Permit CITY OF TIGARD MECHANICAL PERMIT
s: • COMMUNITY DEVELOPMENT Permit St: MEC2009 -00406
Date Issued: 08/06/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S109ACO5700
Jurisdiction: Tigard
Site address: 13177 SW NICOLE LN
Subdivision: Lot: 0
Project: Jun
Project Description: Installation of A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
JUN, BUM JOON Description Date Amount
13177 SW NICOLE LN Air Conditioning or Heat Pump 08/06/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 08/06/2009 $8.70
PHONE: 971 - 227 - 7731 Minimum Fee Adjustment - Mechanical 08/06/2009 $58.50
Contractor:
D & R HEATING & AIR CONDITIONING
PO BOX 1292
CANBY, OR 97013
PHONE: 503 -678 -2517
FAX: 503 -678 -2097
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: °N p/ ..j 7 GD
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.
Aug 05 09 09:57a DR Heating 503 -678 -2097 p.1
.
Mechanical Permit Applic FOOFI�ICE USE ONLY
City f Ti and FlU� It
Received ;ii.
O Pemtit - — � 10 0
I ° 131 SW Hall Blvd., Tigard,OR 972 5 2009 P a n R ��
' I Plan evicty
Phone: 503.639.4171 Fax: 503.598.1 MR] O Datc/Bv: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date RcadyJBy: H See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified•'Method: IFOM Supplemental Information
BUll DINT nIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
New construction ®Addition alteration /replacement Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. aid profit.
• CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
i For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Total
JOB. SITE INFORMATION AND LOCATION . Heating/cooling
Air it si te pl or heat pump
lob site address: 13177 SW Nicole Lane
(requires site plan showing placement) 1 14.00 14.00
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 14.00
i Furnace 100,000+ BTU (ducts'vents) 17.90
Suite/bldg./apt. no.: Project name: I Gas heat pump 14.00
Cross street/directions to job site: Duet work 10.00
Hydronic hot water system 14.00
•
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: • Lot no.:
_ Other. _ 10.00
1 Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 10.00
Gas fireplace 10.00
Air conditioner install Flue vent for water heater or gas
fireplace 10.00
• Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/mserl 10.00
® PROPERTY OWNER 1:1 TENANT
Chimney/liner/flue/vent 10.00
Other. 10.00 _
Name: BJ Jun Environmental exhaust and ventilation
Ranee hood/other kitchen
Address: 13177 SW Nicole Lane equipment 10.00
City /State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (971)227 - 7731 Fax: ( ) toilet compartments. utility roomsl 6.80
I ® APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans _ 10.00
1
Other. 10.00
Business name: D & R Heating & Air Cond. Fuel t to
P g
Contact name: Rena Eubanks 55.40 for first four; 51.00 for each additional
Address: PO Box 1292 Furnace, etc.
Gas heat pump
I City /State /ZIP: Canby, OR 97013 Wall /suspended/unit heater
Phone: (503) 678 - 2517 Fax: : (503) 678 -2097 Water heater
Fireplace
E -mail: drhsattac@centurytel.net Range
CONTRACTOR Barbecue
Business name: SAME
Cloth Ls dryer (gas)
, Other.
i Address: MECHANICAL PERMIT FEES*
City; Statc /-LIP: Subtotal 14.00
Minimum permit fee ($72.50) 72.50
Phone: ( ) Fax: ( ) Plan review (25% of permit frc)
CCB lie.: 84489 i7 State surcharge (12% of permit fee) 8.70
MIA!. PERMIT FEE 312
'this permit application expires if a permit fa not obtained sithin I 80
Authorized signatu d ays a it has been 'accepted as complete.
Print name: Rena Eubanks Date: 815109 ' Etc methodology set by Tn•C'm Building Industry Service Board
::se, ddi:,u:Pm rits -Peet. it App dx 51,10J; 440-46 Ir t I II 2;(catinut,
4ug 05 09 09:58a DR Heating 503-678-2097 p.
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HEATING O. Box 1292 • Canby, OR 97013
CONDITIONING A IR R
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(503) 678-2517 • Fax (503) 678-2097
www.drheating.com
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