Permit < q CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00412
T [ G AR D' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/17/2010
Parcel: 2S104AB01700
Jurisdiction: Tigard
Site address: 12130 SW MORNING HILL DR
Subdivision: MORNING HILL NO. 1 Lot: 23
Project: Dyer
Project Description: Replace existing A/C.
Owner: FEES
DYER, DARREL & MICHELE K Description Date Amount
12130 SW MORNING HILL DR
TIGARD, OR 97223 Air Conditioning 08/17/2010 $46.75
12% State Surcharge - Mechanical 08/17/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 08/17/2010 $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 503.246.669• • I O. - 344.
Issued By: / iy Permittee Signature: //
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.
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Mechanical Permit Application l I,it ()t 1 it l.t,,l n,vl'1
City of Tigard - rX c 9
IT
a n , r F erm u No nip c 4 0 ' - ii. .66 • 13125 SW Hall Blvd.. Tigard. OR 97223
I'. - Phone: 503.639.4171 Fax 503.598.1960 r ' • 80110"
" ; Inspection Line: 503.639.4175 i late/BY' Other Fermin
ii.._ ..- AUG 1 1 2011 i y�Y
,.: <.. Internet: www.tigard-or.gov Nmified/Methad a See Page 2 for
4it . SapplemeatalInformation
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TYPE OF WO e: i t 1 a s n I v
. ; ass re.1. an n;: t;n1no a COMMERCIAL FEE* SCHEDULE - -USE CHECKLIST
❑ Newconstruction an 11 Idle + + t t 1LIsv1,J1Vry Mech anical •
® AdditioNalterstitm�re 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.
CATEGORY OF CONSTRUCTION Value: S
_" dwelling ❑ Accessory bulld RESIDENTIAL. EQUIPMENT /SYSTEMS FEES*
1- and 2-family g ❑ Commercialrndustriat
❑ Multi- family 0 Master builder ❑ Other: For mead tgforraauoa we eher.F!!u.
Description I Qty. I Ea. I Total
- JOB SITE INFORMATION AND LOCATION Heaen,yeoe i
Job site address: 12-130 eW KOrn111.811111 SY Air conditioning
(requires site plan showing pla eat) 1 46.75 k(a • 5
City / State/ZIP: g d 1 Furnace 100,000 BTU Nunn/vent 46.75
Suitalbldgdapt no.: Project name: Furnace 100,000+ BTU (duet /vents) .. 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work 2332
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other 23.32 _
Tax map/parcel no.: Other fuel apothegms
DESCRIPTION OF WORK Water heater 23.32
tacc exist; r� 4.1r co i- oar Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 2132
Log lighter (gas) 23.32
Wood/pellet stove 33:39
Wood fireplace/insert 23.32
PROPERTY OWNER I TENANT Chimney/liner/flue/vent 23.32
1 Y
Other 23.32
Name: - r,1 ,' )Cr �) Environmental exhaust and vemdlatlon
Add n� un e Range hood/other kitchen
V-�► �- equipment 33.39
City / State/ZIP: Ctothes.dryer exhaust 33.39
(C r 2L.1 n74 . (_ toilet
Single-duct exhaust ms,
• Phone: `� t [- ! Fax: ( ) t compartments, utilili rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Anicicrawtepace fans 23.3
Other 23.32
Business name: Same as contractor Fuel piping
Contact name: Diane Meson 314.13 for first four; 34.03 for each additional
Address:
Furnace, etc.
dos heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Tr$ County Temp Control
Clothes drver )
Other:
Address: 13130 8 Clackamas River Drive MECHANICAL PERMIT FEES*
City/ State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee (S90.00) '1(1.00
Phone: (503) 557.2220 Fax: (303) 557.0919 plan review (25% of permit foe)
CCB Iic.: 72623 Sate surcharge (12% of permit fee) I `d` lg
q� fr?CQ2 TO TAL PERMIT FEE I oA u t h z signature: Th i s epplleodon expires if o penult is not obtained within UM ` days after It bw beta ampsd as complete.
Print name: D I rtC, 1 49011 1 Date: 4411)1 t0 I ' Foe methodology set by Tni -County Building Industry Service Board
r1BulklingWermiuNMEC- psr11d1App.deo 10/01/09 440.4617T(1I/O1ICOMAVEB)
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