Permit 7 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00658
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2010
Parcel: 1 S134CD07900
Jurisdiction: Tigard
Site address: 11810 SW SUMMER CREST DR
Project: Johnson Subdivision: Lot: 0
Project Description: Heat pump installation.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: JOHNSON, EVAN
13150 S CLACKAMAS RIVER DR 11810 SW SUMMER CREST DR
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 503 - 886 -9238
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Heat Pump 12/20/2010 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 12/20/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/20/2010 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a , copy of the rules
or direct questions to OUNC by calling 503.232.1987 or :0032-2 44.
Issued By: Permittee Signature: 7
ja w
CaII 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
DEC -17 -2010 03:36P FROM: TO: 50359819E0 P.1
.
Mechanical Permit Application I , 11< oil II , 1 (
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City of Tigard k��P Re���a
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13125 SW Hall Blvd., Tigard OR 97 � Date/By: V� ': '� ��I '1�
• Phone: 503.639.41 Fax: 503.598 ! t• 1 �+ Plan Review
` J Date/By: ; Other Penult:
Inspection Line: 503.639.4175 Date Ready/By:
intt met: www,tigard or.gov ' t , \ ® Id See Page 2 for
. 1 `‘ otified/Mothod: /' Supplemental information
TYPE OF WORIF.Av 1 . \4Cj COMMERCIAL FEE" SCHEDULE — .USE CIIECJOJST
❑ New construction [83 Addition/altetatip��enl Mechanical permit fees* are based on the value of the work
V performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
• CATEGORY OF CONSTRUCTION Value: S
® m
1- and 2- family dwelling ❑ Comercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES'
❑ Multi - farnil •For special Irlo matioousechecF list.
Y 0 builder 0 Description 1 Qty. 1 Ea. 1 Total
JOS SITE INFORMATION AND LOCATION Heating/motiast
Job site address: 1 0 ` o e\N e Air conditioning -
��� + (requires eiteplan showing placement) 46.75
City/State ZIP: curd_ 41220 Furnace 100,000 BTU (duets/vents) 46.75
•
Suite/bldgJapt no.: Project name: Fumace 100,000+ BTU (duets/vents) 54,91
Heat pump , I 61.06 - C7,4
Cross street/directions to job site: Duct work 23.32
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. 46.73
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF
WORK Water heater 23.32
1 neat 1 d.ue e s MI n I Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 2332
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32
Name: Evan doh Qn Other:
23,32
Environmental exhaust and ventilation _
Address: ail Y tM Range hood/other kitchen
V1A 1 1 l equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33,39
duct Phone: ( 93,9062 1 S Fax: ( ) toiilet comportments (uutility rooms) 23.32
® APPLICANT 0 CONTACT PERSON Attic/arawlspace fans 23.32
Business name: Same as contractor
Other: 2332
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each addldoaal
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) 1 Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business me: Tri County Temp Control
Clothes d er gas
name:
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City/Statc/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 537.2220 Fax: (503) 557,0919 Minimum permit fee ($90.00) 0 ,<) c)
Plan review (25% of permit fee)
CCB lie.: 72623 Stan surcharge (12 %ofpermit fa) ' y U ijib
TOTAL PERMIT FEE Ir U E J�V
Authorized signature: am-" "" This permit application e xpires If a permit is not ebtalaed within 180
days after It has been accepted as complete
Print name: bloc. Mahon 1 Date: 1,2117) tb • Foe methodology set by Tri -County Building Industry Service Board
I: laulldina5PamtoMEC-PrrmitApp.doc 10/01 /00 440.4617T (11/1121COMIWED)
DEC -17 -2010 O3:31P FROM: TO:5O3598196O P.1
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