Permit 1 ,, CITY OF TIGARD MECHANICAL PERMIT
111 t COMMUNITY DEVELOPMENT Permit #: MEC2011 -00186
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2011
Parcel: 2S114BA15200
Jurisdiction: Tigard
Site address: 16060 SW COPPER CREEK DR
Project: HAYS Subdivision: COPPER CREEK NO. 4 Lot: 117
Project Description: Heat pump installation. Unit must meet 3 ft. minimum rear and side yard setbacks.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: HAYS, GEROGE C JR & GLENDA T
PO BOX 241 16060 SW COOPER CREEK DR
DUNDEE, OR 97115 TIGARD, OR 97224
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Heat Pump 04/29/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 04/29/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/29/2011 $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 1.800.332.214 .
Issued By: > Permittee Signature: �� '
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.
�4/2/2@11 14:57 503-G91-8556 OREGON HEATING PAGE 01/03
I t, .•.
Mechanical Permit ApplicaRECF 1 V 1, FOR OFFICE USE ()NIA'
City of Tigard
III 4 13125 SW Hail Blvd., Tigard, OR 97223 KpR 1 8
1 '
Phone. 503.639.4171 Fax. 503,598,1960" 2011 w4
Date/By: './ •
Rec*i niiiIMEMZEMMIM
Flan Review
nr other Penult Date/By:
Inspection Line: 503,639.4175
r I G P. R CI -ry n V. - 93PC‘ t Data Roady/By lurk. sae Psga 2 for
Internet. www.tig,ard-or.gov GI " DIVISON' NotiftedNeihod: -- Supplemental Infoonaned
BUO
' . TYVK OF woxic . commEltime FEE * SCHEDULE - , PiECKLIST '
i
0 Other: Mechanical permit fees* are based on. the value of the work
New construction 0 Additon/alteration/replacctnent
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition
mechanical materials, equipment, labor, overhead, and profit.
, , . , • - , , , , Value. $
Accessory building
1- and 2-family dwelling El Cotruncrcisiiindugtrial
I
Multi-family 0 Master builder 111
El Other: 1k4SMEITAL OUIPMENT ?SYSTEMS PEES*
,
Description Far special informatiun use checklist
Qty. EL L Total
JOB SITE INFORMATION AND LOCATION ' IleatinWcoolkig
Job site addreSS: . 0 U?/0 \A) . 16 I 1 telk--- 0 i
Air conditioning
(requires site plan showing placement) 46.75
- .
City/State/ZIP; 1 CR IIP 1 1.23 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (dusts/vectis) 54.91
Suite/h1dg./apt. no.: Project name:
,..— Heat pump I 61.06 (A.Citi
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. 46.75
Flue/vent for any of above 23.32
Subdivision: , Lot no.:
Other: 23.32
Tax map/parcel no.: Other fuel appli MMU
titStiffet: it)* or IiroRk..:., : :,,; .;,,,,,.„..,-; . . ., ,.,.,„.,' Water heater 2332
Gas fireplace 33,39
Flue vent for water heater or gas
_....,
,.. • 14., fireplace 23,32
A. * Ill ' ,••
Log lighter (gas) 23.32
Wood/pellet stove _ 33.39
Wood fireplace/insert 2332
• • , , ...• - , Chinmey/finer/flue/vent 23.32 Other 23.32
Name: d , 7 1 1 11 .r P i nirlial -jt:Wp Environmental exhaust and ventilation
ill ' Range bood/otner kitchen
Address: /.4 , 0 I tit./ OA 0_ 0 equipment 33,39
— -
City/State/ZIP: ,, M .00 ' 2. Clothes dryer exhaust 33.39
Single-duct exhaust (bathroms,
Phone: (Gte L rd — e)5 /3 Fax: (5b3 4' ( - 855te toilet compartmetus, utility rooms) 23.32
_Attic/crawlspace fans
APPLICANT . ' ' ' 0 coNTAcriEksON ' ' ' 2332
BuSiness name: r h „it_ c Other: 23.32 -- Fuel pining
contact name: 1 eneft _ ___. $14.15 for first four; $4.03 for each additional
Address: pD Of1 Furnac,e, _
etc.
Gas heat pump
City/State/ZIP ricice biR " 7 115 . Wall/suspended/unit heater
Phone: 60) oi ( , 1 ci Fax: : ('-'/ ) , • --- gissz,_ Water heater
Fireplace
E-mail: ...,_ Range
CONTEACrOR Barbecue
Clothes dryer (gas)
Rosiness name: • ; al h ill /I •' _a C
.... ,. j _ _ other:,
Address: P c..) r ii , o.e.e. a- I
City/State/ZIP; b Dle 421-irr Subtotal
Phone: ( Lift:SLJ-
9,3 t 7e/ ( Fax: 693 ( i_ess-
i Minimum
Plan review (25% ofiermit fee)
_
CCB lic.: J -7 2_, i z 1,, - State surcharge (12% of permit fee) 1 1_7
- TOTAL PERMIT FEE "7
Authorized signature: I i 4. / / This permit application expires if a permit is net obtained within 180
days after it has been accepted as com 8-
plete- 0
...■ • .
.....- -. 1 a • f 1 IS a 110 /IF I Al , .0 n 61, - 9 41 — I f * roe methodology set by Tri-Commi Building Todlistry Servici Irorrd
04/28/2011 14:57 503 - 691 -8556 OREGON HEATING PAGE 03/03
First Floor
0, 162 dm ®152 cfm & 52 O-%
10
10
1 1
ELJI forofFoor
10
152 crm
*-- Gardge
1 152 chn
Jurisdiction Tigard
SW Copper Creek Dr
- 11 ! 0 116
Job #: Oregon Heating & Air Conditionin... Scale: 3/32" = 1'0" Performed for: Page 3
George Hays PO Box 397 / 992 Hwy 99W Right-Suite Residential
16060 SW Copper Creek Dundee, OR 97115 6.0.106 RSR39325
Tigard, OR 97224 Phone: 503 538 - 2953 Fax: 503 2011 - Apr - 2812:46:19
Phone: 503 - 670 C :IDocuruents and Setlingslsales...
Tomeoregonheating.com