Permit °i • IN CI TY OF TIGARD
r MECHANICAL PERMIT
5 ,. , a ' a COMMUNITY DEVELOPMENT Permit #: MEC2010 -00356
_Y
x ° Date Issued: 07/22/2010
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111 DC10600
Jurisdiction: Tigard
Site address: 15680 SW ALDERBROOK CIR
Subdivision: SUMMERFIELD NO.11 Lot: 602
Project: Robinson
Project Description: Heat pump installation.
Owner: FEES
ROBINSON LIVING TRUST THE Description Date Amount
15680 SW ALDERBROOK CR
TIGARD, OR 97224 Heat Pump 07/22/2010 $61.06
12% State Surcharge - Mechanical 07/22/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 07/22/2010 $28.94
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: ' �� / AL-L JJfi.■
CaII 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 Ap ilicatioRECEIVED FOR 011 us E. ()Nil'
City of Tigard c � - , R D 7 L O ili� / permit No.: M i c
, 13125 SW Hall Blvd., Tigard, OR 97223 . U �- 2 i L I - Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Dnteiay; Other Permit:
T , c D Inspection line: 503.639.4175 CITY OF TIGARD pate Ready/By: � El See Page 2 for
Internet www.tigard -or.goy BUILDING DIVISION Notified/ 4ethoa: 'J ! (/ Supplemental information
l ." ..,1'•.. ! �, ,u f .'..:. r.."^ ;:0e, t oR t) 'd. Z:;'• 1 ∎4 w �.a•, :i: `t 8 i'l `j}; **fi 0*‘4;4* ,r]i# ,
E] New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
ti.' +� : r .,V° M .�. �! ',�.�. '. ..`" .s ` ri n?.'. i > r, „;r. •'; 'value: $
' E .. , ,,,:�; :,,; ?,.ra�.r�yY"!,$, :1. ,,.,, , � . :�'� }�. .'d., : ✓T ,y: ; { ?.� ;hl _ ; ,. .,, ,,
s , 4,. R: :. � ,y r' , f ... > e . X � w 11 S st . Z? � � . n” e, ^r r. �
� �., ,.. , X '� �� 1. � J I�j .��i d *k : °' �P f� J 11F 4,,,,,•,,�,.����M.., •iJU '
Uindustrial El building �) w e'ia s e checklist,
v
El 1- and 2- family dwelling ❑ Commercia e ekli
For special i>fformarion u chekl
❑ Multi - family [] Master builder ❑ Other Description Qty - Ea. Total
.. i.. .,� y ., - `� }��� .. j��� T��v�-. r /�� •! Pr:'=r' ^ir2; . ia, ,
�.
_"316, F. p -8X? :.040.4.4 �4N» ,? 4 5!!'1 t ?. �,..er� Heatiug/cooiina
0 5
Air c ste plan conditioning
Job site address:
_..4. . � � � Y ■ • ti • 'C � � (re is site plan showinS Placement) 46.75
City/State/ZIP: . d • o1 eta * Furnace 100,000 BTU (ducts/veatr) 46,75
• Furnace 100,000+ BTU (ducts/vents) 54.91
Strite/bldgJapt no.: Project name: • b ^J . v
Heat putt \ 61.06 Es). 46
Cross street/directions to job site: Duct work 23,32
H drone 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: I 23.32
Tax map /parcel no.: Other fuel a , , fiances
,�•� v 33.39
r -, � o t a �t(�ypp��[ , r � M � ` � r 4� • � - 'a,�.i Water heater
i 1, r .J �� {,�„v � xr „t ,O�prF!.se,� -ry,� � Y , t,t
f , � � s, ,, tr. � a-f', aR� tit pl,V:d. ll, :g.��t„
Gas fire 'lace
` " r • Flue vent for water heater or gas
fireplace 23.32
Lo: li: ter :as 2332
Wood/ , diet stove 33.39
Wood fireplace /insert 23.32
Chimney/liner /flue/vent _ 23.32
�ia' '* **:O R 1t ,.
' +':<' a, '.f , n "1 '1� I; , ,.:,, , ,, Other: 23.32
Name: C1 a \ • . . Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 1rp(08(1 W Q` .,,; e • r . equipment 33.39
City / State/ZIP: ` - er a (°z _ 4 Clothes dryer exhaust .. 33.39
Single -duct exhaust (bathrooms,
Phone: ( 5( j 3 ) 63 G .- 35cit Fax: ( ) � �, toilet compartments. utility rooms) 2332
i � �„ . .i Ia )
' ` ., 1,400* .` i ;"'��. : i •i' ;f 'F c[1I rA ; 'ERs')N ; ,�1 ^ . • t','i Attic/crawhpace fan 23.32
F
0tlrer; 23.32
-
Business name: Ore , i • Y Pk(.. Fuel piping
Contact trance: • 0,.,5 514.15 5 for first four; $4.03 f each additional
Furnace, etc.
Address: 'd 6 . - a y \ Gas heat pump —
City / State/ZIP: 1' rt:‘.. . . o • °ll 115 Wall/suspended/unit heater
Phone: ( 5Q) 7 f% % Fax; ( 503) � q1_ Ti 55( Water heater
` Fireplace
E-mail: Batt:
' § '� 1 . s t � y ": ,.c kf . t ,, , s La q 1 N ✓ r ! }, 1 1 fy. Darbocu
-
Business name: .s. e • • ►... Y A C!o es dryer (gas) _
Other.
Address: y , - .r ?±� ,c?. :. � :- >. -:;: ,(
City/ State/ZIP: q� 11 S Subtotal (,-,l . (o co
'. d Minimum permit fee ($90.00) C(a, (
r
Pho (5 c - .c1- Fax: (5(13) 691— S5 $ 6 Plan review (25% of permit fee)
CCB lic.; Ica 1'a State surcharge (12% of permit fee) 10 . $ O
1 TOTAL PERMIT FEE k • A Q
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: ga:,`,,tle_ S.3bt: Date: —1-1c1 - polo • Fee methodology set by Tti -County Building Industry Service Board
van,, .6..111.......;.11JV I Ann Ann ffi lNA 440.4617r(1U(02/comiw a)
E0 /t0 39dt t se S c \ r -- - 9NIIV3H NO932i0 9558- t69 -E05 b0 :60 0t0Z /6t /L0
10a -0196
First Floor
Robinson Home
N
SW Alderbrook Circle 1 54" Garage
2'
Existing
Jurisdiction - City of Tigard Unit
5'+
Job #: Oregon Heating & A/C Scale: 1/8" = 1`0"
Performed for: Page 1
Ralph and Jean Robinson PO Box 372 / 992 Highway 99W Right-suite Residential
15680 SW Alderbrook Circle Dundee, OR 97115 6.0,90 RSR28586
Tigard, OR 97224 Phone: 503 538 - 2953 2010,1UF 07:17:40 Phone: 503- 639 -3581. C:1Documents and d SettiingsLance\..
kirstencoregon heating.com
60/Z0 30Vd 9NIld3H N093d0 9598 -T69 -605 170:60 0192/61/L0