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Permit CITY OF TIGARD MECHANICAL PERMIT :• COMMUNITY DEVELOPMENT Permit #: MEC2010 -00429 Date Issued: 08/26/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S134CB05400 Jurisdiction: Tigard Site address: 11125 SW TONY CT Subdivision: Lot: 0 Project: Flax Project Description: Install NC. Unit must meet 3 minimum rear and side yard setbacks. Owner: FEES FLAX, LAURA Description Date Amount 11125 SW TONY CT Air Conditioning 08/26/2010 $46.75 TIGARD, OR 97223 12% State Surcharge - Mechanical 08/26/2010 $10.80 PHONE: Minimum Fee Adjustment - Mechanical 08/26/2010 $43.25 Contractor: SKY HEATING & AIR CONDITIONING, INC 1637 SE NEHALEM ST PORTLAND, OR 97202 PHONE: 503 - 235 -9083 FAX: 503 - 235 -0454 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: /P547671.-e___ Permittee Signature: Qj , C2977e 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. Ce.20 /D 00/ c , ZI Mechanical Permit Application - moot of it: i'. t,;f: 0Ni, \• City of Tigsxrd 41. � ti%\0 Received ,` d ' „ 00 it-Pi l 13125 SW Hall Blvd., Tigard, Ott' 97223 , www.ti d-OC, t� V Plan Review 503.639.4171 Fax; 503.599.19AV „ `� ' - ` � , ❑atart?y: Cuter Permit: Inspection l int : 503,639.41 75 ■ :o t ' : \ION Date Ready /By: luris: bay See Page 2 for Internet • t I t ;,� iu i :: o � '1 �� °� t '(� Supplemental lnfurulntion 6 Notificd/Mettttld ,• - J TYPE OF W Oitk COMMERCIAL'LEE” SCHEDULE - USE CHECKLIST Mechanical permit fees* arc bused on the value of the work New construction Addition/alteration/replacement performed, Indicate the value (rounded to the nearest dollar) of all 0 Demolition . ❑ Other mechanical materials, c ui meat, labor overhead and rotit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/ SYSTEMS FEES* iil 1- and 2•fatnily dwelling 0 Commercial/industrial ❑ Accessory building For special information are checklist. 0 Multi- family 0 Master builder ❑ Other: Description _ Qry• Ea. I _l'utal JOB SITE INFORMATION AND LOCATION • Heatinticoaling .— _ 1 ` �� J ob site address: / 1 541/0 J Air conditioning Cremates site plan slwwiue Ptucun ( eno 46.75 /r f/ �. Furnace 100.000 d1 "U (ducls/vents) 46•75 - CitylStrtlr /'LSP. � G( (r(/f - Furnace 100,0009TU(duos/vents) 54.91 Suite /bldgfapt nu -: .. Project name: Heat •Inn. 61.06 Duct work 23.3? Cross street/directions to jab site: Duct w is hot water system 23.32 Residential boiler (radiator or • h dronic) 23.32 _ Unit heaters (fuel•typc, nut electric), in -wall, in -duct, suspended, etc. 40.75 _ " Flue/vent for any of above 23 •= 2 1 5' ubdivision: Lot no Other: - T— 23.32 fax map /parcel no.: w Other fuel appliances .— . Water heater 23.32 DESCRIPTION OF WORK . .- • Gas fireplace ,. _ 1. /k� l G Flue vent for water heater ur gas t'At.��1 - — fireplace 23.32 Log lighter (gas) 23.32 — Woud/pellet stove - 33.39 �� Wood fireplace /insert 23.32 • Chimne flinedtluelvent 23.32 • _ ❑ PROPERTY OWNER ❑ TENANT Other; 23.32 Environmental exhaust and ventilation _ `'ime ��' Range hood/other kitchen equipment 33.39 Address: 33.39 Clothes d et exhaust • City /5satr/Lll : _ Single -duct exhaust (bathrooms, — Phone:( ) hex:( ) toilet com •attmcnts, utili rooms 23.32 Attic/crawls�acefans 2x32 _ • ~~ ❑APPLICANT ©CONTACT PERSON Other. 23.32 Business none: Fuel oipinj 514.15 for first four 54.03 for each additional Contact manor: Fu rnace, etc. A �j 'e 7.. Gas heat pump L City /State/ZIP: • Wall/suspendcd / unit heater IM Water heater Phone: ( ) ra "' ( ) Fireplace 1 inail; — Ron r� CONTRACTOR • Barbecue _ Clothes dryer (gas) • • B usiness name: 5/� t '_' - f ` Other: / J/ � _ - Address: / f� /r� �' MECHANICAL PERMIT FEES' S ..--- L. City/State/ZIP: 10 / tit A t:(, 0 12-. �� °2 0 °2' Minimum permit fee ($90,00) 7 a ` P. •nc: ) 7Z' ' 3 0 7 ' 4 ( Fax :5 2% -1 Plan review (25% of permit fee) /, Stan surcharge (12% of permit tee) � � � 0 • ,IS 1 ■ CCB tic.: ��"i TOTAL PERMIT FEE ► /,I�� S'? ■ 4 J Tins permit application a piret it'd permit is not obtained within t:0 days after it hay Wen accepted as complete. FPritst name: Authorized signattue; i � / �/1, /b • Fee methodology Set by lti Count y au Building lnduy Service Huard I Date: • ..--_ aaa46 tT p uoui:ot,envt:ul 1 An i1dul.rt'anU6UiEC- Permi.App.dn: 10f0110 _ •. "" £0 /Z0 3Jtid DC QNti 9NIlti3H ANS b9b09EZE09 8S :I0 OI2Z /bZ /80 08/24/2010 01:58 5032350454 SKY HEATING AND AC PAGE 02/03 • • ' K i - . • t. • . .