Permit 11P CITY OF TIGARD MECHANICAL PERMIT
°- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00324
T1GrARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/13/2011
Parcel: 2S 112C B 17100
Jurisdiction: Tigard
Site address: 15111 SW 83RD AVE
Project: Walker Subdivision: Lot:
Project Description: Install heat pump. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: PYRAMID HEATING & COOLING Owner: WALKER, AMANDA L & MICHAEL E
5699 SE INTERNATIONAL WAY STE A 15111 SW 83RD AVE
MILWAUKIE, OR 97222 TIGARD, OR 97224
PHONE: 503 - 786 -9522 PHONE: 503 - 704 -7432
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Heat Pump 07/13/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 07/13/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/13/2011 $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: e„ �/ G . j e,y -� ,,/
..Z 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.
07/11/2011 MON 12:42 FAX 503 786 3432 PYRAMID HEATING (f7]001 /003
tw
Mechanical Permit Applicat' : ECEIVt',.::"-'. FOR OFFICE USE ONLY
.
City of Tigard Date/By: y, /3 //
4
,+ permitNo./r &G' 2 O // tro3_2
'1 13I25SW Hall Blvd., Tigard, OR 97223 1JUL 1 2 20U Plan VL
C c - Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit
Inspection Line: 503.639.4175 Date/
TIGARD C ITY ®F TId^ �1 Pt"` Date Re Ready /By: H See Page2for
Internet: www.tigard or.gov CITY B ui+ < <'I
f at r r„_,r r Notified/Method: Supplemental information
DIMS - l�.,
BUILDING _ •
• 1 " xm �.: .., �. e B '.,. 'lix� .i . ?3 r ..; § k 673 6` 013.4 ;, a1.. a r.; 8 a V '• -
}:..:.t ; s- afx , y9. t. 1 .:fora 4.1•Al^ "at;W tgt.:... a i ...:4 ..�. O GL
❑New constructionAddition /alteratlon/r Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
eP performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
1• S+ li ..,. iu �,' + -x+ g w , ,. ,, ,. 17T a� W:55 `, 1 '. ' Value:
w Ef• -za€, ca ,:,a:rs + ;a 5` a k `� 'hill S.'t; " s, � 6 ' ;F _ `," ». it - . . t ' °`' o ` i c a il " ' k .p'"
in I - and 2-family dwelling :) •• a a - .,......F.-4_ i k + - 11 + l t,- C .S,
y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
t" i' lit ...,, 8 � C i e r � 6 t p " o �,.. t ,mmaa; p > ::f cooling:
,,, •.:� t. �t .: - �. .,, , , t„a- HeatingiAir conditioning
Job site address: r • , I (requires site plan showing placement) 46.75
City/State/ZIP: r3 , ► as Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: W t Heat pump y „,
(requires site plan showing placement) 1 61.06
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:
- 5 � 3 la- :. -. m � --�
. .... . •'" L(. z p ,- s� w-q. • ' Water heater 23.32
� � 1 Gas fireplace _ 33.39
IAt% ✓ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
-- I 1 I1 & � -• ; - , A• • t - t t P e - • 4 Chimney/liner/flue/vent 23.32
1 � � � 4 Other: 23.32
C
Name: if 1 L 4 „ 4 ' ∎ / IM Environmental exhaust and ventilation:
Address:
Q 3 !' / Range hood/other kitchen
■ ( j � � equipment 33.39
City /State /ZIP:- lit - Fax: / t ri 01A, Clothes dryer exhaust 33.39
Phone: - r Single -duct exhaust (bathrooms,
,��� ( ) toilet compartments, utility rooms) 23.32
.''..
st a z - � t , h - l ;;gg' r 4 a $ � • ' a r Attic %rawlspace fans 23.32
b r�t#.YS'x'z i �
t �� 1., Other: 23.32
Business name ,--
L Fuel piping:
Contact name: . ! I � S $14.15 for first four; $4.03 for each additional
Address - 5 - a 9/- 3 $ f' +" i l I Furnace, etc.
a / 1 . 1.�.1r:�� Gas heat pump
City /State /ZIP: • . 4r � `y 1, ,■ Wall/suspended/unit heater
Phone: 4 " ) a - ` M Fax: : ( ♦) A Water heater
�s 111A. 4. Fireplace
i.'�iiSii/,O * S & ea h / �iA:ii A ' tiL . „Arum Range
16 1121111-r :- .
' ems, a, ry a t e,•_�a � X 7• ' Fk. }w a r �
"�' �.,>� '_d`c`+n£ 9 o-n t t,c x�c '� v , Barbecue
i Clothes dryer (gas)
1 r w '
�1R� /�.��iulr 1 / r e Other:
Address: ' + . , u 8 ) C, -a ,.. `t=, q :„q1:0,74,1,44 ,r.§-
City /State /ZIP: -
r► Subtotal , Q ■
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) 0 -----
a/
Plan review (25% of permit fee)
F 4 State surcharge (12% of permit fee) Q. 8"0 i
TOTAL PERMIT FEE i 00, go
N This permit application expires if a permit is not obtained within 180
Authorized signature: / //��
� .n�. ' !' I ( o days after it has been accepted as complete.
Print name: ! P/lot 6 rtYcS all Date: 7 ti r, I f * Fee methodology set byTri- County Building Industry Service Board
1:i Building \Permits\MEC- PcemitApp.doc 09/09/10 44 -4617 (11102 /COM/WEB)