Permit CITY OF TIGAR MECHANICAL PERMIT
1,1 4 COMMUNITY DEVELOPMENT Permit #: MEC2009-00202
Date Issued: 05/12/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111CC21600
Jurisdiction: Tigard
Site address: 10280 SW GREENLEAF TER
Subdivision: Lot: 0
Project: Watkins
Project Description: Install a /c.
Owner: FEES
WATKINS, VIONA J TRUST Description Date Amount
10280 SW GREENLEAF TER Air Conditioning or Heat Pump 05/12/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 05/12/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/12/2009 $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: Va akrU \_ U 17(J Permittee Signature: � on
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.
05/06/2009 1 0: 50 503 - 691 -8556 OREGON HEATING PAGE 01/03 ki . . . Mechanical. Permit. A.pp1 i s MAY E . . y FOR OFFI F USL ()NLv . -:;. r '` ,
iih City Of aI B1V Tigard MA l 0 6 �OQ9 Received • � • • �J' ! Prmicrro.. 1 ' ?, + - 00 2.'77
1 3123 S'W Hall Blvd., Tigard, OE 97223 Piao Review -TO
Phone: 503.639.4171 Fax: 503.598.1960 Qats /Dy Other Permit.
T' G AIt lmapectien Line: 503,639,4175 CITY OF TIGAR D Date Ready/Ely: r "�� 5 ' El See Paee 2 for
Intenzet: www.rigard,or.gov BUILDING DIVISION Notife(iiMetltOd: T �� Supplenteutal Iuformatioa
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❑ New construction 1:. Addition /alteratiOnireplacement
Mechanical permit fees” are based on the value of the work
performed_ Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, atlipment, labor, overhead, and profit.
( +" is q� t ;f ,. '; �.. ]t! ,. ,. I , t r, ,,, „r,, , r. ,r. i y ' , , 1a11I Ji ; t i i d9 Value: $
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dwelling 9 ,•' 1JtlP] y Y � 91JFM3Yi , p1Ar. , , !l,1. : ,, k . f ..t.r , .:'r ii,ci3 raq , ,'fIl'i!r
2-family g ❑Commercial /indusnial ❑ Accessory building
For special irEfiarmatton use checklist.
{tt�t❑ Mult - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
79� i ldt �.,IFJII' NV �J.p�74El
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, _.._]v.t > d { ray it tY, 1 1�4] 8
Air condnlonmE Or heat pump
Job site address: e _\ c' 7t g p ( Iequiressite �lsnshowinl tplacement) { 14.00 ,
” r'
City /State /ZIP: \ 1 Q L U rurnaee 100,000 BTU (ducts /'ens) 14.00
Suitdbldglapt. no.: Project name: Furnace 100.000+ BN (duct;i�cnt) 17.90
_____ , Gas heat pumice . 14,x ...
Cross street/directions to job site: . Duct work 10.00
TTydrenic hot water system 14.00
Residential boiler (radiator or
22yAronic ) 14.00
— Unit heaters (fuel -type, not electric),
in-wall, in-duct, suspended. etc. 14,00
Subdivision: Lot mo.: Flue/vent for any of above 6.80
„.._ Other 10.00
Tax map /parcel no.: Other fuel appliances
., $'� 7} f @ y J
, . ,. .sr i ..., I f S 'i �� illl3 S° 1 r'l 4 R '�!1'd�fl '{rr�a 4 L +. 1 1 lr 1 .1; il: W atcrhoatcr
— — 10.00
Gag fireplace 10,00
1 imsiC)A l - rif ix 6 CA c' 'i `k c-x i CiY, ' _1 flue vent for water heater or gas
fireplace 10,00
Log lighter (gas) 10.00
_ • µ , Wood/pellet stove 10.00
Wood amp/ace/insert 10.00
@@��;;((}} re_ ,t 'p'.� '111' w , a I��kI iu; n 3 � ry �� � , ':.f q.4tol� 1 �,�. d CbinweYlliner /flue /vent 10.00
t8�f '+ : ;1' .,1 �r t idlusr`l t�' f,kllfl�1!' 't1i11 , , �,1'_ •,•• Other. -- 10.00
Name: V\O\RC, '�(Ak\ Environmental exhaust and ventilation _.
n 54\.; �'�'( r Range bond /other kitchen
Address: V
10 Q j t(1_'Q` Ai'
t_ � 10.00
City /State/ZIP: i Q �. c �� '�� Clothes dryer exhaust 10,00
single-duct exhaust (bathrooms,
Phone: '3 l Fax: ( ) toilet compartments, utility rooms) 5.84
, 1, s t t1 � pa , ai r a a, , n e,', try
Ir= i �b 6 i i HC11' t � �< s � f. d 1 3 1 1e' t � 1 , !° i '�' 1' �' 1 1i , f � Attic /crawis z ace f ans 10.00
, i 1, i tl1 � <. , .a' , � r �i1 ii,i t, a ;'i? 1 ,, 4, 1, ;a` 1, I t &1 �,i. 1_ ..��.
Other 10.00
Business name: C7 \ e - FCC- MY Fuel pipit w. _ �mw
Contact name: 55.40 for first four; $1.00 for each additional
Address: 'T.''') l F J�?x _/\ I Furnace, etc.
--M --- . Gas heat pump
—
City /Staic/ZIP: ) im (Aee on i ‘ 5 TM Wall /suspended/unit heater
Pbonc: (50,5) C- may, ".I,I ” 96 � " 1 f� 1 Fax: : ( c tJ J 3) 6ct t 8 r , Water heater r, .--.,..,.
Fireplace �—
• E-mail: - e
S • t” • 1111,' s• �yl s �. bar's „M�__r
Z! 99I'�r'`d 1 , IIi R!t A { ..„ j 1, r �ri ?..„, 1� ' 1 , „ r< r ,
1 1t! li lllik I,, i ? �� .01 1 , i;lh i. h ,l f r me ,i to? 1 ;o opimA ` i gh t l a l _ S,I,L, Baarbecue
Ig, k �!,�� Il; w { {I 13 ,9 ,l._ k � 9 . 1µ rt ` . it 1 111, 's '' 3„ , t0i17. t „ �r ir!�4., —
Business name: OTC` _ ` 1s C k , Clothes dyer (gas)
Ot$ez
Address: 9 4 If 1�al( v,,. j ! ; A e i ¢e , , (S ,I , Jiii
f ill n� �r3ilS'(1 €1 zu'i�i]t+!> . -,„ ;,:,,, . ,r:. t r ; x, „� „0 4111 1,1 �i 1191 T.
City /State /ZIP: \T e , °1 \ • 5 Subtotal
Phone: 1 C.7A ) 'C�
, Q Fax: (5O ,1 S Min imum permit fee ($72.50) `4 0 _ . Pl an review (25% of permit fee)
CCB lie.: 1�,1 ;. -.M_— —_— — u' State surcharge (12% of pennit fee) Q ,1C) ..
TOTAL PERMIT FEE Z . WQ I
Authorized signature: ({ . This permit application expires if a permit ix not obtained within 1
r : — -• � _ 80 days after it has been accepted as complete_
Print name: elle & 4 Date: - / • oo • Fee methodology set by "Uri-County Binh:ling Industry Service Board
81.20
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CUSTOMER 1 FOI MATICI`
NAME: U. O HA ' WA - (A '1
ADD.R SS, pr.to _ 1...• i 7 y
PLEASE FAX APPLICATION WTfFI SITE PLAN m
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