Permit I CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00358
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2010
T 1ARD Parcel: 2S 1126607800
Jurisdiction: Tigard
Site address: 8260 SW FANNO CREEK DR
Subdivision: Lot: 0
Project: Gwynne
Project Description: Install furnace and heat pump. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
GWYNNE, G DANIEL & Description Date Amount
8260 SW FANNO CREEK DR Furnaces < 100K BTU 07/22/2010 $46.75
TIGARD, OR 97224 Heat Pump 07/22/2010 $61.06
PHONE: 503 - 624 -1132 12% State Surcharge - Mechanical 07/22/2010 $12.94
Contractor:
OREGON HEATING & A/C
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 $120.75
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 UNC by calling 503.246.6699 or 1.800.332.2344.
/�
Issued By: , j / . - Permittee Signature: Qji/ ��� /Cam /c7
Cali 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 FOR OFF ICE USE ONI.V .
City of Tigard RECEIVED D ? /d I emit No.: / 9 6- r020i0 - 003 , r
l ig n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax; 503.598.1960 �� DatWgy. Other Permit:
- T ! !: . f. D Inspection Line: 503.639.4175 JUL 2 1 [ u ! O Date Ready/13y: IESI 0 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: SnpphmentalInformation
CITY OF TIGARD
'.. r. , i .,, ' : : : o S 'P )d. - g .•: _. i:.,a.. P .!.h.i I,� ;'h; � ,";:oj�!'� { �'7;iitUi. ,LF ,. ,r'r�11?, t.isi
❑ New construction 15 Addition /alteration/replacement M� � p it fees are based on the value of the work
performed. indicate the value (rounded to the nearest dollar) of all
0 Demolition • Other. mechanical materials, equipment, labor, overhead, and profit.
x ,) , < ,,� . ` 6lE', .�� r 4: t ` . Tr a Value
p�r�p •, y
Y );..• x! ,3:' 4. �0d N,VVA.: .'vo �' "' ' ' y ' •,,.' Q ' l r , , , it ' ' ce x4 t '." _ o , .. S'
i. h I- and 2- family dwelling 111 Commercial/industrial El Accessory building ?'. r " � ' ' :
For special information use checklist.
• Multi fantily g�yypp lfisy� ❑ Mas a t�r� :, ❑ Other: Description 1 Qri 1 Ea, 1 Total
' � 1 i� ;J :
. �"t f. El l: dfii�'k 14',a�!�,*..: 4 .t . - T1O t L J t1 i . 4? M, a neetrn
Job site address: *At � -0� .. Air conditioning
. dl.. � 'L� �. ". �1 �! (requires site plan showing placement) 46.75
City / SEate/ZIP: 4111 1, Furnace 100.000 BTU (oilers/Vents f 46.75
. � Furnace 100.000+ BTU (dncts/vents) 54.91
Suite/bldgJapt. no.: II Project name: Heat pump 1 61.06
Cross street/directions to job site Duct work 23.32
Flydronic hot waterem 2332
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended. etc. 46.75
Subdivision: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
r '.'u+'.i Y` ': �v ; . i'� 0y�1 1 1 .. . t it ,' / f w. d ; '3' ! v_ ,.I Water heater 23.32
.:x i „� n x
tr',- ( .. ., ^,`, ., w. ,J.. +:•. i, ,, ., :n • , < Vn . ., '∎
iliip place, Gras fir ace, 33.39
a L tLL►��� ■ . +, / , t 117 . 1 l . Flue vent for watcr heater or gas _
fireplace _ 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
..•. ..:.... .. . - '...,.,..:''.,.:.. - .. 'n: :`,;t,, .r;. ` 'a `t Chimney/litter/flue/vent ���� +� � • . r��t�y.'y�yy . 23 32
i < ',' i 0 # 0�r. f +��,t., r* 1 .', e. t r 11 j {, . • -• :i.. f' r d „ , Other: •: .,.,,, ..:�� .� 1, .,...; � �,.�.� • .�, .., . ,� .,, ,, ?' :. _ Other: 2332
Environmental exhaust and ventilation
f IA...
Range hood/other kitchen
Address: 42 , i equipment 33.39
City/State/ZIP: 01 0-..A r - 1 a.,.... Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (� t 1 wr Fax: ( ) toilet compartments utility rooms) 2332
° r , ti 1 i Xr', , ,v , <! ,. : Attie/crawlspnee finis 23.32
Other: 23.32 ,
Business name: - `l ` �• ` J Fuel piping
Contact name: giriror 514.15 for first four; $4.03 for each additional
Furnace, etc.
Address: k 46 ! ... Gas heat purr
City / State/ZIP: • h LL , , Wall /suspended/unitheater
1 tag ( S 5 j 0 Water heater
Phone: i / J / lSL"l { LY Fireplace
E -mail: Range
.tW ?'R'N.') :i t, <: , ,' 1 4b ..
I i S'° r r I' , Barbecue
Cl othes d ryer (gas)
Business name: / ` , _ .a i. i
Address: b \ I �. t 0 t9 .. L r ! ' ^' ' - 1 "�lk )
City/State /ZIP: . - S ubtotal
Minimum permit fee ($90.00)
one: 1 t • Fax: ! IA a / plan review (25 of permit fcc) •
,. - ? - State surcharge (12% of permit fee) } /�i /
TOTAL PERMIT FEE ( h C ✓
1 t This permit application expires if a permit h not obtain d i0itti 1i
Authorized signabrre: itf �AL d A da� after It has been accepted as complete.
Print name: Date: * Fee methodology set by Th-County Building industry Service Board
T\n„ad;ncAP•e s,.\t,mr..ao.,,5 A* .dae 10!01109 440- 4617T (11/O7/CoivMIVEB)
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Job #:
Performed for:
Dan and Pat Gwynne
8260 SW Fanno Creek Dr
Tigard, OR 97224
Phone: 503 -624 -1132
Garage
First Floor
Dan /Pat's Home
1
:7
High Cig
SW Fanno Creek Drive
Jurisdiction - City of Tigard
Oregon Heating & A/C
PO Box 372 / 992 Highway 99W
Dundee, OR 97115
Phone: 503-538-2953
kireten@onagonheating.com
- 10 0191
RECEIVED
1 +
JUL 2 1 2010
CITY OF TIGARD
BUILDING DIVISIOT
5
Scale: 1 : 77
Page 2
Right - Suite Residential
6.0.90 RSR28556
2010-Jul-12 09 ;44 ;38
C:IDocumentsand Setting&LancA1M...
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