Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00180
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2011
Parcel: 2S104AA02800
Jurisdiction: Tigard
Site address: 12235 SW 126TH AVE
Project: Jackson Subdivision: BELLWOOD Lot: 38
Project Description: Install heat pump, unit must meet minimum 3 ft. rear and side yard setbacks.
Contractor: SPECIALTY HEATING & COOLING INC Owner: JACKSON, EUGENE L
7500 SW TECH CENTER DR #130 12235 SW 126TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE: 503 - 997 -5480
FAX: 503 - 681 -0793
FEES
Specifics; Description Date Amount
Heat Pump 04/27/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 04/27/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/27/2011 $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, o • Irk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility •tification Cen :. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d• ect questions to OUN► by c- . 50 32.1987 or 1.800.332.2344.
Iss - By: 101 Permittee S • • • � zzi fr
A eel'
Call 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.
APR/25/2011/MON 01:11 PM FAX No. P. 001
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City of Tigard Received r PVW .
D if EC i 0 l Pennit No.: tft a , –ed. n
III 4 13125 SW Hall Blvd., Tigard,00t 252.6 2011 Plan Review
; 1 : Phone 503.718.2439 Fax: 503.598.1960 Dete/By: other Permit
TI GARD Inspection Lino: 5(13.639.4115m OFT/GARD Date ites it'll': Pi See Pose 2 for
Internet: www.tigard-or.goy `-' NotifiedRviethod: Soppiementei II:dementia
BUILDINGDIVISION
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Mechanical permit fees* are based on the value of the work
0 New construction 0 Addition/alteration/mplacernent performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials. equipment, labor, overhead, arid profit
Value: $
aoowttoggogoogwo.0o..ioo,i*;t!';,!;?'. - s ''. ---• , .. -.
4,..F..; :i. ,, `::i .,63... . ; ,,..„. t ■ 'fr 6 . V .. .. . 4, ..
1- and 2-family dwelling D Commercial/industrial 0 Accessory building _ For special leVoesnallon use checklist
• Multi 0 Master builder 0 Other: Description I Qty. I Ea. I Total
1. .'r iiti4.00,001.:;..7 '. :::. ‘i1"' r.4)516,04000Ndiqgq:mroP`KiPvii;: H
Job site address k. laA14 .01 ' (reqUire$ site plan showing placement) 46.75
, Puma= 100,000 BTU (duets/vents) 46.75
City/State/ZIP; ''It3ek roi ' Furnace i00,000+EITU (ducts/vents) 54.91
Suite/bldg./apt no.: I Project name: Heat pump
(quirea'szte plan showing placement) 1 61.06 Sii.6
Cross street/dir' ections to job site: Duct work 23.32
Hydronic hotwater system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
. in-wall, in-duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/Vent for any of above 23.32
Other: 23,32
' Tax map/parcel no.: Other Nei appliances:
J.,.... 4***;014i ig. Wate"cater 2332
.', I Gas fireplace 33.39
alp. D. 1 . a - a 111 _. A. n1 • Flue vent for water heater or gas
fireplace, 23.32
. . Lc:: li)itei as 23,32
■:. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
i lt. '0 '. tiliiiikalittitilillidttliWit41:04lifFiiititillii1ittit:Titirr.":',. Chnnneyilinedflueivent 23.32
,:.14t,44.,;,1,;.,.. • . ' • • ' -- NiApper.,.
Eugene Jackson R11109 2332
Name;
12235 SW 126th Ave Environmental exhaust and ventilation:
Range hood/other kitchen
Address: Tigard, OR 97223 equipment 3339
City/State/71P; 503-997-5480 Clothes dryer exhaust 33,39
Single-duet exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 23.32
ITEIMMEETEDIMIElai 71q,Z-taffiii,i2'0..;::ift.:;."0.0*ORP.iiiiat.* AntinklaWisPase fans 2332
Other., , 23.32
Business name: .
1 piping: • - ' ,
Contact name: . l' ,.. 114.15 for first fonr, $4.03 for each additional
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t: '4-4" ' -.. . Fumace:etc. ,
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City/Stke:ZIP; ; , : W SM1. 4ediimit heater
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Water heats ' ;;*: . MN '
Phone: ( ) ...':. Fax: : ( ) .
. . . . 'fireplace
E-mail:
Range
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Business name: lotheso er as)
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Addrag; q '
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' 1U.,4 '-4 1 . 0 1' 1: " .F. : ,... : : ' : , • ,".. A ' ,. '" L l ..,,147 7 ,
. •
City/State/ZIP: 11 g:06-- • i 404 q12.1.4 • Subtotal \
Phone:( 6= 3h'(3 1 FEbc.(5os ..v : • ii.
COES lie.;,. 6, G r ig . • . . mini permit fee ($90.00) •• 0 06
• . Plan nevi w (25% of permit fee)
' , State surcharge (12% of permit fee) lignrni; a
. . . - .7.'77 -7 .'" . TOTAL PERM:erFgE ;
, . ....,
AuthOize4 signature: .S-UCCrn afar/I-ie..' . ' This permit application expires Ifs permit is not Obtain - . vrti.bin 180
' : ' , dir after it has been se opted as complete,
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•
APR /25/2011/MON 01:12 PM FAX No, P.002
SITE PLAN
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P�
PL PL
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•
•
4I
STREET
NOTE — Please show the following on the site plan:
• Location of Indoor Unit and Outdoor Unit
• Indicate how the flue will be run (thru the roof — out the sidewall — etc)
▪ Indicate with dotted line how the lineset will be run and approx. distance
Indicate how the condensate will be run
7500 SW Tech Center Drive
Specialty Suite 4130
Tigard, OR, 97223
HEATING 8.c COOLING INC. (503) 620 -5643 Fax: (503) 681.0793
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