Permit CITY OF TIGARD MECHANICAL PERMIT
if
COMMUNITY DEVELOPMENT Permit #: MEC2009-00165
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639.4171 Date Issued: 04/17/2009
Parcel: 2S110AD05900
Jurisdiction: Tigard
Site address: 10555 SW DELMONTE DR
Subdivision: Lot: 0
Project: Becker
Project Description: Install heat pump.
Owner: FEES
BECKER, JOAN M Description Date Amount
10555 SW DELMONTE DR Air Conditioning or Heat Pump 04/17/2009 $14 00
TIGARD, OR 97224 12% State Surcharge - Mechanical 04/17/2009 $8 70
PHONE: Minimum Fee Adjustment - Mechanical 04/17/2009 $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
Issued By: _ 10AN I ` I �, - I A , Permittee Signature: t r1 Q- 0
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.
r *• . Q4/15/2009 10:41 503 -691 il ., FIVE P OREGON HEATING PAGE 01/03
. t - � . •!
Mechanical Permit Application ,FOR 01 I I 1 ONLY" � wi.= g ' ' t
APR 15 2009 Received n
City of Tigard pate/B a ` 1� Permit No,. rr f _ a • 00 1 /
Y' c ` l
V 13125 SW Hall Blvd. Tigard, OR 97223 Phu' 1Ze iew
lig
Phone: 503 4171 Fax: 503 598.1960 CITY OF TIGARD Date/By: Other Permi
I' C;1� " R 17 Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By lulls E1 See Page Z for
Internet: www.tigard - or.gov Notified/Method: r 1 C Seppletnental Information
t= ,} 3t 3 `ryr trr tl ., .. ° '] I>':_, . .1..... Rife' "W :" f t5ti i t ` 3�.u, mu/ l}1tl 4 /11 m,,. , 1 i=. ia *4th :,
�� ''11 . .i : . jj? .. f I ( ; i�Fy{p � �I . a ., ' } yp '.,,, y r t t .,11t , f, h r cn rlmis � 1 (' it r cE, m_c lnn>r l # li;� r s 1, n ?GCftl: `:Iztx'olt�'a
i, {; zL';t1S�h a�f . ; #1 �iltlf 1:,i,u, i.,�ff111mF9f14 'MI theirt!}Ytt, t' 11�. I1ttA,t I III 14 If 11 : til halt f 37
❑ New const ruction (it A.ddition/alteratiot) /replacement
Mechanical permit fees" are bated on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: � k mechanical materials e ui.mont labor overhead. and profit.
f . , .,,., 1 if ? 71 l . .; t it Ir } tt�nitY P{Y 7 � q x si ::. t l ( +t
R {r{] 1 (( t] '1�t� � � ¶T tf ��� } } {I t }, t { I 1�t yp� } [�fy�� Value: �
I F I�SFk 1 `- • r :.S.. I i x !'.nrf fi 1a11A'n }B SRW't1i ,[`'fIt1. N1 ,1 ; i. I k, � �!}l.H= ir/31vk: �99 FF 1 : If ; $ +lllt}Iflir p G $ d , .. , t t „4.„ dg i} Ff }l lf ktr7R , 44, i,� y: ' ,:
Egt 1- and 2 - family dwellirld ❑ Contmerciailindustrial ❑ Accessory building 1,.: =sr triitrt ir= {ir +; :arGiro-d rmT�.,f .Hf.. �tlsh �; , me tin >RI hi, nulst t ={ , C
For special information use checklist.
