Permit , CITY OF TIGARD MECHANICAL PERMIT
;;' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00367
TIGRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009
A
Parcel: 2S 104AA01100
Jurisdiction: Tigard
Site address: 12400 SW BELL CT
Subdivision: BELLWOOD Lot: 60
Project: Kearney
Project Description: Install Heat Pump
Owner: FEES
KEARNEY, JOSHUA L & STACEY L Description Date Amount
12400 SW BELL CT Air Conditioning or Heat Pump 07/22/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 07/22/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/22/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
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. /' r -
Issued By: ( �(1J pi/I.C1- /,7 , Permittee Signature: Q }L n.)G(.f'�Q.t� _
C /
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.
1 i� o G 4 o , •t., a !�iN fl t as tz'a i, `>, ' n j s } " ' a
Mechanical Permit A icatio I .FOit OFFICE USEjgNLY ' :i,4 , ' ° 1, ;Y : : °j
Cit of Ti.gaz -d JUL 2 1 2009 Received Permit N ��,,,,�}
t " 13125 SW Hall Blvd., Tigard, OR 97223 DatclHy: Gp�t/v ►� 34,/ Plan Review
• Phone: 503,639.4171 Fax: 503.598.1960 CITY OF TIGARD Date /By: other Permit;
TIGARD Inspection Line: 503.639.4175 Dew Rasity/Ny: .halt: 21 See Page 2 for
Internet: www.tlgard- or.gov BUILDING DIVISI01`! Not fcthod: Supp)etoottal )nform 9iinn
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_ .; � t1r . .1 r . :. i r ^l i,E OF ii r R' „i a iii r+,'RCI.A.� ) E 54173'ED[;1X:E.,�15 'kF C” ,IS'1
ill New construction Addition /alteratiori/replacernent Mech nice. permit fees* are based on the Pelee of the vote
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanicalmatersals, equipment, labor overhead, and profit, _____.
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,l ' b -,;. i w r ; r "I< 1 ',6 w CAT EGtO RY 'OE': � ONSTl7OCTION ' 1 :1 i 7 '. i ' r Value: $
i , J_. � V ,• :.': .: : r ^ , ....' 1 . '.1 I wwi:. 1 '.:• ': , ,_ �, 4 " � -„ -. v, 1 "%r',_
A 1- and 2- family dwelling ❑ Commercial /industrial D Accessory building "
For speck:: dnfonnarion use checklist,
0 Multi- family ❑ Master builder 0 Other: Description Qty. Ea. Total
14 i du., , r11 O)t$ ,'INFQd l0TO „ ) L OC, &'i 0, 'r... ': festin
Job site address: la).-100 Air conditioning or Beat pump
_ • (requires site plan show placemen �_1
J M 14.00 —
C ` - Flunace 100,000 BTU (ducts /vents) 14.00
ity /State /ZIP:
17°� �' Furnace 100,000+ BTU (chior.HCnta) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14,00
Cross street/directions to job site. Duct work 10.00
— Hydropic hot water system 14.00
v_. Residential boiler (radiator or
jydronic) 14.00
-----
Unit heaters (fitel_type, rot electric.),
in -wail, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue/vent for any of above 6.80
.... --- . Other: _ 10.00
Tax map/parcel no.: • Other fuel appliances
404'-' ,. ' �y' � 't l o j /, . , ,. r � y {t ,4 i "" °lI lip ater beater .
