Permit ''
CITY OF TIGARD MECHANICAL PERMIT
t " COMMUNITY DEVELOPMENT Permit #: MEC2009 -00459
13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/02/2009
TIGARD Parcel: 2S 111 CA00105
Jurisdiction: Tigard
Site address: 9463 SW LAKESIDE DR
Subdivision: Lot: 0
Project: Warrvick
Project Description: Installation of heat pump and air handling unit. Unit must meet 3' minimum rear and side yard
setbacks.
Owner: FEES
WAARVICK, TILVEN M Description Date Amount
9463 SW LAKESIDE DR Air Conditioning or Heat Pump 09/02/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 09/02/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 09/02/2009 $8.70
Minimum Fee Adjustment - Mechanical 09/02/2009 $44.50
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503- 598 -6746
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: Permittee Signature: 7 ,,,,- P L, fe.e5 770
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.
. 08:11 5035986746 THERMALFLO #1096 P. 002/003
i
Mechanical P milt Application FOR OFFICE USE ONLY
City of 1 igard iFC :r / 0 1 nit
No. .gr re 0
a 0 i - -1 , -
,.......
1 , 11 . 13125 SW !al' Blvd„ Tigard, OR 97223 L _ i I i
111 ' Phone: 503 639.4171 Fax: 503.598.1960 ' •••.- 1 Pian R " I ` w other Permit:
-I..
rT ,-,,, N v 11 inspection 'ne: 503.639.4175 AUG 3 1 2 109 I NtE R .' sd . 3 ' ',IIMMIIII uris.1 : -- El See Page 2 for
-• • - Internet: tigard-orgov S.'" - upoemenrai Information
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VN I: 44 '4g 'i. '-''..''., , . ',7.t71 :.......,„....,..,.,. ,•.,, , ., , :."7:"....
Meehanical permit fees* are based on the value of the work
U New construction XrAddition/alteration/replaccrnent : ' performe(L Indisete the value (rounded to the nearest dollar) of all
D Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
; '. \ '"' - - ' '''" ,',,..."....- -•ri - .,,-,,,,,,:,,,,,,,,,,`, ,,, ., ..
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and 2-family d , Iling El Commercial/industrial 0 Ao . .sory building
For special information use checkl ist,
Multi-family El Master builder Jii Oth. : .
Description I QtY. I Ea I Total
•
Ilipz,T, .. ,k Ileating/coolity
Job site address: 4f , r i 8 Freide ,#w- Air conditioning or heat pump
(requires site plan showing placement) u_.....
I 14.00 rr
Cit 77 0„.-‘ et 12e fil.24- . Furnace 100,00 BTU (ducts/vents) 1 14.00 14--
i Forma= 100,000+ BTU (ducts/vets) 17.90
Suite/bIdg./apL no.: I Project name: Ar/ 20 ., (3 heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
. Residential boiler (radiator or
0 a 'f' 111/ eit &Oe't hydronic)
14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duet, suspended, etc. 14.00
" Flue/vent for any of above 6.80
Subdivision: Lot no.:
. Other 10,00
Tax map/parcel no.: Other fuel appliances
/1,4 . .0" . [,fik ii 4 i '. ' th " iiiti4tAW-S `Z 14 ' d , k , igii i .::■45; 7 4 7474 '" :7 ' ; Water heater 10,00
Agf4V ,,, ,;:...',., Ni4XIM`':.■:.47,', '',, ' C:' ,
Gus fireplace 10.00
4 .mm- Flue vent for water heater or gas
- 1./2072 t / • ai■MIIMArriN fireplace . 10.00
MI Log
Wood/pellet lighter (gas)
stove ,,
0
Wood fireplace/insert 11°0-.°0°
10.00
10.00
, -, _ i ,4 „. .",„ '' , ,d
.. ...... ; d!■. , :i...g.'‘'• ',' '' ' ' . ,. ' A ,,,,;,, '...', :-;,',...''' .. % ',..' ((( A : k.).- . ' ',.. . ..,.' ' • n NH% 0 other 1 10.00
Name: r /4 ! I eK__.• Environmental exhaust and ventila ion
. Range hood/other kitchen
Address; 1. equipment 10.00
City/State/ZIP: i & 4 CI;b ( 4 5ire. Clothes dryer exhaust 10.00
- -
- Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
,•,•• ..y.
... ° ' 7 " -- '''' . 0 -. ,,.•°,gff,,,„ , Al , '''.',.:" :'.'97.*'," ,, .,,.., ., ..,....zi„...,,, Attic/crawlspacc fans 10.00
I „,,,...„,,i..,•±47, , nv ,4,,, ,..:.4.,,,),,„,...-,,,,,.‘7.PAce),, other
Business name: • rrrIal F14 .rtie.-- _ 10.00 -
Fuel piping
-
Contact name:ge:, e ,... e en , ifg ; _ _ s5A0 for first tour; 31.00 for each additional
e,
AdcireSSI 110a le ,Our1241, S. Furnacetc.
At,0 .
, OaS heat pump
City/State/ZIP: i i / zt, 04 2g.l. Wall/suspended/unit heater
1 )6 IP ; ;,;16 Fax: ,6 6 -r--4,74.47
if water heater
Fireplace
54n311: • 1 " 4.. CO 7 , * ant.' Rgir ei .
... .,,.:::::,..
a:4;4* ..•.' . irr44efiltif.Ntitiktia ;,, ••.Wit,41.:Wk 'a i» ,,,, Barbecue
•
Busin name:
Clothes dryer (gas)
:
_ . Other:
Address: i r i e /Yip e.... .
i,i41,44;;Pk.,,,45v , ,, , ,.......ticiitk. , ^clid.)1.4.^...,.. • . ...,....em.....,,,,,,p„.4., ' .
1 ' 1 ' ,: .
,-
City/State/ZIP: S ubtotal
_
Minimum permit fee ($72. ••
50) / ei
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
i./
CC B lie,: 1,510 State surcharge (12% of permit fee) i5.47 P
TOTAL PERMIT FEE 91, 1,0 IV
This perrnit application expires if a permit is not Obtained within 180
Authorized sign. . ' days after it ht _a been accepted as complete.
Print namcgali, j# C404/6/ l ey . ___ Date:-/..)q lo Tri
.0q * Fee methodogy set by -County l3uilding Industry Service Board
,..... AX 3 'IT 111 /175/1-711.1/U/FL
A.8131‘2009 08:11 5035986746 THERMALFLO #1096 P. 003/003
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Site Plan
Prepared by: x Date:
Customer Name:1 '1; A6 �c Addr ss: c't (035/; ,- tM :: .
Customer Phone CZ . -5'- . • 2 �
oprp _
Property boundary Line -
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aF-1 C� P L'
cr E NBC '
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street