Permit �' ; , CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00299
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/23/2009
Parcel: 2S101 BA00401
Jurisdiction: Tigard
Site address: 12265 SW 72ND AVE
Subdivision: Lot: 0
Project: Martin
Project Description: Install heat pump. Must maintain a minimum of 3 ft. side and rear yard setback.
Owner: FEES
TRI- COUNTY CENTER TRUST Description Date Amount
BY ADAMS & STEWART, 8565 SW BARBUR Air Conditioning or Heat Pump 06/23/2009 $14.00
BLVD 12% State Surcharge - Mechanical 06/23/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 06/23/2009 $58.50
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100 •
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503 - 598 -6746
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
•
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 calling 503.246.6699 or 1.800.332.2344.
Issued By: / Permittee Signature: `
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.
U/20/2009 12:42 5035986746 THERidALFLO #0627 P.002/003
Mechanical Permit Applicaii'�1 , ED FOR OFFICE: USE ONLY
City of Tigard �� Received //��
104 . Datc/By: l�- sp Permit No.: 6 L.03 - O��
13125 SW I Iall BIvwL, Tigard, OR 972:3 P1en Review
Phonc: 503.639.4I71 Fax: 503.598.19 )UN 2 2 2009 Dsuc Other Permit:
TIGARD inspection Line: 503.639 Date Ready/By: 3°.itL H See rage 2 for
Internet: ","w.tigard- or.gov CITY OF TIGARD Ncu ified/Me od: Supplemental Information '
RI 111 DING DIVISION
.... ...... :.. ._...:..... . - : .:._.. ....... ;....._..............._ . ... . .......,,...,_........ .... .. .. _.. ...
: ._.__.. : HFDIJI:'F.t_ .
EAST
❑ New construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
I 0 Demolition ❑ Other: • mechanical materials, equipment, labor, overhead. and profit.
.. 'CA'TEGORY -�OF CONS1'RUCEIOI� --- Value: S
S1bEi,1 ; 0-tili Ni /
S MS1 EES`
X1 - and 2- family dwelling 0 Commercial/industrial ❑ Accessory building * ...
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. L Ea. Total
...._:,., _.::t:.:..::30B;: O1N =4ND :
AT4O ' _ - ...:: ;::: .:::::c: LHeafittg/cooiinr .
Job site address: ! 2 Z6 11 � 1 Z 4 el Air conditioning or heat pump
IrcouiresMc plan placement) I 14.00 14
City/State/ZIP: �� � �� Q��a Furnace 100.000 BTU (ducts/ventc) 14.0(1
d I w � �� Furnace 100,000+ BTU (ducts/vents) 17.90
Suitr/bldg.Japt. no.: Project name: /� ` (mot pump 14.00
Cross street/directions to job site: • Duct work 1 10.00
Ilydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
• Unit heaters (fuel -type, not electric), .
- in -wall, in -duct suspended. etc. 14.00
Subdivision Lot no.: Flue/vent for env of above f 6.R0 .
Other. 1 10.00
•
Tax Map/parcel no.: Oth r fuel appliances •
.._ .. ......,._. _•.....
. . ...... .:.
. .r( • - A
-tcr healer 10.00
-
. Cies firt:plac: i 10.00 i
Fluc vont for water heater or gas
fireplace 10.00
Loa lighter (gas) 10.00 I I
. • Wood /pellet stove 10.00 .
1 , Wood firepiace/insert 10.00
�. - ..:..,.. ..................:... :...__,:_ : Chimney/liner/flue/vent . 10.00
: -7.ROF caw _ ;..; p-: 14tS'�= ;1'... :.:`::
:= : ;, ; ;
_.. : .
_ ... ..: _
..._ I other 10.00 •
Name: . / /1 _ aI 19 _ Eavirollr„8ntnt exhaust and venlila tinr
■
VVr T IrL�(/ Range hood/other kitchen
Address:
• l 10.04
equipment 1
/I. / r ,D 1 / ' • Cloth dryer exhaust l 10.00
/ Sin* -duct exhaust (bathrooms,
Phone: y I ' & J -Ql ; 4' Fax: ( ) toilet compartments, utility rooms) 6.ft0 •
I ,auicJcrawlspace fans 1(1.00
: :1:At ceiSvT -- ::. ;. L7 /00157 Cer'Yf.KSO - ::: -----
_ Other: 10.00
Business name: Fuel pipir>r
Contact name: L ' , _ a
55.40 for first four: $1.00 for each additiona
Ire / , • Furnace, etc.
Address: I A / i Gas heat pump -
City /State/ZlP: y • Wall/suspended/unit heater I i
Phone: ( )
i Fax :: ( . ) . . Water heater ],
n fi / //�►►//J����yyyy r Fireplace
E -mail: yt ipe,rfa/ Qtj�. • W��i. Rams
. . . ...... ar cue
��/ /� �"` " Clothes dryer (ens}
Business name: The . ! fl/ ei
/ j // Other.
'£W • 11 20
Address: - . .. -.:#(EGI.it AZ1!`, *o,,' : ::
City /State/ZIP: f fr a,441 el Subtotal * Q
- 70�� I Minimum pennir fee ($72.50)
phone: � Fact , b1D (v Plan review (25% of permit fee) ale) —
CCB lip.: j/ • ( Q A _ State surcharge i/
rm 'O (12% of permit fee) • l$
TOTAL. PERMIT FEE j %dig
This permit application expires Ha permit u not obtained within 1 %0
Authorized Ski o_r /tatllI• �f dnvr,. after it has been accepted ex complete
Print nF ne:_ 't�� I�DO4 ' f e j 1 Date : � , ' W e en I T . m, s: b� Tai- Cowct� Bacot 16. ludusud• &a vice Board
"6/20/2009 12:42 5035986746 THERMALFLO #0627 P.003/003
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3Ibe Plan: Harrill
t
1
5
Ilse
long
driveway
From
SW Mid