I +J h, + 1 r ., , w h U .v, n i f .4 tJr r�,I ,r $ raf V. :{ < s i,q , '? „tti( paGC
.r >; A.l1,OY)oll'._net .4• r 3 n+rraemiii:Orc /Odow:.a " '` A :uiC!r!?;IJle.r.., 45'
Other. 23.32
Business name: 1 t _ r, R h Fad piping
Contact mac; A r- `� 1 � S14.15 for first four; $4.03 for each additional
Address: f m' y kR Gas heat pomp
City /State/ZIP: (: • t, ,..., d ,,,, crib ` Wal1/suspcnded/emit heater
Phone: 4. Water heater _
Pho
.' - ::ir Fax: r _ _.. Fireplace
E -mail: Range
a. , � y,sk.. . . by C ' A l w .r :. ..,6 1, Y �9 . 4.:4 . Barbecue
� A 4 f � N � / 1 Y� � ry„ 4 1 .`i � T �k "Ulf�f�� ��
8 ».1 t r w 1 # '�" j 1 E �,v,S`^0 - ;.yr � tgC c .... .. ' ��,��! .. , «,.,.R�B 3 �r.+tv:,�oir+..;... ! ,.( u , `d r ..�r.�s� , ,�4. ,. _ @ .
Business name: it +t e �' Clorbcs (gee) _
f outer. -.
Address :.:. •a•• l a ft y' < ?.; . , ..4 yHA } ii ' t o
g
City /State/ZIP: • r I" aia AIL + • Subtotal 's c
Minimum permit fee ($90.00) ,.
i one:. r 46 �.+ a Plan review (25% of permit fee)
4 CCB lie.; .. ;, 1S 1 O e State surcharge (12% of permit foe) i 1,'2.,, ✓
TOTAL PERMIT FEE It d4 1
r T bis permit application capita; if a permit is not obtained within 180
Authorized signature' g 9, f days after It has been accepted as complete.
Prim name: a t ' ... Date Mira. • Fee methodology set by Tri-C.otmty Building Industry Service Board
rue. r:lAi..1n...- ».1.1.4r;r -Or...E a.... errs. IAM 1 me &Ar1 -4F1 ^1T I1 1 II lerlIA/WRA\
07/09/2010 14:24 5032835070 ROSEMEATING #6667 P.002 /003
LOT LINE:
FIRST NAME: INA4-te IL IAST NAME: S Y1C.Gr
ADDRESS: CITY: STATE; ZIP:
• N. _ ..
INSTALLATION ADDRESS: CITY: STATE:
PROPERTY LINE
FT:
• FRONT
5 i ter:
PROPERTY LINE
•
X = OUTSIDE ONTO