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Permit CITY OF TIGARD MECHANICAL PERMIT III ° COMMUNITY DEVELOPMENT Permit #: MEC2010 00391 T [ G ARb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2010 Parcel: 1 S135BC01100 Jurisdiction: Tigard Site address: 11131 SW GREENBURG RD Subdivision: Lot: 0 Project: Jump Sky High Project Description: Mechanical for TI. Owner: FEES ROBINSON FAMILY TRUST Description Date Amount BYE LEE & EVELYN L ROBINSON TRS, PO Permit Fee 08/18/2010 $589.01 BOX 91305 Plan Review 08/18/2010 $147.25 PHONE: 12% State Surcharge - Mechanical 08/18/2010 $70.68 Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 PHONE: 503 - 692 -1565 FAX: 503 - 691 -1879 Type of Use: COM Class of Work: ALT Type of Const: IIIB Occupancy Grp: A -2 Occupancy Load: Stories: 1 Fuel Air Handlers Fuel Types: Natural Gas Units < 10000 cfm: Gas Pressue: Units > 10000 cfm: Furnaces Boilers & Compressors Furnaces < 100K BTU: 0 -3 HP: Furnaces >= 100K BTU: 3 -15 HP: Floor Furnaces: 15 -30 HP: Unit Heaters: 30 -50 HP: Vents w/o Appliances: 50 or Greater HP: Air Conditioning: Heat Pump: Appliances Vent Fans: 2 Vent Systems: Total $806.94 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: 1 Fire /Smoke Dampers: 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 1.80 _ Issued By: � ./ — ,� Permittee Signature: // Call 503.639.4175 by 7:00 a.m. for an inspection that bu ' ess 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 OFFICE USE O'��L' 5 City of Tigard Q<C "`'o' �, @� Received _: t._• _,�, 1 . ` 13125 SW Hall Blvd., Tigard, OR 972 3 �� � Date/By: 1 l . ' Puma No.. _ q s!i Phone: 503.639.4171 Fax: 503 .. .. - 19$09t0,- ; .: "t •. 0 Plan Review �b �i jj�q Other permit: T 1 GA R D: Inspection Line: 503.639.4175 u s> 1 Date/B r � /� (� lt� ri r • 10 - o ass Internet: www.figard- or.gov � � t9 Date Ready : / i n Sec Page 2 for P� `\ t \CP.r OC \ hIotifiod/Mahod: �!� a Ir / Supplemental Information .�... :. , <. �..5 i `wN> i_. .. � e'- ': 1'i .,.- ;i41Mf v ` 3 . `-- 5+;� ,� t7ky ch m` . t't ll 4.4 ie 4 ...., a - + ....� -.0 1 t i "ti::Y' Ji'� ' -�� ta- Aa A El New construction C/ Addition/alteratittiVacement Mechanical permit fccsx arc based on the value of the wort ❑ Demolition ❑.Oth performed. Indicate the value (rounded to the nearest dollar) of al �4 � , .• " �i I mechanical materials, equipment. labor, overhead, and profit. El 1— attdf 2-family dwelling CommerciaVindusi ial ❑ Accessory building ' = ''_ � x 1 1 iVi a ❑ Multi-family ❑Master builder 0 Other: For special information use checklist. r < w L s n0 . r Ta �, �_ : Description Q(Y. Isa. TtHal �' .... c 4a ... r P - +x, : 0 . 4;* <.,-- < r ,•, `'ire. 11s y . 5 ` s • . � � s. ��,. '� r., , _ Ileatinglcooluig Job site address: ll1 0 1 L t7 v4 G� 0 e Air conditioning R �� t (requires site plan showing placement) 46.75 City/State/ZIP: 7 1140 . r 4 Sipe 4722.3 Furnace 100,000 BTU (ducts/vent9) 46.75 Suite/bldg./apt no.: I Project name: JV S� Furnace 100,0001- BTUY.(duhas/venv) 54.91 y Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water. system 23.32 Residential boiler (radiator or h dronic 23.32 Unit heaters (fud -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue/vent for any of above 23.32 Tax map/parcel no Other. 23.32 Other trial appliances n q c ,' Yr- ' l^'-`R) : Tyr �i t• ft , i _:.'i'+":. ° <. 1 : i: nj t KT*1 Water heater 2332 r'^ 1 1, / ° ,A , °+.n �- ma y -.. .. `4 .' C 2 J /� W vA S eA G �J 2/ Gas fireplace , 33.39 e•)L6blfpj"T PAAtS, >�ewTyvpl Flue vent for water heater or gas &Ai 4, 6A 0 ICI4...i fireplace 2332 ✓J Log lighter (gas) 2332 Wood/pellet stove. 33.39 Wood fireplace/insert . 2332 h S F -* '* . a `,A ee 4 . .-- <u: .; , ey tier /flue/vent 2332 ' r i_ - �8 Al . - > . ` ? Chime /li other 23 / .32 Name: CI, n 3 �y PtrF/l / ✓ Environmental eirhaust and ventilation Address: 11l 01 6, / � N6vi¢h .. I Ran hod/�Iter kitchen J� • equipment 33.39 City /State2IP: - e , d . e Clothes dryer exhaust 33.39 Phone: () Fax ( ) Single -duct exhaust (bathrooms, _ _ toilet compartments, utility rooms) 23.32 174 ` � r' `?` ' g'7a ' ` P �. � '. F ' ?r., s f .. Attic/crawlspacefans 2332 � on Business name: A�tow �- 23.32 I yl �L Au, K�A ` Fuel piping Contact name: )( 104 iC et,5l�Vtlfp le i $14.15 fort first four; S4.03 for each additional Address: ' p 3 6 %04 . I T N rd Gas heat etc. i Gas heat pump City /StatefZIP: ¶ A l ensd Mit 47062. Wall/suspended/tmit heater Phone: (6)3 69 2-/ 6 6 - 6 5 , Fax: : (5b3 )6q1.167:1 Water heater E- mail: Fireplace '. ��i.� s, " ,r_" f3 -;, ; ,< 4 - ' C2 t u w `M� s '' _ ., -, 4 Barbecue Business name: A►1� ite 1�1./ ■teL E bl4Atl i I e..4 ! Clothes dryer (gas) Address: 16530 sJ TV Cit�h.: x �3 r mo �... cit Tv A licri•v © 1 9 706 Z subtotal f 9; Of Phonc: (62,3) 64 z -16 ; Fax: (3) i /871 Minimum permit fee ($90.00) Plan review (25% of permit fee) / y7 , CCB lic -: 51 43 State surcharge (12% of g ( permit fee) 7 t kr TOTAL PERMIT FEE ei, 4, f'y Authorized signature j � This permit application expires if a permit is not obtained within 1: • days after it has been y accepted as eompiete. r �, :t ., • rr:." • D ��� n° *P' 7�27�20/ 0 1 • Fee methodology set by Tri- Comity Building lndustry Service Bo 4