Permit o CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00185
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11/2012
Parcel: 2S103CB03900
Jurisdiction: Tigard
Site address: 12360 SW MARION ST
Project: Miller Subdivision: WILLAMETTE NO.2 Lot: 18
Project Description: Install ductless heat pump system.
Contractor: FIRST CALL HEATING & COOLING CO Owner: MILLER, SHIRLEY I
1650 NE LOMBARD ST 12360 SW MARION ST
PORTLAND, OR 97211 TIGARD, OR 97223
PHONE: 503 - 231 -3311 PHONE: 503 -654 -2342
FAX: 503 - 286 -5194
FEES
Specifics: Description Date Amount
Heat Pump 04/11/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 04 /11/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04 /11/2012 $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 questio UNC by calling 503.232.1987 or 1.800.332.2344. �
{A(\ Gjee__ Issu ed By: , ` , //
Permittee Signature: U GC !
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.
04/10 /2012 TUE 9: 47 FAx 5032865194 FIRST CALL HEATING 0001 /003
Mechanical 503.598.1960 0 i t 0 i
Phone: 503.718.2439 Fa Permit APPlication .''' roR OM IC USE L () 11
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City of Tigard 0 kr) Received • ,
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,rv , 13125 SW Hall Blvd., Tigard, OR 972 ‘ I.k) /
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x: N t?'Rl 0 /ikV) FESIIIIIIIIIIIIII Permit NV
OMerPenoit
1 !GAR!) Inspection Line: 503.639.4175 r WI" 1 it 'ate Read fB • Id See Page 2 for
Internet: www.tigard•or.gov OV \NI \ Notifleddetht NO Sapplesnental Information
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Mechanical permit fees* are based on the value of the work
0 New construction I: • ddition/alteration/replacement perfbrmed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition • Other: mechanical mated. -.ul . men labor ov- . -.. and .rofit
,...- ,7',1.7.i.,-,-'i --r- :.- r., r'.- P - i:-.'' - '' %- ' '' .'i .7 :-.- v....-1---: , , , , , , Value. S
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..."-....,.,...-:. ..- ... , . ';',„.. ,. ,, -;-..,,.- L ., ,,.... '..: •, ,:.. ::.,,-_-, 2.
1- and 2-family dwelling 0 Commercial/industrial El Accessory building For special htfontwilon toe checklist
Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
- `. .: . ' : '-i : ".:;;; , , : : : .. ' ;';'::;'-i . ..' 1 1.':".',: z , ,, ,c.1.'1, ; ;. ,. '.;:',1:11 •:t'!.'' ‘ ..'' '7 ' 1; ;; -; : : :% ; . ,1 `...' , ' 1 ,!'../.'n';. : ::i: ' A, 1,: 2 ,: ::': ' 1 ' `:. ; :-`''4;"...; : ' '''.: : : :.1: ' I AL adn' cli c el m : i
con ditioning
Job site address; 12;5 / 6 u.) Mar %(-) n Sk- re Tres site .Ian showin . 'Iacement Ell 46.75 ,
Furnace 100 000 BTU ducts/vans IIIII 46 .75
City/State/Z1P: "Ts ‘,. a. ,-(A ) 0 g. 4,; 2_2_3
Furnace 100 000+ BTU dams/vents III. 54.91 '
Suite/bldgiapt. no.: I Project name: Heat pump
,
free site 'Ian show( . .lacernerit II 61 .06
Cross street/directions to job site: Duct work IMIl 23.32
H dronic hot water stem IIIII 23 .3 2
Residential boiler (radiator or NMI
h dronic MI 23.32
Unit heaters (fuel-type, not electric), Mil
in-wall in-du etc. EM 46.75
Subdivision: I
Flue/vent for an of above Mil 23.32 I
Lot no.:
1,
Other: MI 23.32
Tax map/parcel no.:
Other fuel a . , nets: I
4 %Z.L.rLR'' TI 5: Water heater IIMI 23.32 1
Gas fire . lace/insert MI 33.39
(15 >r-a- 1/4 cILA_)c-1 55 h4 a..•-i. p 0 rile Flue vent for water heater or gas III 1
fire . lace 23.32
..., c•-• Ire rYTh
R 2 3.32 1
41 oe. et.
5- c...4.4,1/4. s ?a-c) k Wood/. Ilet stove IMI 33.39
alb rSt ^* ,. Li 1 Wood fir 'lace/Moore =I 23.32
1 ;:"'-- , i':' ' • • ,,,,,,,- ',".•'••• 7 -- '7■ s ' . t '= '• "'"''' -7 Other: 1.1111 23.32 I
Name: 6 11. ■.r . e_c Inn t k,k., r Environmental exhaust and vendladon:
6 $
Range hood/other kitchen I
Address: 123 42 5 t _.8.--- rr \-0....‘ 4- - k - -- e. u ...ent III 33.39 I
City/State/ZIP: T ri _ ..,pk 434., e l. 1. Z,....1- Clothes er exhaust IIMI 3339 I
Single-duct exhaust (bathrooms, M. 1
Phone:SneD 1 4.. 2_ I Fax: ( ) toilet com. . is utili rooms MI= 23.32
k - '," 1 .." . ' 'f,1;;Ty ',,..,-,,. Attic/crawls ace fans IIMI 2332 1
Other MI 23.32
Business name:
Fuel . . i . ... :
Contact name:
$14.15 for first four $4.03 for each additional I
Address; Fumac etc. II= I
IMMITIMINIIMI111.11 1
City/State/Z1P:
Wallis • dad/unit heater NM
Phone: ( ) I Fax: : ( ) Water heater MI I
Fl dace 11.111
E-mail:
Ran: e MI
4 , L , ,,;c,.% -A-5; : ,.-11 ,; . ; ,..."'.., 0: . ' v t! -:, '''.,' ' .,- , r .`" :-' -._ : Barbecue IIIIIII 1
Business name: t..- e...e.-4.-- ....6 C .a.. \ kic. a ct... 4. , ,,.‘, p_ Cist)1 ( Pt. 5 Clothes d r ' IIIIIII i
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Address: k. Cop 1 .. v c o 4 ..., 1/30._. re 5 - ' : %, , S,'_:: L ..y,...,, ;:e.•; . ,_,',.. r .,,.. ,..,-,,,,..-, _ .r, i
City/State/DP: .? 0 r .- A. „, e- e ..... 4 _ t a .,1 (
Subtotal _ 1
Minimum permit fee ($90.00) ICarOj I
Phme: 23 ) - ?s'b 1 1 1 Fax5 2462- 5 ttt-I. e Plan review (25% of permit fee) i
lic.: ; 0 2.0 cp
State surcharge (12% of permit fee) ' 0
TOTAL PERMIT FEE riorair,r, t.-''t
Authorized signatu • a c s Lev.... L .‘:, This permit application expirts if a permit is not obtained within ISO 1
days after It has been accepted as complete.
I Print name: L 1, A) .0 leC I Date: 1 -1 / (o/ I )_„,1,.. * Fee methodology set by Tri-County Building Industry Service Board
DBuil d ingTermi151MEC-Permlapp , dos 03/07/12 440-4617T (11/02/COM/W1313) I
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