Permit CITY OF TIGARD MECHANICAL PERMIT
v
7 , 7 ` :: COMMUNITY DEVELOPMENT Permit #: MEC2010 -00363
[ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/23/2010
Parcel: 2S109DD09400
Jurisdiction: Tigard
Site address: 15576 SW RAPHAEL LN
Subdivision: BELLA VISTA Lot: 24
Project: Gill
Project Description: A/C installation. Unit must meet 3' rear and side yard setbacks.
Owner: FEES
RIVERSIDE HOMES INC Description Date Amount
1300 DEXTER AVE NORTH #500
SEATTLE, WA 98109 Air Conditioning 07/23/2010 $46.75
12% State Surcharge - Mechanical 07/23/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 07/23/2010 $43.25
Contractor:
PYRAMID HEATING & COOLING
PO BOX 1502
SANDY, OR 97055
PHONE: 503 - 786 -9522
FAX: 503 - 786 -3432
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. 1.
Issued By: , Permittee Signature:
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.
07/22/2010 THU 13:43 FAX 503 786 3432 PYRAMID HEATING 2 001 /003
Mechanical Permit Application CEIVED Foe OFFICE 1 sr ONE v
: Ci of Ti and CEIVED Received'
li,,,, g 8 Date/By: P No.:
a, 13125 -SW Hill - Blvd., Tigard, OR ��� t� 1 0 - j
Plan Review -_ -`
s Phone . 503 639 Fax: 503.598.1960 Date/By: Other Permit:
n
Instion Lme- 503.639.4175 J U L_ 2 2 2 010
f
ll pec Date Ready /By ]uric; a See Page 2 for
T I GA R
<..:' Internet: wwwaigard- or.gov Notified/Method: I Supplemental Information
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Mechanical permit fees* are based on the value of the work
New construction
❑ ® A ddition/alteration /replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other. mechanical materials, equipment, labor, overhead, and profit.
''a'�. a rte"{. =.,"'' t . ; -� s,. ,c+ �t , �. - , � r,; .t .::,. "eF. „ s, �,s, �
El� , W USX `,, 1.14 s d.. `. �� , Value $
@: ' Vriro , "�3'E T3?aeoC ` i ... v9mn 67 ; ft - A3 t r.A e:-. B aa• 4� t . ■
/.1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building - " "' ° " "` ' ' as��'
For special information use checklist.
❑ Multi- family E Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
u ' • rahm, r .._... a , o _ nit..., <
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: a an. ''i ,O ;W, ,t� ti . �d5 : pl ', r* , - . w� 11 n r . a "r`a Heating/cooling
Job site address: 15576 SW RAPHAEL LN Air conditioning
(requires site plan showing placement) 1 46.75
City/State/ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ducts/vents) 46.75
' Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: 6;7) Heat pump 61.06
Cross street/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 electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other 23.32
Tax map /parcel no.: Other fuel appliances
''''.:47-744;t11--' . C 11 �t t � - (j a o .. t yR 7 ., . : Water heater 23.32
INSTALL AC, USE EXISTING DUCTING AND GAS PIPE. ELECTRICAL Gas firepla 33.39
Flue vent for water heater or gas
UPDATED AT TIME OF INSTALL BY OTHERS fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood frreplace/inse t 23.32
o. .....
'! v •- m . r } v lr ., . n . t. ;f ps p r ;t x • - Chimney /liner /flue/vent 23.32
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t ' , n, r t; . ° e t _ ,5t ' a ge ° � s* dv 1 t .: .�.y:t, _
�s .�___ .,_ - ._.... Other. _ 23.32
Name: BRIAN AND YVONNE GILL Environmental exhaust and ventilation
Range hood/other kitchen
Address: 15576 SW RAPHAEL LN equipment 33.39
City/State /ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)351 -3733 Fax: ( ) toilet compartments, utility rooms) 23.32
a.,,`; -4. H nF N • Attic /crawls ace fans = 7-..7-4'1.**,.....„ -t `•`t . fiY r_.., 5 , '•x,.„4"..., i ) ;� ' 'Psi I 1 p a 2332 ai Other 23.32
Business name: PYRAMID HEATING AND COOLING Fuel piping
Contact name: MEMORIE BROWN $14.15 for first four; 54.03 for each additional
Address: 5699 SE INTERNATIONAL WAY STE A Furnace, etc.
Gas heat pump
City/State/ZIP: MILWAUKIE OR 97222 Wall/suspended/unit heater
Phone: (503) 753 -9522 I Fax: : (503) 786 -3432 Water heater
Fireplace
E -mail: mbrown @pyramidheating.com Range
r
' =' t --. y .tv,u ,1}..1 , : ∎ R �. ° 4 - = ,. t S '. . ' x,, = Barbecue
Business name: Pyramid Heating and Cooling
Clothes dryer (gas)
Other:
Address: 5699 SE INTERNATIONAL WAY STE A '� ' ;ia' se ''a•"n'¢y'�,•y�mt t50 G"t�° '
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u��1! "• d ��i�sf -ial,94i',Ra'n��;f,if�'{rd ;�s� '.�d,,t -
City/State/ZIP: MILWAUKIE OR 97222 Subtotal 46.75
Phone: (503) 786 -9522 Fax: (503) 786 -3432 Minimum permit fee (590.00) 90.00
Plan review (25% of permit fee) -
CCB lic.: 59382 / State surcharge (12% of permit fee) 10.80 -
TOTAL PERMIT FEE 100.80
Tb is permit s _. applicatioaerxpires if a permit not obtained .within 180
Authorized signature:
days after it has been accepted as complete.. •
Print name: MEMORIE BROWN Date: . ' Fee methodology set by Tri- County Building Industry Service Board
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07/22/2010 THU 13:44 FAX 503 786 3432 PYRAMID HEATING 0002 /003
MECHANICAL SITE PLAN
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Job #: Pyramid Heating & Customer Information
Cooling, Inc.
Yvonne & Brian Gill
5699 SE International
Performed By- Way, Suite A 15576 SW Raphael Ln.
Milwaukee, Oregon 97222 Tigard, OR 97224
501590.8525
PH: 503- 786 -9522