Permit ti
CITY OF TIGARD MECHANICAL PERMIT
E ° 1 COMMUNITY DEVELOPMENT Permit#: MEC2009 -00440
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/21/2009
Parcel: 2S104BC07900
Jurisdiction: Tigard
Site address: 14125 SW MITCHELL CT
Subdivision: Lot: 0
Project: Hindman
Project Description: Installation of NC. Unit must meet 3' minimum rear and side yard setbacks.
Owner. FEES
HINDMAN, GAVIN D Description Date Amount
14125 SW MITCHELL CT
TIGARD, OR 97223 Air Conditioning or Heat Pump 08/21/2009 $14.00
Duct Work 08/21/2009 $10.00
PHONE: 503 - 521 -1390 12% State Surcharge - Mechanical 08/21/2009 $8.70
Minimum Fee Adjustment - Mechanical 08/21/2009 $48.50
Contractor:
OREGON HEATING & AC
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.
Issued By: Permittee Signature: e--Ac � 1'i ° Gi eel
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 Permit Application FOR OFFICE USE. ONI,l'
City of Tigalyd �� Received /e
1 111 4 �(j Date/Hy: i . r 'j� / 6. .. Permit Nn. y /,- "" DO 0
13125 SW }Tall Blvd., Tigard, pit 97223 ` \ \I Plan Review
s Phone: 503.639.4171 Fax: 503.39 on Cane: 503.639.4175
�WC� 138uBr OtherPetmit:
T 1GARD
Inspection �YJ (1 pate Reedy/By: 6J Sec Pa 1 for
Internet: www.tigard- or.gov 7 Notifieektetho,t Supplemeotal1aformatioa
1\6 9,07-*
•
-1Y �,.1, ..... .n r_. .. 1, .:i.. .. .. •' r,..... Q '.�V ��':�:' '.j ':�lY..'..
L_... ... L .;�I, .._. ...1. .1.
... .. . ,..1 � 4.��.
.. �.1��,. �F,�•t. .r"���. y t li��,•�l•L.Q'•��!'7 r�,� q�,yp��.•'•
, .. ., �, 5. � ... . . �. 1 �•}, ..n't }���( -'' ti :r..... ,'Y:' : r.� �„,�.'„ .. ,,. `�'�'1!2-!!tG�ii."`1'+ ..,... .. ._ ...r
El New construction Additian/alteratle Mechanical permit fees* are based on the value of the work
❑ Demolition ❑ Other: 03 performed, Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
.r... „ °., : r : 1; :,:;::; - ,: .'.;i : -;�;?,� s •,'. - 'Value: $ •
� •,.,,..,.. -:� �. , CA�EG< �tY:`Oh;:'GONSiR.00rT�QN'�;;`• ''4' ,
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building r ` "' °''` ' "' " "' Q MtEJ ''''�' '
Multi- family ❑Master builder ❑Other: For .tp.tcial infnrartertnn tcee dretklirr.
_�t.':a :• ��;:a' ° iY l 't:� 'v �` r '�r'� `J .. ... .,,�,� - a�� , ., °�_� .,i
Description I Qty. I Ea. I Total
I .Ii! : -,.i. 1.;x:10$ . 1 y�. 'O " 1AQ $. .OG°A7f;710,A1 ��:'i'! I::i:,fi:.:- .! Heatt con
Job site address: 114 1 a5 C r ,, I- - , r Air co ' 'oni�o or heat pump �eJ J� (requires sit p n showing placement) 1 14.00
City/State /TB: T � q a a3 Furnace 100.000 BTU (ductstveuts) 14.00
Furnace 100,000+ BTU (ductslvents) 17.90
Suite/bldgJapt. no.: Project name: heat ptnnp 14.00
Gas -
Cross street/directions to job site; Duct work 1 10.00
Hydronic hot water system 14.00_
Residential boiler (radiator or
hydronic) 14.00
- Unit beaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. _ 14.00
Flue/vem for any of above 6.80
Subdivision: Lot no -: Other 10.00
Tax map/parcel no.: �{ 1�yy�� � � y � Other fuel appliances
