Permit r
q CITY OF TIGARD MECHANICAL PERMIT
NI la ` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00411
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/11/2009
Parcel: 2S 109AD00700
Jurisdiction: Tigard
Site address: 14545 SW 126TH AVE
Subdivision: BLUE RIDGE Lot: 7
Project: McCullough
Project Description: Replace furnace and install A/C. NC unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
MCCULLOUGH, MELANIE J Description Date Amount
14545 SW 126TH AVE Air Conditioning or Heat Pump 08/11/2009 $14.00
TIGARD, OR 97224
Furnaces < 100K BTU 08/11/2009 $14.00
PHONE: 503 - 624 -9150 12% State Surcharge - Mechanical 08/11/2009 $8.70
Minimum Fee Adjustment - Mechanical 08/11/2009 $44.50
Contractor:
SKY HEATING & AIR CONDITIONING, INC
1637 SE NEHALEM ST
PORTLAND, OR 97202
PHONE: 503 - 235 -9083
FAX: 503 - 235 -0454
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: .1115 � / • — Permittee Signature: (7 "1 /51-,Z. / �*�% / Or
A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
9, 0$(06/2009 23:07 5032350454 SKY HEATING AND AC PAGE 01/03
- Mechanical,Permi_ it A, np]icatio ,f ECEIVED
I tll:OIlli F.C�I (1 \I.1
City of Tigard Received pa
• ]. 3125 SW Hall Blvd., Tigard, OR 97223 AUG 7 2009 Date/By; O // PcrmitNo. ;�� C Q /
a ' Pho ic: 503,639.4171 Fax 503.598.1 Plan Ravi
Inspection Line: 503,639.4175 IT OF TIGARD D o R a ay/By' other Permit,
Internet: www.tigard- or.gov BUILDING DIVISION N °Micd/Mdhod Iu See Io x For
B°ppletncntAT Information
New c onstruction
T f " pVtl .... •: . ;
❑
. _ Mechanical R� t1L Fes+; 'S�'E '� tT5';l�1��87"
Addition /alteration /replacement .ter apical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical materials, ui mc„t, labor overhead, and profit
k' 'EGOR " or O tq Value: $
(D 1- and 2- fancily dwelling c ` buildin
- g
> ❑Commercial /industris,l [� Accessory bui :..,.... ,,,,... affrt x
❑ Multi- family 0 Master builder ❑ Other: For special hlfprnru:ion use checklist
Dcscripti0n Qty, Ea. Total
3' S7et. TrkittkitATION 'AND LOCAT Realm /icnoling
Job site address: if eittrZis-3_ 1 cDig rI Q Air conditioning or heat pump /
• trues site . Inn showin : • lacemeet F 54.00 1
T City /Statei71P: '/ furnace 100,000 BTU (ducts /vents) 14,00
Suite/bldg./apt. no.: Project name: Furnace 100,0001 911) (duets/vents) 17.90
Gas heat I . 14.00
Cross street/directions to job site: Duct work
10.00
•
,_Nydronic hot water system 14.00
Residential boiler (radiator or —`
hydronic 14.00
Unit heaters (fltel -type, not electric),
in-wall, in -duct, suspended, etc. 14.00
Subdivision: Flue/vent for any of above
Lot no.: 6.80
Tax map /parcel no.: Other, 1000
Other fuel appliances
10,00
Ctph7(i
' Wes' Wakcr heater
• C.� Y Q. t'! Gas fireplace 10.00
Flue vent for water heater or gas
. .4 all / e__ _fireplace _ 1.0,00
— Log lighter (gas) 10.00
Wood /pellet strive 10.00
,, '''lf td>I '1v twilit* :1:' ; ;: tz Tr NAN C C
Wood
a /tine Fluff rnt _ 10 00
ame ' t , if / e 4� �I
� /b L' Other: 10,00
N
_Emvironrmental exhaust and vcnt;lAtlon
Address: Range hood/other kitchen
City/State/ZIP: — equipment _ 10.00
Phone: ( �
Clothes dryer exhaust 10.00
0 — 9 As-- Fax: ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.84
APPLICANT
CD' CONTACT i'1 SON Attic/crawlspaea fans
Business name: SEE BELOW Other: -- ]0.00
Contact name: Fuel pfplltK
$5.40 For first ft rr; 51.00 for each additional
Address: Furnace, etc. 1
City/State/ZIP:
~� Gas heat pump_ _
Wall/suspended/unit heater
Phone: ( ) Fax :: ( ) Water heater
E-mail: Fireplace
+YIV`Cl Rang
Darbccue _
Business name: SKY HEATING & AiR CONDIT/01'7 G Clothes dryer ns
Address: 1635 SE NEFIA.LEM ST ha:
1d1E! 'l li ' 1ik 11`?gtr ;
City /State/ZIP: PORTLAND OR 972112 , ` , . o _ , .
Phone: (503) 23.5 9083 — Subtot al �•
Fax: (503) 235 0464 Minimum permit fee ($72.50) 7), C
CCB 1i0.: 50244 ✓ Plan review (25% of permit fee)
State Surcharge (12% of permit fee) $' ' /)
4 ,ill 1 el --- '
Authorized signature: TOTAL PERMIT FEE
Thie permit Application expire if a permit is not nhtelned within 180
173:-:...., ,�- rt NT r ram. Ter sr der After it ba. been accepted as tempfete•
j e a rt 1' p scul , ~ '•n• 8" 10 "" + rn^ mnlhnel.,4.nv err h,. Tri�'.rnrn n. A.tilriino tnri..aeTy Corvine gnnrvl
...,....,.,._..:,,..,..._
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