Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2010 -00500
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2010
Parcel: 1S134BD07005
Jurisdiction: Tigard
Site address: 11350 SW COTTONWOOD LN
Subdivision: ENGLEWOOD NO. 3 Lot: 230
Project: Speaks
Project Description: Heat pump installation.
Owner: FEES
SPEAKS, STANLEY M & LOIS J Description Date Amount
11350 SW COTTONWOOD LN Heat Pump 10/13/2010 $61.06
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/13/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/13/2010 $28.94
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217
PHONE: 503 - 281 -0752
FAX: 503 - 282 -5722
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.
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Issued By: � Permittee Signature:
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.
. . . .
• . ..
Mechanical Permit Application --)R 01 1(1 1 si.i ()1N1.v . .
City of Tigard C...eD Received •
Date/By: 0 4 /II 6 ,.91. .
rififirMIERIM
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
INI
• Phone: 503.639.4171 Fax: 503.598.1 c lit‘ a l .0 Other permit:
.4. k c\ Date/By:
.,,- I ci A .F.1 1 -, Inspection Line: 503.639.4175 ,4 9 QV.) Date Ready/By; till sec page 2 roe . ..
*Internet: www.tigard-or.gov Notified/Method: IIM Supplemental information
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7` , 4f4 , 4i.1,,TAW: ,,,, 'T.: J - • :,,,,?,..; .7a), ,L311 SEEN EZTIFIvsMOM:, iliMMEMMT.F
Mechanical permit fees*, arebased on the value of the work
0 New construction rgl Addition/alteration/ - 4 l ; •V performed. Indicate the value (rounded to theta:am-a dollar) of all
0 Demolition 0 Other s3 mechanical materials, equipment. labor, overhead, and profit.
...41N. ' ..t'AL-, 1 ,t§TOET` Ne I?" l''' d.'141 . value: 5 '
01Przc;•- FRpiraiwziwptirv434.0r,Itirdixit”7.;37.7 . .
ILII,61Wiligitar.t;Fir;16
IE 1- and 2-family dwelling ID Commercial/industrial 0 Accessory building
fior special information use checklist.' . ..
0 Multi-family 0 Master builder 0 Other: Description 1 Qty. 1 Ea. j Total • :' :
-703/44i. Ail ), 4' ' ' '''''''' 1,o,w4 a oat ta" ' ' c Pm 0 . '''' ig ' ' '
Heating/coo"
Air conditioning
Job site address: 11350 SW COTTONWOOD LANE (requirft %tie plan showing Placement) 46.75
-
City/Stale/ZIP: TIGARD OR 97223 Nmace 100.000 BTU (duct's/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: 29 • 0. Alh, Heat • . . 1 61.06 61.06
1 -
Cross street/dircetionS to job site-. 1 work 2332
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
Fluc/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32 .
_ --
Tax map/parcel no.: Other fuel a. . fiances
i ar
i ' . ;... t, 1 Via lirtani Water heater 23.32
•
,, ,., , , , , . ; ,
33.39
' '• Gas -lace
INSTALL HEAT PUMP Flue vent for water heater or gas
..,r■-•-•-•su..e.-■-••••••• fl , ..lace 23.32
Log lighter (ga MN 2332
Wood/. Ilet stove 111 3339 •
Wood fta • dace/insert 23.32
Chimney/liner/flue/vent 23.32
,, ,. ' -Ns , 4,..ratcre;,,• ,
ti L '•" ''' Met' '
Name: STAN SPEAKS Environmental exhaust and ventilation
Range hood/other kitchen
Address: 11350 SW COTTONWOOD LANE e. ui . mein 33.39
City/State/ZIP: TIGARD OR 97223 Clothes dryer exhaust 33.39
Single-duet exhaust (bathrooms,
Phone: (503)579-8393 Fax: ( ) toilet compartments, utifiat rooms) 23.32
qii1 Attickrawlspace fans 23.12
' 3= VGI ,,,,,. ..'14.ing.ftikft6c4iirtriiiiittrhiti'Magtis, ■ s ,) Other: 23.32
_
Business name: ANCTIL HEATING AND COOLING Fuel piping__
Contact name: CHRISTINE 'BARTON
$14.15 for first four. 54.03 for each additional
Furnace. etc.
Address: 4320 N WILLIAMS AVENUE III
Gas heat pump
City/State/ZIP: PORTLAND OR 97217 Wall/suspended/unit heater
Phone: (503) 281 Fax: : (503) 282 Water heater
Pi •lace
E-mail: INSTALL@ANCTILHVAC.COM Range
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*.lit , gyi vi; 4 <..: . fi ; *VA 13arbecue
, , , .p11i ioi.x4.9...;9:4% - , ...7... ,.,,. I , I , ,,..,-! ,- ..1 - . • ri ,, • ' ' ' ' Clothes dryer (gas)
Business name: ANCTIL HEATING AND COOLING
Other.
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Address: SAME AS ABOVE VIC064477 Ilmila.,-)1
. * Subtotal 61,06
City/State/ZIP:
Minimum permit fee ( %).00 ,
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee)
('C'B lic.: 8897 State surcharge (12% of pem fee) 10.80
TOTAL PERMIT FEE 100.0 1
'VII% TArtrtit appMmion enact., it a otoult Is not oblitiatti within 180
Authorized signature: days after it has been accepted a comPleic.
. . 1,2e methodology %CI by Tri-Counry Building Industry Serv Board
I Print name: CHRISTINE BARTON Date: 10/13/10
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