Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00152
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2012
Parcel: 2S103DA04900
Jurisdiction: Tigard
Site address: 13365 SW WATKINS AVE
Project: MURFINSIMMONS Subdivision: FANTASY HILL Lot: 10
Project Description: Geothermal heat pump and air handler installation without an outdoor unit.
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: MURFINSIMMONS, MATTHEW T &
1637 SE NEHALEM ST MICAHLE
PORTLAND, OR 97202 13365 SW WATKINS
TIGARD, OR 97223
PHONE: 503 - 235 -9083 PHONE:
FAX: 503 - 235 -0454
FEES
Specifics: . Description Date . Amount
Heat Pump 03/23/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 03/23/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/23/2012 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80 ,
•
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /� Permittee Signature: /
amp
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
03/23/2012 09:08 5032350454 lc lc) SKY HEATING AND AC PAGE 02/02
Mechanical Permit Application*, r t, i; e) i i I c I :: 1; I: i � 1,,
City of Tigard c p�ti 3 "No.: 1
13125 SW Hall Blvd.. Tigard, 01 - - 4 1 ' ® i1r� n I�dC O�Id
' � h • Phone: 503.7182439 Fret: 5 h '• X60 9 e ;`Q d ' D ye �"" Other Permit G. - .., , _ U 50, ,
r i ,..; n F; _ Inspection Li 501639.4175 , ' $ > Bs* Ready/Br See Page 2 for
interne: www.tig/hrd�r,gafv ,d( Q\
` Notified/Method: Srpprearcatai [arornurdoo
~ Me c l xtmit fees' me based an the value of the ' Wink
❑ New construction ® Addition/altcrati . - .lacernent perforated. indicate the value (rounded to the neatest dollar) of all
Q Demolition 0 Other: mechanical materials, equipment. l� overhead, and profit.
,. y
El 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For wedaI btfraftallon use checklist.
. ❑ Multi- family ❑ Masao' builder ❑ Other: Description I Qty. I 6a. I Total
... .. , ... , .. ., .. _ . Air e:orhditiemehg •
Job site address: 13365 SW WATIIQNS AVENUE (maims simples showing placement) 46.75
City/Sta'tc/ZIP: TIGARD. OR 97223 Furnace 100,000 BTU (daetx/ven s) 46.75
Furnace 100.000+ (duos/von) 54.91
Suite/bldg./apt no.: I Project name: MURFINSIMMONS Heat pump
(snuiirs sac plan slowing Mamma) 1 61.06 61.06
Cross street/di•reetion to job site: Duct wont 23.32
is het water • ,- 23.32
Residential boiler (radiator or
hydronii) . 23.32
Unit heaters (fuel-type, not electric),
in-wall, induct. suspended, etc. 4.6.75
Subdivision: ( Flue/vent for any of above 23.32 no.:
Tax map /parcel no.: I Other 2332
Other lire! applestneca:
= . t . . `• Water heater , 2332 •
INSTALL GEOTHERMAL HEAT PUMP AND AIR HANDLER. (NOTE - THERE Gass fireplace 33.39
Flue van for water limiter or gas
IS NOT A SITE PLAN INCLUDED BECAUSE THERE IS NO OUTDOOR UNIT TO fireplace 2332
Log lighter (m) 2332 _
SHOW PLACEMENT OF). Wood/pellet stove 33.39
wood fireplace/insert 23.32
" 1I!, :; {{ ChimncyAincrffitrc/vamt , 2332
: 1. Other 2332
Name: MATT & MICAHLE MURF11NSIMMONS
Environmental exhaust and vare3adotue
Address: 1.3365 SW WATKINS AVENUE other kitchen 33.39
ettuilwnent City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 3339
Phone: (97X}226 -3444 r Fax: ( ) Single -duct exhaust (bathrooms.
toilet compartments, utility rooms) 23.32
:,..1 : • .. :: li: 'i0 ' Attic%awlspace felts
Business name: SKY HEATTNG & AC. INC. Other: _ — 23.32
Foci piping:
Contact name: TAMI BAGEMAN $14.15 for first fora; S4.03 for each additional
Addicts: 1635 SE NEHALEM ST Furnace, dc. _
Gas heat pump
City/State/ZIP: PORTLAND, OR 97202 Wall/suspended/unit heater
Phone: (503) 235-9081 I Pax:: (503) 235-0454 Water heater r
E -mail: TAMI@SKYHENTING.com Fireplace
Range
• : :SOON CTOX
Business name: SKY HEATING & AC,1NC. Clotho J, (en)
Address: 1635 SE NEHALEM Sr Odrer y.
r
City/State/Mt PORTLAND, OR 97292 - Subtotal * f 61.06
—
Phone: (503) 235.9083 I Pam (503) 23,5 -0454
Plan review permit fee ($90.00) 90.00
CCB lie.: 511244 eview (25% of permit fee)
State sur charge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature: This permit application- eaptrn ifs permit Is ant obMiacd within 180
days after it has been aceepted no complain
[Print name: TAMI .RAGEMAN ._ I Date: 3/23/2012 a Pee methndetoaer sat Ili
by AMY naming !Mowry Service Heard
Llew ;U'ermitAMEC.PenniaAov.doc 09/cw1 n 4404617T (1 t102/COMMER)
IAkk erkA.SA ram 'QS ala os l R I P
M
T 1T 4 REc2o12_ooi5 'DiiVAZA . Lob?
N
w U c u
0 l.�363 s cc/ E
0_ �,4T �,�JS ,ma
5
U w a
ra
z
a
;
0
w
b
1 6 20( ` . T f adDY U q
o siolii%4 15 4 ) i iv a Z
L lot
%ftilli
zap pec� A 30 Ocfp I
m
N s' Ow Ittal
N
m
m
.. V' °cam j q 1) ( 4 Pe
m
Na
is` lQ
N
N
N
V
�L 5 4f lc 115
., -rte
.04/23/2012 12:31 5032350454 SKY HEATING AND AC PAGE 01/03
RECEIVED
APR 2 3 2012
CITY OF TIGARD
BUILDING DIVISION
t,S; -.`"
HATING &AIR CGND MtG °g° � a + °O �s
Get Co ft rta /ide lf*Zir (I.s 1 6s S L � ��t�� L4S
FAX COVER SHEET Ac./6
DATE: 423. 1
TO:
NAME: C7e0y 1■.' 'Y
COMPANY NAME: C p f I alt(4)
PHONE #:
FAX #: 503-- Sq - -1q(a0
FROM:
NAME: Tt M
TOTAL PAGES, INCLUDING COVER:
COMMENTS:
•1) yl it-tit/444 vlsperjor 1 Gir°64-
• I o d d �. s P et �,� ., • yolk=
- rov,i, -