Permit CITY OF TIGARD MECHANICAL PERMIT
2 .•' COMMUNITY DEVELOPMENT Permit #: MEC2010 -00461
TIGARD 13125 SW HaII Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/22/2010
Parcel: 1 S 136AA01900
Jurisdiction: Tigard
Site address: 6807 SW OAK ST
Subdivision: Lot: 0
Project: O'Brien
Project Description: Installation of heat pump and air handler. Unit must meet 3' minimum rear and side yard
setbacks.
Owner: FEES
O'BRIEN, MARGARET E Description Date Amount
6807 SW OAK ST
TIGARD, OR 97223 Heat Pump 09/22/2010 $61.06
Duct Work 09/22/2010 $23.32
PHONE: Other, Heating /Cooling 09/22/2010 $23.32
12% State Surcharge - Mechanical 09/22/2010 $12.92
Contractor:
FOUR SEASONS HEATING & NC INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503 - 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $120.62
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: Permittee Signature: (9nv eg/ C , 5 7 -770 •✓
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.
08/21/2010 15:36 FAX 5035380165 a002/004
RECEIVED
.. .
Ni ?ik A ii....2011ioca n
i City Tigardi S E P 2 1 2 010 ; p 9/02 ex / 0 04— ! Poisit Na /VEro - 00 /6, /
1 13125 SW Alen 131vc1. Tigard, OR 97223 ..,. ! Pisa Review
Phone: 503.639.4171 Fax 503. OF TIGARE) ; Datell3y. Other km; 4;
Inspection Line: 503.639.4175 BUILDING DIVISION
. , intoner: www.ligard-or.gOv Notirred/matbraiSoppleence leformados
TYPE 011' WORK . .. .
. COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
. • . • •
, Mechanical permit fees* are based on the valu o
a th w
t
9 New eonsauction Addition/alteMionireplacarnent 1 pert:med. Indicate the value (rounded to the nearest dollar) of all
• ' 0 DemolitiOn Other: ine__=icai materials- ui labor. overhead. and profit.
CATEGORY or. Coristattrox7 vai44: s
_..._._________
RESIDINTIAL EOLLPMENT / SYSTEMS PEES"
- and 2
1 2-family dwelling 0 Commercialrtaduslrial 0 Aceessory o;.:Iding
For glacial irtforraosion tiss checklist.
' 0 Multi-family . . 0 Master builder 0 Other Des=iptioty._ Ea. Total
„ JOE srrE DIPORMATION AND;LOCATION ...... LIkatinetkoolleg
. —....1___
A.;:. conelltionuig
, ad sit_...L.3._.112ek_ Useares sac' tilan %howle; omeomme) .
46.75
Ciy/Sat/MP: '73(11, 0, * CI - 1 7,2.4 1 Fi:=ace 100.000 ETi.; (aucisivcins) 46.75
1 - F.,:.-at:..e :00400+ BTL. tducaiyoats) 54.91 ..—
1 Suite/bldg./al% no.: Prc iiCal CUVIA . .
1 _61,06 AO . 010
i !---
' + Cross street/directions to job site: I _ 1 work 1 1 2332 1
1 2 3,
1 HydrOmie hot water mann 2312 1
Residential holler (radiator 07 .
I
. . •••■■----
hydrortio) 23.32
heaters (fue1-type . not electric).
----
in-wai., in-duct. suspended. 0iC. 46.75
• Filicivnn for any of above 23.32
Subdivisio: Let no.:
,
Other: : r 0:„ • 11111111E1R , 1
Tax map/parcei no.: Other fad applbtoca
DESCRIPTION OF WORK .. •• . Ws= meter 1 23.32 1
:71.6 li, — ace 33.39
Ir. • FLe vent for water heater or
23.32
Log ii (stas: .
,
23.32 1
Illb - ■ - L. Wood/Pellet stove • 33 39 —
Wood fuvelacedlnsat i 23.32
. 1 Chimney/litterlfluevent 2332
. — 13 pstopErry oPerM Immtaii
I Other I 23_32
.. /1.4Z-1974-6-7 .1 1 lavimamental aquas: &ad vegfiladoc
I Range bood/other Eicher. ! , .
1
Address: 6, e 5 A.) 0 /9-fr-- Sr - . rtrzL___A__39
cityltaterz.2: - 7t - rt-6 - ,V .2_3 i C:ortes dryer exhaust 3339
I Single-duct exhaust Nahroorft 1
Phone: ( ) Pax ( ) I - -
Zue- comparrmars, Aility. roomal
- I 23.32
• 1=1 A,PPLIC.ANT . . I .:. .' "...: CONTACT PERSON ... , Aatic/crawispacc farts l 2312
Orir_i_r: 2132 1
Business MOM: Ertel pipion
-! eb . . - _ _ - :- t. : :. __ -
Contact ne: ANDTAIIMERChlt&INC. $14.16 tor flew tour: S4413 for each additional
Address:
NDU IAL ,....fnacc.etc.
1
., ..
- : • -- - - - C haat outdo
' :: , : r' !
City/StaterZIP: Wall/suspouted/unit heater i
Water heater
Mom: ( ) Fax: : ( ) -- r -- -----4---..
• Fireziaric
&moil: 117 :TMIIIIIIIIIMMIMIMII. .
, IMMIIIMIIIMMEME •
ISIME
Business name: 17711111111
it 4 - ' -.4 ' 1=- • ' - ' ' r
Address: MECIIAIIICAL PF/Mirf MES
I*
City/State/ZDI: AN IN DM13141 M IC DUSTR(AL . Su btotal /e , $
• 11_ , . : - - , •'" 7 f ) minimum permit fee (590.00)
' ' •• , ,.- giej ) 53g -If - -
OS-
. 1 . Pim review ;23% of permit fcc)
CC/3 lie,:
Stare surcharge Ct2% of permit fee) 1 /A ,. 9,2.
__ TOTALT FEE ...Z,0 ,
IIII This peratit applicatIoa expire' if; permit et sot obtaiaed within I ,V
t
Allthpria:Cd .; 2 ' :.. ' • '1 W A 2.:_AA.A days attar it has oom accepted as complete.
Date: i * Fee methodology set by Tri-CowitY auuding Industry Savi.v Soars
Print name: r e , C.- In ‘,., In
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440.461rr 0 i tricosowts)
imaiteisammutomEc.perememst 10,601109
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