Permit n CITY OF TIGARD MECHANICAL PERMIT
a • COMMUNITY DEVELOPMENT Permit #: MEC2010 00452
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/16/2010
Parcel: 1S134AB90181
Jurisdiction: TIGARD
Site address: 11341 SW SPRINGWOOD DR, UNIT# 18
Subdivision: Lot: 0
Project: Mann
Project Description: Heat pump installation.
Owner: FEES
MANN, JAN Description Date Amount
11341 SW SPRINGWOOD DRIVE Heat Pump 09/16/2010 $61.06
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/16/2010 $10.80
PHONE: 503 - 350 -5099 Minimum Fee Adjustment - Mechanical 09/16/2010 $28.94
Contractor:
PARALLAX CONTRACTING INC
P.O. BOX 92068
PORTLAND, OR 97266
PHONE: 503 - 760 -3427
FAX: 503 - 760 -7183
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 r— .2344.
OP
Issued By: / `�` Permittee Signature: fr
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.
Sep 15 10 01:12p Parallax Contracting Inc 5037607183 p.1
Mechanical Permit Application : FOR OFFICE USE ONLY
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City of Tigard Cr IN v Rec ,,..1.,
_
° 13125 SW Hall Blvd, Tigard, OR 9, 1!< _ Date/By: IS /0 - Permit No.: M ' C
Phone: 503.639.4171 Fax: 503.598. • • . 1 ry� Plan Review :J
1,1 T I G A Rll Inspection Line: 503.639.41 t� 1
5 '1-C.6\ OtherPenni,:
Internet: H�vtigard or.gov t Date Ready/By: kris ® Page 2 for
O � 11 r r O NolNotified/Method: 77.6 I Supplemental Informufioa
TYPE OF WO
Vi °V �lvl COM.1YIERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the wale
❑ New construction ® Addition/alteranon / replacement
performed. Indicatethevalue (roundedtothencarestdollar)ofall
❑Demolition CI Other:
median teal materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist
Description ' Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Ileating/coaling
Job site address: 11341 SW Springwood Drive Air conditioning
(requires site plan showing placement) 1 4.6.75
City /Statc/Z1P: Tigard, OR 97223 Furnace 100,000 BTU (ducts'vents) 46.75
Suite/bldg./apt. no.: M _ / Furnace 100.000+ BTU (ducts vents) 54.91
Project name: / . /V Heat um
P p I 61.06 61.06
Cross Areettdireetions to job site: Duct work 23.32
• fiyehonic hot water system 23.32
Residential boiler (radiator or
hydronic) _ 23.32
Unit heaters (fuel -type. not electric),
in-wall, in -duct, suspended, eta 4 6.75
Subdivision: I no : Flue/vent for any of above _ 23
Other: _ 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Mini Split Heat Pump Installation Gas fireplace 3339
Flue vent for water heater or gas
fireplace _ 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
ti PROPERTY OWNER 1 ❑ TENANT - Chimney/lineriflue /vent 23.32
Other: 23.32
Name: Jan Mann Environmental exhaust and ventilation
Address: 11341 SW Springwood Drive Range hood /other kitchen
es
equipment 33.39
City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Phone: (5031350 -5099 Single -duct exhaust (bathrooms,
Fax: ( ) toilet compartments. utility rooms) _ 23.32
❑ APPLICANT ❑ CONTACT PERSON Atticicrawlspace fans 2
23.3..
Business name: Other: 23.32
Fuel piping
Contact name: S14.15 for first four; 54.03 for cach_additional
Address: Pomace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended /unit heater
Phone: ( ) F :: ( ) Water heater
E -mail:
Fireplace
Range
CONTRACTOR Barbcate '
Business name: Parallax Contracting, Inc Clothes dryer (gas)
Other: I
Address: PO Box 92068
MECHANICAL PERMIT FEES*
City /State/ZIP: Portland, OR 97292 Subtotal 61.06
Phone: (503) 760 -3427 1 Fax: (503) 760 -7183 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee) 0
CCB tic.: 178629
State surcharge (12 °.'0 of permit fee) 10.80
TOTAL PERMIT FEE 100.89
Authorized siglraeure: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
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Sep 15 10 01:13p Parallax Contracting Inc 5037607183 p.2
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