Permit n CITY OF TIGARD MECHANICAL PERMIT
� . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00210
Date Issued: 05/13/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112CC16500
Jurisdiction: Tigard
Site address: 1586 __AV.ON_P_L -,
Subdivision: DURHAM OAKS Lot: 1
Project: Puckett
Project Description: Install a /c.
Owner: FEES
PUCKETT, ADAM M & BROOK I Description Date Amount
15860 SW AVON PL Air Conditioning or Heat Pump 05/13/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 05/13/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/13/2009 $58.50
Contractor:
S & J HEATING & A/C INC
1004 NE 4TH AVE
CANBY, OR 97013
PHONE: 503 - 651 -2702
FAX:
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
•
Issued By: ) _ Permittee Signature: ` 1 I ,
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.
Mechanical PermitApplicatio �plVFI I*
1.(112 1 l SF.c►\l1 Received
City of Tigard Date/13y: • Plan Review • Q ` _ - Permit No.: 90,0 -
Ili
q 13125 SW Hall Blvd., Tigard, OR 97223 MAY 1 3 2009 4
Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit.
1 I (., A R D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: BM H See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method Supplemental Information
.. , gin) � .;;. . � .�, . m`, y e'° .: '. .,'; ` , y .5: `� 4 . air
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ er: mechanical materials, equipment, labor, overhead, and profit.
£ „1,.-, , r Value $
in 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description . I Qty. I Eu. I Total
s � s t ' ', a e s' s miffing/mum .. /^ \. Air conditioning or heat pump
Job site address: 1 ICj S br) S 1∎ / A �/ O PL A ( (. (requires site plan showing placement) 1 14.00
City/ State/ZIP: r!D 0 R... ci / 2,-2,4 Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgJapt. no.: I Project name: '.2(-t471] Gas heat pump 14.00
Cross stieet/directions to job site: - I- 4A1_L Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: I Lot no.: Flue/vent for any of above 6.80
Other. 10.00
Tax map /parcel no.: Other fuel appliances
. ' . ' - a Water heater
10.00
s i'.#: 9 , Q 1 * ,t .;
Gas fireplace 10.00
,.A l (_ Cow 7 I 11 ° M e i?, I1-1s7(IA... Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
„, n Chimney/liner /flue/vent 10.00
t , y; i ,. Other 10.00
Name: AnAN 1 p (A. L l ' Environmental exhaust and ventilation
l Range hood/other kitchen
Address:
I ,rj 5 to o �� A DNI p i , A -6 equipment 10.00
City/State/ZIP: ---Fs C�'(z, f) o2 l 7 2 j�, Clothes dryer exhaust 10.00
I Single -duct exhaust (bathrooms,
Phone: ( 3) 7440_ (.4- p C • Fax: ( ) toilet compartments, utility rooms) 6.80
., a'`; gik '` . -' g °4 J , ';'• , ' :' Att ic/crawlspace fans 10.00
1 ,� /� /^ Other. 10.00
Business name: S d �' n ,� [ r'TN6-, 4 Ai 12 th 4O 1'1 ON I ,46, Fuel piping
Contact name: 1 / --... 7 1(X $5.40 for first four; $1.00 for each additional
01,1-4. , I /� ,� Furnace, etc.
Address:
I r E `T� /"vvo , Gas heat pump
City/State /ZIP: C N1 r3 t 02 C) "") 01 3 WalUsuspended/unit heater
Phone: (5 3 _-2-27 Fax:: (5 ( _ 24E-2 Water heater
Fireplace
E -mail: Range
�' ',. a g • � r > Barbecue
Business name: <Ael /ti � e. Other. (gasA-4 vict
Address: 1t d ., .` i , � -� ' t ;
. t .r
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lie.: q (e `I 2 State surcharge TOTAL PERMIT t FEE 8gt . 20
Authot7zed Signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
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