y$❑ Multi family ❑ Master builder ❑ Other: # Description Qty. Ea, 1 Total
1 if . r Y r i it ' . t l }! > 71 , , l,i I f i ' N f l fii; . :i l cfi 3 F II.tiu coolin
: I1 -js ) f Alt conditioning t heat pump
Job site address
• �( j� }� '�' (requires site tr)en SIIAk'Ing t lacefYietl[ 1 1400 n
City /State /ZIP: - Akr nr;� 91 'a} m Furnace 100 000 BTU d,tcts /vents 14.00
Furnace 100,000+ BTU ducts/vents 17.90
Suite/bldg. /apt. no.: Project name! Gas treat pump 14.00
Cross street/directions to job site: Duct work _ 10,00
llydronic hot water system 14.00
Residential boiler (radiator or
bydronic) 14,00
— -N .- Unit heaters (fuel -type not electric),
in -wall, in -duct, sus ended, etc. 14.00
Subdivision: Flue/vent for ay of above 6.80
Lot no.:
- Outer 10.00
Tax map /parcel no.: Other fuel appliances
31111 SS .� t +t+ alrs.fr ; YF , a . ` � 10.00 i l
if 5181111 11 ; 1 =t. nS R » t1 i I Ilif1 Water heater
Cris fireplace 1000
t i r f - • a' Flue vent for water heater or pas
- lace 10 -00_
Lo; li:.ter _as 10.00
Wood/ . ellet stove 10.00
Wood . - )laceI/USCrt 10.00 Yr-
I y IIIIa at ut t ttttt } y��p' q 1 a r 4 1 . , # ; ; Cbtirnriey/1iner /flue /vent 10.00
i. r' f �. 1 11 t: � ` a • f � IW P. l`Ilr�� 7 I ':"t 1 . Y 3Itt }:I' •I : h fl -
tc /lxlre PtIl #ttftt>.NI n 9 I { F Other. 10.00
Name: c:Kex 75
Environmental exhaust and ventilation
Range hood/other kitchen
Address:
1() j ,\ ivy-TA t( a aliment 10.00
City /State /ZIP CO ' a m Clothes dryer exhaust II 10.00
Single - duct exhaust (bathrooms.
Phone: ( ) C D '3 o lb w et Fax: ( ) toilet com•artmeaus, uti1ttymoms 6.80
y. slrfnsf . l� WN -u 1 t r al if fTTI, 1I{'; Attic /crawls ace fans 10 -00
�i}} c ,q { { { y ff { PA I$.' hh' tf fil ' i i� . ,, , 0 fr {{ {}}. g y ti � ..,.
� 1 r.,11 � 1, i , 14�t~},:I I I .. ' . = I, 1 11 { aili �t.rl�.11lf ff 4' 44 13 1 4 I I1'
O ther: » _ 10.00
B ;
Business name: _ -
r�o�cl YY� �� - F uel 1)ln_ m
Contact name. F.4 E'..,, $5.40 for first four $1.00 fur each additional
Address: ' '�i Furnace etc.
Gas heat turn) �
City /State /ZIP: 'c:91, )�d�e �y C\' 115 Wall/sus ended/unit heater _ IE
Phone: ( 533 ) 1 " c 6 ' _ Fax:: ( �) c � 7 � Water beater
Fire lace
E-mail: R r • e _�
1. f: ffr'. (ff # rr „ {� ' ; rt a )ff ( f ) 1, ' . 1 6 '11111111111R111 __—
E: ° a1 tie l r i�,, l i - filhr h n n P t ? — a m i t?tf:,, i ,,i, , . " l ig l i taa , Barbecue
v
Business name: O1�e it \
%(y k r' �r AC _ � l Other
es dryer
Other
, , � { r ?u mint .e , ,
Address: + p.t t ,1 rhn f)It}firs ) iii4 �ctiri 110/x. i i:,
City /State /ZIP: V)l r \e P Si \ \ Subtotal
( ) mil- CI �t� Fax: (5O ) C
C6A6 - �
Minimum permit fee ($72,30)
P hone:
' • flan review (25% of permit fee)
CCB lie,: f a \ D, G w State surcharge (12% of permit fee) `3,10
TOTAL PER IT FEE i , a N
• Thic permit application expires If a permit is not obtained wittlln 15t
Authorized signature: da}s after it has been accepted as complete.
Print name: Date: ' Fcc methodology set by Tri- County Building industry Service Board
I:13witi g\l'=uts \MEC- Pcvm,WPp.doc 01/19/07 440- 40171' (II /021COttWEE)
E 10:41 503 - 691 -8556 OREGON HEATING PAGE 03/03
First Floor
•
•
1' to Chminey Living
Dine
5' + 4---
Stair /Hall
5' + Kitnh
Bath
4 _.c.. .. —. .. _............... ..
Hall /Entry`
N
Garage TV Room --• 0 9 6. 0 7 2 0
�Ill'RIY�® 'IAII I III II
Del Monte Dr Jurisdiction - City of Tigard
Job # Oregon Heating & Air Conditionin... scale: . 80
Performed for: Page
Joan Becker & Roger Haight PO Box 397 / 992 Hwy 99W Right -Suite Residential
10555 SW Oelmonte Dr Dundee, OR 97115 6.0 119 RSP.28586
Tigard, OR 97224 Phone: 503 -538 -2953 2009- Agr -14 16.58:17
Phone: 503- 639.0930 craig @oregonheating.com C: \My Documents \Wrtghtsoft HVACIB...