Permit CITY OF TIGARD MECHANICAL PERMIT
h COMMUNITY DEVELOPMENT Permit #: MEC2010 -00671
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 2S112BB11300
Jurisdiction: Tigard
Site address: 14256 SW FANNO CREEK LP
Project: WINKLER Subdivision: Lot: 0
Project Description: NC installation.
Contractor: ANCTIL HEATING & COOLING Owner: WINKLER, ANITA M A
4320 N WILLIAMS AVE 14256 SW FANNO CREEK LP
PORTLAND, OR 97217 TIGARD, OR 97224
PHONE: 503 - 281 -0752 PHONE: 503 - 701 -9471
FAX: 503- 282 -5722
FEES
Specifics: Description Date Amount
Air Conditioning 12/22/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/22/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/22/2010 $43.25
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 1.800.3 . •
Issued By: Permittee Signature: (( %5
Call 503.639.7:00 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.
Mechanical Permit Applicatla ` ` t . FOR oil :Nil is oNI.\ .
City of Tigard ffll ( ,) $ °At e;vcd Pertn;t No - / • IN '� 1312$ $W Hall Blvd,, Tigard, OR 97223 U L I L -i; tLt Darelsy: ( 0 sit
I Phone: 503.639.4171 Fax: 503.598.1960 t7rher Permit:
. 1 ( i 1 AYt D Inspection Line: 503. 639.4115 CITY OF TIG 3win; RI See Page 2 for
Internet: www.tigard- or.gov �GII�iNG D IVISION - � Supplcmcntnt Information •
164 NIN' t i t l t�lGa A rl t l,r t r tv ' r r ' ° Y P F rOZIFEM ll .0 Lt ` 11., k
Mechanical
, ,: 4�rr. rr etW ➢;, QR .rr<; � ;" 6' d..
v. ) ! i , � .:, r �lu, „>�;�I,wruu.. ; 4;" .1 permit on the valu of
❑ New construction ® Addition /alteration /replacement the work
performed. indicate the value (rounded to the nearest dollar) of all •
• [] Demolition .0 Other: mechanical materials, equipment, laboj, overhead, and profit
Y.(Ail rF r r "G? !r�$ai9. S ri v / n Ypf.r. Value: S
it. w i' :' '' .#1Z1 + a l�°u1 � m�la ° , r F�F AtI.Y��'1{. iVlvl Il .,' , � 1�, lJ i n , R R '�i o m a y ,r� 8 , : n'� o t I
I -and 2- farnil dwelling A' . au � °s u s�• 5t 6tn, trse', ." I '..
® y g 0 Commercial /industrial El A ccessory building Io, special fnformonon use checklist.
• ❑ Multi family Q Master builder ❑ Other: Description I Qty. I Fa. Total
i W M r r A �,r(;! R . �sY r ., . 1^ h I ,rl P1,V 'i lY
, Iii. ,"f°t 11 , Tney5 ��a "r Gt d Q 1 r Fm ' ' J ta � r r t rY ' 1�' Heatingl000liftg
�:' J: .Itrb4 tJFti' k Y ..r . ,.
Air conditioning
Job site address: 14256 SW FANNO CREEK LOOP (requires site plan showing placement) 1 46.75 46.75
City /State /ZIP: TIGARD OR 97224 Furnace 100 000 BTU ducts/vents 46.75
Furnace 100,000+ BTU (duewventa) 54.91
Suitc'bldg. /apt. no.: Project name: #29238 W.� Heat pump 61.06
• Cross street/directions to job site: Duct work _ 23.32
"-" Hydronic hot water system _ 23,32
Residential boiler (radiator or
hydronie) 23.32
Unit heaters (fitel-typc, not electric),
in - wall, in - duct, suspended, etc. 46.75
Flue/vent for any of above 23 -32
Subdivision: ision:
- 1 Lot no.: Other: - 23.32 •
Tax map /parcel no.: , Other fuel appliances _ y
r c ii r p"Y��y� r 'd ! i� I MAJ fix nr9pm,4p. 0 , P .., 0 c , , "r, 8 F(fhvti "4i' 1 ,, ' s J 1. t Water h 23.32
ry7f. 1i
.ra t . Nti4 �k1r'1"t:'Ir,1�lt, . 1�i „+" "J m� ";, . >l�`rW . ptA3311 • , m`P +n: i , , {t.: 33.39
Gas fireplace
Flue vent for water heater or gas
faee 23.32 ,
• Log lighier (gas) _ 23.32
Wood/ pellet stove 33.39
Wood fireplace/insert 23.32
li v "il a Y ;o� a ' .. l J^w,,V,,., iM1 ri' { . lglalft# AM, a .,n ' -1 p� , C
10 himney /liner /flu 23.32
�vwtP{.,G!] Y m , t. t1t t S) 11 av tr. m1 +YF1K r (l,µh¢ Y e A 4" y )Y �lrc, „ 23.32
-S" Other:
Name: ANITA WINKLER Environmental exhaust and ventilation
Range hood /other kitchen
Address: 14256 SW FANNO CREEK LOOP - epipment 33.39
City /State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)701 - 9471 Fax: ( ) toilet compartments. udl y rooms) 23.32
see fans
Other w , p. • • 23 32
' y' rev4 r . � w v .,xor 11 1y1S
il��`)hr� 9 v i�'Cah�G>!� iEi , �0,0,::.,:g:,-.0,,.,L 'a ..,h Attic /CYa
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Business name: ANCTIL HEATING AND COOLING - Fucl;rlg
Contact name: CHRISTINE BARTON $14.15 for first four; $4.03 for each additional
Address: 4320 N WILLIAMS AVENUE Funxrrce etc.
Gas heat pump _
City /State/ZIP: PORTLAND OR 97217 Wall/suspended/unit heater
Phone: (503) 281 -0752 Fax:: (503) 282 -5722 Water heater
Fireplace
E -mail: INSTALL@ANCTILHVAC,COM Range
•;:iP4 JIX,11iMi n") k ' {r " vt... R 7 � M 4r M,L SW A d i I. 44fillvi raa il0P Barbecue ._. -
Business name: ANCTIL HEATING AND COOLING Clothes dryer (gut)
Other:
i .... ..._.. °- r,,'7i, �•'.0 „'%�.,;;��9t li G'st'.:,i:.;�.. ,� „e rraoo ri l s, } �� � a�,,�:r]�; s� � , ::a;J�',iw:��,iii'�i °I "�,,� %is
Address: SAME AS ABOVE , a 1, lO ' . :, r: !): ,.,,N `., , ,i ., ��.''h+, 1:, r„ K Aa' ;
City /State/ZIP: Subtotal 46.75
� - - ' Minimum permit fee ($90.00) 90.00
Phone: ( ) Fax: ( _ .) - .. � Plan review (25% of permit fee)
CCS lic.: 8897 - State surcharge (12% of permit fee) 10.10
-- TOTAL PERMIT FEE 100.10
his perm„, m,„y.e;Jripn rzprrev it a permit is not obtained vrithin I84
Authorized signature. � 1 , • T
L l r days after it has been Accepted aA complete.
Print name: CHRISTINE BARTON 1 Date: 12 /21/10 ° l'CC inethodology sat by TI't- county Bali Id int IPdaytry .Srrvtne fioard
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