Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00272
TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/09/2009
Parcel: 2S104CB04000
Jurisdiction: Tigard
Site address: 13324 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 86
Project: Mills
Project Description: Install heat pump.
Owner: FEES
MILLS, ALAN J & CATHLEEN A Description Date Amount
13324 SW ASCENSION DR
TIGARD, OR 97223 Air Conditioning or Heat Pump 06/09/2009 $14.00
12% State Surcharge - Mechanical 06/09/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 06/09/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 538 -2953
FAX: 503- 691 -8556
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: di , A Permittee Signature: O_
1 P
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.
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06/05/2009 11:01 503 - 691 -8556 OREGON HEATING PAGE 01/03
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Mechanical Permit Appl lilt � �•° .. FoO:OFrlc:r. LSE ONLY f",,,.,,, ,'','; , 0
31 25 S W Tigard J UN 0 5 20 09 Date /By _ , A Permit No.: r'y� e , /1 J`(' Z '7R
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^ Phone: 503.639.4171 Fax: 503.598.1960 3125 W Hall Blvd. Tigard, OR 97223 • D aU Review Other Permit:
Date/By
TIGARD • Inspection Line: 503.659.4175 CITY OF TIGARD n Ef See Pa ge 2 for
Aau Ready/k:
Interact: www.tlgatd- or.gov fiedMlethod: ` Supplemental BUILDING DIVISION Noti
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S i t t7d� w l,. t 0.re� ➢ re4r, e�, B I • r d i l l; U: •r i J N h
❑ New construction ® Addition /alteration/replacement Mechanical permit fees are based on the value of the wort
performed. Indicate the value (rounded to the ocaicat dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and mfg.
r ! t i a ' ,r, .• �,�p � t ^ r, + _ ; i; + � l !€ � . i� 1 q s; � v
; alue. $
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® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family I] Master builder ❑ Other:
Description I Qry.L Ea. Total.
c (;� q` rf tit r 11 jp � r • t „�.� r 1} r r, � �,�,�, qi r i n a r+ F', r �� v �. l �f 71 !l3{ h .11 !i � h
1f f lfiil f p } S`!! I I !!iii! 1l � '�H gfu1 k n ° 1 .- ITA .�{J�, ( ��fy{RS�1 t {( �,,t'i `f1' i 7V�E1 P,a i�, 1, H coo
f ) s ,,,,, P,l b'4 ,11 `' S "9Iti, Jl:tl �l:,r,r,,, ;,, '..„,„ �-714d.S :,� 1, r�,.i ,, ��:iK ;l�l,iti ; ,1 ��' , , .�ir. S1.1. t411i. @11Uk.'t.. 6�2 ''' � ,...
Job site address: `'3 3 -ay "W Air oondite plan h o beat lac uup
_ �(''f{ l� 1 ._ ro uires site plait 3howinq plplacement) , 14.00 y,}
__
City /State /ZIP: ` 1C r - f aa Furnace 100,000 BTU (ducts/vents) 14.00 _•.,. -_
Furnace 100.000+ RT1 J (duct4 /vent) 17.90
Suite/bldg. /apt. no.: Project name: _ Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
_L y1 hot water system 1 4.00
• . Residential boiler (radiator or
hydronic) 14.00
Unit beaters (fuel -type, not electric), .
• in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue ✓vent for any of above 6.80
„ . T Otbor. _„ 10_00_
Tax map/p
arcel no.: Other' fuel agances
11 811111.11V,? 1! lk{l 3'. >a rr ',MEMBRANE ixflft;Yi`G �l glr; Gas fireplace 10.00 —
i lf\s tc \ aM \-. poly, \ o Flue vent hr water .heater or gas
Fucplace 10.00 ,
- Log lighter (gas) 10,00
Wood/pellet stove . 10.00 u
Wood fireplace/insert • 10.00
Eill Am Cl u/lu�er /.floc /vent 10.0
�.! cat r.�,..;p '3, �. hri MIL I ;( Rf) ° l {'
Qthcr 10.0
Name: , • - . ��n,vm s CoNim Environmental exhaust and ventilation r w v
Address: f/�� Range hood/other kitchen
� D A W c eir- Cyr) _e uipment )0 .19 I .
City /State/ZIP: M q-1 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( 0 ° a4 - ( Fax.: ( ) toilet compartments, utility rooms) 6.80
n r i hi o f cf. i '
¢ I l 7 � i� S .1, Attic/crawl ace fang 10.00
`H 'N # `. + •'r °. vd. t9 '!B�`f� i l l . l t 3 ' e „ a ". fir . f` ° '1� 1 1 ,1
7 to, I,^ , 1 ,
Other- 10.00
Business name: •4t is Ak c I f . C.. , -
. Fuel piping -
Contact name: R0 ∎nV C $5,40 for first four; $1•00 for each additional
Address: • furnace, etc.'
�r °�L � Gas heat pump - - --
Ciry /Statc/ZIP: ell 1 , ) Wall /suspended /unit heater
Phone: (5(0 ( 1- CC "` Fax: : (565)5Gt _ 8-5 Water beater
�L Fireplace
E -mail: Range
q l, p E Barbecue '
pi °fcI #.Ii M h 1 1 i��1 .rtI i 1 ' 11 1$ 1 tr� . t b } i liu ifiElC tilt k'liPi)tllt'I%liii 9 ,I }ii !' cue _
Business name: QrC'c -\ t 1 C A. Cther:sdrYor
� Other:
is m, L' 6 pp k y t {�'s t`1 jpq q { { )1 It-►��7p�;,�,tyj,'6!�r i t s { { {��I''' ^�, j;�y'�`rp�fi73—
Address: Tr) \ 'c t t --- Ift � �}'11`flPilf�F$�1 %�lkl`£ 1 0i'�or��h� 4 ti �l • +k'. fr 2 r „ itt f1i� iSIHIRfI1iY1f i ..L•
City /State /ZIP: ` 1• ) Wy k ,. 91 1 5 p Subtotal
\ ( (� (Q l t t �
minimum permit fee ($72.50) _
Phone: �, FaX: -- -
- �` 1 w Plan review (25% of'}�ermit fee) •
CC13 lic -: 1"J (r , Y — State suichar (12% of permit fee)
V TOTAL PERMIT FEE - T)0,
Authorized signature: �3 JLY ` 1 This permit application expires if a permit is not obtained , 4thau 180
_ days after It has been accented as complete
i Print name: R. l \e_ ,_ Date; j r-/ ' Fee methodology set by Tx County H riling Jxidu;uy Service Board
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. PLEA.SEFAX APPLICATION Wi'1'H SITE PLAN
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