Permit CITY OF TIGARD MECHANICAL PERMIT
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II . ' - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00248
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011
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Parcel: 2S 104AB 12800
Jurisdiction: Tigard
Site address: 13332 SW BENISH ST
Project: MIYASAKO Subdivision: MORNING HILL NO. 7 Lot: 156
Project Description: heat pump and furnace installation.
Contractor: SERVICE NOW OF OREGON INC Owner: MIYASAKO, KENNETH & MARJORIE T
12042 SE SUNNYSIDE RD #359 13332 SW BENISH
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 445 -2440 PHONE:
FAX: 503 - 445 -2443
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/07/2011 $46.75
Type of Use: SF Heat Pump 06/07/2011 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/07/2011 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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 toe --NC by calling 503.232.1987 or 1.800.332.2344.
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Issued By:/ �ti / _ . �. Permittee Signature: i f� / - ..46. -
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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.
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Jun 03 11 09:59a Se v c EJI:11 rl 5039541005 p. 1
Mechanical Permit Application FOR OFFICE L SE ONLY -
- City of Tigard JUN 3 2011 Receive d � �
• 13125 SW Ha11 Blvd., Tigard, OR 9722 y V AY/ • r • r
Phone: 503.718.2439 Fax: 503.598.19 - 1 OF TIGA �D Plan Review
Date/By: Other Permit:
T,IGARI7
Inspection Line: 503.639.4175 BUILDING DIVISION DateReady/By: El See Page 2for
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Internet: ww.tigard- or.gov Notified/Method; Supplemental Information
TYPE OF WORK COMMERCIAL FEE° SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES.
Ei.I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
' �J Air conditioning
/ Job site address: 3 33 a Y / 04 /'.. 5 , k s� (requires site plan showing placement) 46.75
r !!! //N�� 1 � Furnace 100,000 BTU (ducts/vents) I 46.75 % 1 - 6
/
City /State /ZIP: ,re, e � 77 / Z3 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: k SQ Heat pump /
Y (requires site plan showing placement) n 61.06 y/. CK0
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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
. DESCRIPTION OF WORK Water heater 23.32
� Gas fireplace 33 -39
f '� /I2 D //C_ 14,5 -1 (/1 !!,- rt re -, 0/ Flue vent for water heater or gas
ii, At �r ��!(,rSrl ` Y 4 (C
(A ' fireplace 23.32
��J Al Log lighter (gas) 23.32
/GerYLa ✓ G . X1 �j !v1 y A! 6 - 44 /J Ani)/ , ._ Wood /pellet stove 33.39
b4-2/ 11-1 Z.7/L:1- PU 4 4 Wood fireplace/insert 23.32
ar PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: /,�e ,1 - ! /�; y ei 3 /- /- Environmental exhaust and ventilation:
Address: l Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33,39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans 23.32
Business name. - � C Other. 23.32
-j° /` 1J /Cl� � Fuel piping:
Contact name: $14.15 for first four, $4.03 for each additional _
Address: • Furnace, etc. I
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: 6 v / ( e „ild /, > G, Clothes dryer (gas)
Other:
Address: /. 0 V2_ Jv ,, /)yam J
- d s".3s1 MECHANICAL PERMIT FEES"
City /State /ZIP: 6 /a G Li 47 4,,s. 7)A ! 7 p /s' Subtotal 1_, /o, gj
Phone: (SD3) 4 // y6--.... o Z l] Fax: ( ) y 45 — .2 "/ Minimum 25 %it fee r mit fee , '
7 y Pl an review (25% of permit fee) -----
CCB lie.: ) 6 / .6-,:). e:1))-6/11- � State surcharge (12% of permit fee) M r C( 1 1
TOTAL PERMIT FE / )( 7 "�
Authorized signature: 1� This permit application expires if a permit is not obi ined within ISO
f _' - n j} days after it has been accepted as complete.
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Print name: / LV / Date: G - 3- / j • Fee methodology set by Tri -County Building Industry' Service Board
0. \1't Building \PcrmitssE PermitApp doe 09/09/10 440-4617T (1 t /02 /CO.bt/N'EB)
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.AIC-HAT PLIMP- -UNIT SITE PLAN • t
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