Permit ��.. � CITY OF TIGARD MECHANICAL PERMIT
!'� ' t; ,..- COMMUNITY DEVELOPMENT Permit #: MEC2010 00416 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/19/2010
Parcel: 2S103AD02600
Jurisdiction: Tigard
Site address: 10800 SW PATHFINDER WAY
Subdivision: PATHFINDER Lot: 17
Project: Brown
Project Description: Replace A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
BROWN, JANNETTE C Description Date Amount
10800 SW PATHFINDER WAY
TIGARD, OR 97223 Air Conditioning 08/19/2010 $46.75
12% State Surcharge - Mechanical 08/19/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 08/19/2010 $43.25
Contractor:
CLACKAMAS HEATING & COOLING LLC
15115 SE PENNY LEE CT.
CLACKAMAS, OR 97015
PHONE: 503 - 658 -4808
FAX: 888 - 500 -2912
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: 4(/, 4 * .r, D
Permittee Signature: D. / /51--/° e_.. _� � 0 _ /
Call 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.
Fm:Clackamas Heating & Cooling 18885002912 (15035981960) 23:28 08117110G MT-07 Pg 01 -03
Mechanical Permit Applicatiofl1, -, ' : rUR (JF 1J( l sl () \t ,
104 City of Tigard s Received , /9 /d /O, permit No kC'� /0 -r
13125 SW Hall Blvd., Tigard, OR 97223 AUG 18 2010
1>s Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
-r) (A . >_�. Inspection Line: 503.639.4175
Internet: www.tigard- or.gov „' - 1:' Date fled/M 1u 7( See Page
en.aj I far
Noiified/Melhal: Supplemental information
TYPE • OF WORK •,; : , . COIWMERCIAI ;EEE °'., .U CC4IS1,
❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work -
El 17elnolltion ❑Other: performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials equi pment, labor, overhead, and profit.
C/t 1EGdRY -0W' ?CON7AI7Q1 ia9!T
Value: $
® ln
1- and 2 - family dwelling ❑ Comercial/industrial 0 Accessory building R1HfENTIAIL/ Sy '
0 Multi- family 0 Master builder 0 Other: For special ' 7rmation use Jrecklist.
' `..,J S ITE I NF ORM ATION: AND LOCATION Heating/cooling Qb Ea. Total
Job site address: 10800 SW PATHFINDER WAY Air conditioning
(requires site plan shower placement) 1 46.75 46.75
City /State/ZIP: TIGARD, OR 9722.3 Furnace 100,000 BTU (ducts /vents) _ 46.75 _
Furnace 100,000+ BTU (ducts:vents) 54.91
Suite/bldg. /apt. no.: Project name: - -
lleat 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: Lot no.:
Other: ( 23.32
Tax map /parcel no.: Other fuel appliances
t
DIFSC[tlPTfb?�i: OF;WORK r -
,., . Water heate 23.32
A/C REPLACEMENT Gas fireplace _ 33.39
Flue vent for water heater or gas
' fireplace 23.32
I Log lighter (gas) 23.32
1 Wood/pellet stove 33.39
Wood faeplace/insert 2332
. Chimney/liner/flue/vent Chimney/1'
;� • PROPERTY' : (Y W! !1 ER [] TENANT. 23 32
Other: 23.32
Name: BROWN, JAN Environmental exhaust and ventilation
- T Range haul /other kitchen
Address: 10800 SW PATHFINDER WAY _ equipment 33.39
CityiState/ZJP: T1GARD, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)7472701 Fax: ( ) toilet compartments, utility rooms) 23.32
PPLICAI4T (] :CON 1 �iC I PERSON. Attic/ rawlspace fans 2332
Business name: CLACKAMAS HEATING & COOLING LLC 23.32
Fuel piping
Contact name: VLADIMIR MIKHATS $14.15 for first four; $4.03 for each additional
Address: 15115 SE PENNY LEE CT Furnace, etc.
Gas heat pump _
City/State/ZIP: CLACKAMAS, OR 97015 Wall /suspended/unit heater
Phone: (503) 6584808 I Fax:: (888) 5002912 Water heater
Fireplace
E - mail: CRCLLC @COMC:AST.NE1' Range -
Gt >NTR 1G FUR Barbecue
Business name: CLACKAAS .HEATING & COOLING LLC
Clothes dryer (gas)
M
Other.
Address: 15115 SE PENNY LEE CF MECHANICAL PER .MI FEES*
City /State/ZIP: CLACKAVIAS, OR 97015 Subtotal 46.7
Phone: (503) 6584808 Fax: (888) 5002912 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
('(:R lic.: 165630 Stllre sarrehnrge (12% of permit fee) I0.80 L/
TOTAL PEILVIt•1' FEE 100.80
Authorized signature This permit application expires if a permit is not obtained within 180
,, days after it has been accepted as complete.
Print name: F LADiMIR MIKIIATS Date: - r 1 ' tee methodology- set by Tv- County Building Industry Service Board
1 . ''Bnldingl?ermia1MEC- PcrmiLApp due 10:01!09 44e.d617T(11m2/COMME13)
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