�a f.°!'r" ie !File i t' r
f.-•iy .. a . a ( ` rf ` dtjt? 1 w"Ft l�ltl. '• ! { ' l id ! Water heater 10 -00
/�y N `� U' Gas fireplace 1 U.00
1 Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
_ Wood/pellet stove 10.00
wood breplacelinsert . 10.00 •
W , s a er , a �y� t{ f T;ge zs Cbimneynincr /fluc/vcnt 10.00
i �� I 6,:Aoa ri �I ? ` Ml L"a ltat!� ier'11 �F n �- oth - 10.00
..AJi ': " �i>•7t6itt8Ki1 .[}; '- swl - "�i�
Name: - ) lYV.. Environmental exhaust and ventilation
Address: , r a rJ t.)3 . Range hood/other kitchen
equipment 10.00
City/State/ZIP: T 1 al a Clothes dryer exhaust 10.00 •
Sidle -duct exhaust (bathrooms, •
Phone: 93) Z.:9-1 I R9 0 Fax: ( ) toilet compartments, utility rooms) 6.80
t "�� t p 1 v, r r . r *, ;i - `! 1 hN.•;.. r , :., : b.T'l! I'
�t1 t i ;; h Attic /cr fins 10.00
1' . x1 4 yyep T ,N Ij : � ri g { 1.� ; : , 0'i T+> i . .... t L . r; Y ..,,,, , ,. ' Y . 4 - q ? it i . 1sP ace
Y . �1 ,,.`s= t�f1111��.!ir.!1'!„1,: �'�y14'fiti�' 'Y.�:.f4.`, i.�_�:�,,..1 :., r�.:�<'�.a�i_i:S +�y !1� re #!oil
- . Other 10.00
Business name: NP �i <AG Fuel piping
Contact name: t {�(� $5.40 for first four; $1.00 for each additional
•
Address: k A }x a i 4 ( Furnace, etc.
Gas beat Pump _
City/State/ZIP: C� k rndPe mil' `S . /� Walllsuspeeded/unitheater
Phone:( eft) ' � V f� D a q Fax: :( )6S 1 8556 C3 �e
E- mail: L 1 ,. �1 Range •
• , tt l{!. ' yy',,;1fi�: hul .Oiitli..M4 �p 4: F 7k iry �,..Pd• ..1 "''''
, j %ittir•,i :! (ii& "( �'i'i?i JA 'ii - i Barbecue
3i , i,: , �h.6� ._4!lw, -.:p. ,qi ;fi it !,:il 1!. -1.4 • / O : ''.7.- . �� . : i , , .'; r : ,r:v : -.. :j , ,t!6, -
. :',
+ ry i _ :AP' � u' s :��.5'.r•':�. .i. ` + ^ e.it'•;;� � i!•�:e!
Business name: Q �Or \eak •\r c a L .. Clothes dryer (Ras)
Address: . OOther. ' 1 ii;i T c . >~ii:Mi� ` :rl "t�'a
� f l• ,. ., g .. ' .: :., ' ,i ... �'„i :4Cd.
City/State/ZIP: �t )ri t�;e e_ ' I Subtotal ,
( � r i ^ Minimum permit fee ($72.50) 1 �, a
Phone: ( \ - q 6qQ Fax: ` 1 - plan rcvit w 25 °/a of
( pcmlit fee)
CCB lie.: f a a V o p
State surcharge (12% ermit fee) 1
!,. TOTAL PERMIT FEE @ s ) a
f )
Authorized signature
t � , I T his permit application expires of a permit as not obtained wltl to 180
f , r days after Lt has been accepted as complete
r Print name: 1I 1 bate: grA(-( * Fee methodology set by 7ti -County Building Industry Service Board
L'\ BtnldtnaTersai +AMEC.PennitAnp.dx 01/19/01 440-4617T (11/0E/COM'WEB)
E0 /t0 39tid 9NIld3H N093N0 9998- t69 -E09 8E :tI 600Z/0Z/80
- - •
M
N
Flint Floor
O
Main Floor
C7
Z
w
I
Nook
O
qQ' a s I I flange
LD
Li"
O 1V+ - -
cn
Mitchell CoUrt Jurisdiction - City of Tigard
Job o
M
eI: Oregon Heating & A/C Seal$: 1: 130
o,
Performed for Page 1
gy m ., • Gavin Hindman PO Box 3971 992 Hwy 99W Right -Suite Residential
14125 SW Mftcheli Ct Dundee, OR 97113 9,0.119 RSR28586
N Tlgard, OR 97223 Phone: 503- 538 -2953 2009-Aug-20 07:26:46
m Phone: 543-521,1390 oreigiaaregonheat -tom CAIN Doourrlente1W41yhtsoR HVAC1...
r