Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00134
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2011
Parcel: 2S111BA02300
Jurisdiction: Tigard
Site address: 14320 SW 100TH AVE
Project: JONES Subdivision: TIGARDVILLE HEIGHTS Lot: 29
Project Description: Ductless heat pump installation. Unit must meet minimum 3 ft. rear and side yard setbacks.
Contractor: HONKE HEATING & AIR CONDITION INC Owner: JONES, VERNON G
840 NE CLEVLAND COLLEEN D
GRESHAM, OR 97030 14320 SW 100TH AVE
TIGARD, OR 97224
PHONE: 503 - 666 -3725 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Heat Pump 03/30/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 03/30/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/30/2011 $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 1.800.332.2344.
Issued By: . Permittee Signature:
a 03.639.4175 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.
Mar28 11 02:44p Honke Heating 503 - 666 -0589 p.1
1
Mechanical Permit Application �� FOR OFFICE 1 :SU ONLY
City of Tigard Da- [�i/Li�f = 11111.1 _ 1�
•
III II 13125 SW Hall Blvd., Tigard, OR 97223 , Plan Review
Phone: 503.7182439 Fax: 503.598.1960 t Date/13y: Other P 1.. it:
l' 16A.1.1.3 Inspection Line: 503.639 Date Ready,By: hrs' El See Page 2 for
Internet: www.tigard- or.gav Notified/Method: &ye, Supplementallaformation
TYPE OF WORK CO 1' IAL FEE* S • DULE - LSE CHECKLIST
Mechanical permit fees* are P d on the value of the work
o New construction Addition /alteration/replacement performed. t :te the value o I ounded to the nearest dollar) of all
Demolition Other: mechanical , aterials, equip t, labor, overhead, and profit
Val I $
CATEGORY OF CONSTRUCTION r • VTCAL EQ ENT /SYSTEMS E1v1S FEES*
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special tnf, i , ration use checkast
Multi - family ❑ Master builder ❑ Other: Description QtyJ Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cot ing:
Air conditio ing
`
Job site address: 14 ' vG 'S L•; if.) 0 44" + 1 (requires site , lan showing place • , t) 46.75
Furnace 1** 000 BTU (ducts/ ) 46.75
City/State/ZIP: 7 /h n i Furnace 1l1000+ BTU (duct- nts) 54.91
Suite/bldg. /apt no.: " J Project name: Heat pump / I
c �i ;' -� (requires site 'plan showing phi. - i ) I 61.06 (p f . L,.a.i
Cross street/directions to job site: Duct work 23.32
Hydronic h* water system 23.32
Residential «oiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not el .
in -wall, in -d • ct, sus • ded. 46.75
Subdivision: Lot no.: Flue/vent f• any of above 23.32
Other. 23.32
Tax map/parcel no.: Other fuel . • pliaaces:
DESCRIPTION OF WORK Water heat: 23.32
1 ` i . 4' eSS 4 1 Flue vent 33.39
fm 54 � {'` (' � f � �i L � Fhte vent water heater or
fire.lace 2332
-- Lo.lia ter I,: 23.32
Wood/pellet stove 33.39
Wood firep : ce/insert 2332
1PROPERTY OWNER ❑ TENANT Cbimncyllin - /flttelvent 2332
Other: 23.32
Name: CO 1 (f t __ C., Enviroume . tal exhaust and ntilation:
Address: str J_ f Range h. • • other kitchen
- t/1/L'td'. g S r� 0 J / L, e 3339
City /State/ZIP: 1 Clothes dry exhaust 33.39
Far ( ) �) � :�,3 4,1e 1 t Single-duct comp • is (ua
Phone: ( ' lity r
toilet comp = ts, utility n l 23.32
APPLICANT 0 CONTACT PERSON J j Attic /crawl . ace fans 23.32
^ (4 f Other: 23.32
(ft-144
Business name: Le-J1,44./ -
Contact name: Y.p-\ 1� C,� ,, Sl feu each IS for first four • .03 additional
I
Address: ('' f 1 1 NI' Ci eui,� f lc, l J.2 J i v , Furnace, etc '
/�, Gas heat p
City /State/Z1P: L r ��(} --7
4 �5(r1�•ti� L r✓� 1 63 6 walUsusp • . ede'tmit heater
„') ' '+ ( Fax:: ( Water heat
Phone: (15y5) fj - 1 72 ' • ) cgl
,. (r, � Fireplace
F -mail: ILA,. U l �ti lit ruL ilk of � {, {Yj Range
CONTRACTOR Barbecue
• B usiness name: s 4 `.a k y cp Clothes d (gas)
lr Pv
Other:
Address: MECBANI ` PERMIT FEES*
City /State/ZIP: II Subtotal worm
lvlininum 1 erm it fee ($90.00) 410 .(f-t
Phone: ( ) I Fax: ( ) Plan review •5% of permit fee) •---
CCB lia: I ( i ( i State surcharge 2% of permit fee) ., .._1
( ! . TOT - PERMIT FEE j p (} _ ss
- L)71,41,tit This permit p pficatioa expires a permit is not obta. withia,W'
Authorized signature A ys after it has b accepted as complete.
Print name. 14-7 D 3/ C,6 1 ! • Fee metho..logy set by Tri . .ty Building industry Service Board
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A/C OR HEAT PUMP UNIT SITE PLAN
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