tl,`' . sm.i' , 1N. ..,, t L. Y . k • . , , i .: . = s i ll 1 ,.,; .... ! �fr� di,: l 44; :t ),,r', W ht 1000 —
Gas fireplace 10.00
�,� a .... (.�_ p Flue vent for water hater or gas
fireplace . 10,00
— Log lighter (gas) _.. . I0.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
x,wt' e r ty" � )'ill x t prs e. r: ^ y y Chimney/liner /flue /vent � 10,00
! ,;,Ai e,ajl 6 a 1y'S"hj' r.'11:.1b� q Shit l'lllki !hl B{1� 0 S �1�4�, $ .:r r 'J )'1 lrxil �!9 . i
Othe 10.00
Name: Y _ ' • , -. Environmental exhaust and ventilation
Address: - Runge hood /otherldtohen
t equipment 10.00 �. —
City /State. /Z P: t . 0 r • c i 7 .� Clothes dryer exhaust 10.00
54 1 i c y `1S) Fax: t o i letc omp nrnen (bathrooms, utility r
Phone:
vc� ( ) toilet compartments, utili rooms) 6.80
LIP r ::ito]; 1, re . 4 :,l � 1 . r:` �( • ; r l , ; "i . I . i � ra i AtttckraW ac4 fans 10.00
° 1 A - yi. ;',.1,- ,IS ;f ' ,, A -4t { , , s4 . . ,i3oF tl A„.:^. „ti��..,' :9, a, `�T . .: +',_iA1
Other ,_
Business name: , ..,. ." ,.,,...,,.,,,._,..._ �._�.���. � .,.
AI. 4 o a ” t R ,..._ Fuel piping
Contact name: U iGV i , . MM. — $5.40 for first four; $1.00 for each additional
Address: Qr, , f l I
Furnace, etc.
__,.,.,,.,,,,,.�,,,,V,� _!,-µ of 7 `.w. Gas heat pump
City /State /ZIP: lail,m6 e old 1 5 WaU /ouspended/unit heater ,, . .�_
(�) i� I - V "L •
..,1 ( S�V 5)'C- I - 8- Water heatia . ..�_�._.w..,. _.
Phone: � � r Pax:: •
Fireplace
E -mail: . Range
�. �':+ ,. x li), .r 5koii`.'(� :'ii' .'t' `: ii:' i.`; •;
' ; :ii:i: ..r ::5,� e :: t "' 1TR. a - ., - ,.,,..,.1% - Z .,'Cbli'i J ; . :Ii ; r t In B ar b ecue _
.1- <,:'�s�t „ 'ld;d N ' 7�;r , , , :l�, l `;':;:n l v ^ri .Of. '�O r :.r i . ..: „1,' :;f . , .. . f, ' .A r y — _,- ,,..«._.`.— .
.. .,.�, ..r ,r :_rr� � ;�"it ;t , . .:. , . ;rr:c.,r h�. t ^r - :r :.rn (.r, ..: :, , -„a •r '�,,
Clothes diver (gas)
Business name: L Other
Address: i • c t,d . l t ,, i „ . - yr; e...
r y � :eol qr 1 '
f► ���.� ; i . ,S l i ::�a A k , Ii , , ., A 1 3 1 ` E£' ,'.. ; t1r 1 ' qi yt• '2.
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City /State /ZIP: II C 1 >) Subtotal
.111-g *• Fax: Minimum permit fee ($72.50) s „
Phone:
( (5O b �- '65 • plan review (25% of permit fee)
CCIi he.: `1 - State surcharge (12% of permit fee) 4� c I
C � I TOTAL PERMIT FEE il [i ay;
Thta permit appllcatloo expires if u Permit is net obtained within 180
Authorized sittature:
� y / asys after it has been accepted as comptete.
tint name: r i r ., ,�,,. ` g & Date: f /�.1 , * Fee methodology set by Td -County Builduzg ludusay Service Board
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First Floor
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ID
Job #: Oregon Heating & Air Conditioning... Scale: 1 ' 93
Performed for: Page 1
Josh and Stacey Kearney PO Box 397 / 992 Hwy 99W Right - Suite Residential
12400 SW Bell Ct Dundee, OR 97115 6.0.79 RSR28586
Tigard, OR 97223 Phone: 503 - 538 -2953 Fax: 503 - 6918556 2009 - Jul -06 14:42:10
Phone: 503- 590 -4525 WWW.OREGONHEATING.00M Kirstenioregon... Projectl.rrd
60/Z0 39dd ONI1d3H NO93d0 9558- I69 -E99 VS:TT 6922/TZ/L3