Permit •
Er I IN
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 00201
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2012
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TIGARD g Parcel: 2S104AC00900
Jurisdiction: Tigard
Site address: 12980 SW 132ND AVE
Project: Norton Subdivision: MORNING HILL NO.7 Lot: 165
Project Description: Install ductless heat pump. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: SUN GLOW INC Owner: NORTON, BRIAN D & MARGARET
2428 SE 105TH 12980 SW 132ND AVE
PORTLAND, OR 97216 TIGARD, OR 97223
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PHONE: 503 - 253 -7789 PHONE: 503 - 521 -9484
FAX: 503 - 253 -7693
FEES
Specifics: Description Date Amount
Heat Pump 04/24/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 04/24/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/24/2012 $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: 40 j9 € / e- - 7 7 9
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.
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Mechanical Permit Amlicatio
RECEIVED FoR OFFICE, I iSF.: ONLV
City of Tigard Received
1 1, q 13725 SW Hall Blvd.. Tigard, OR 97223 APR 2 3 2012 Datagy ,,,z 1.1 /"... /.... Permit No."16.--eta 0 2 _ i Ago/
Plan Revi .
Phone: 503.718.2439 Pax; 503.598.1960 Other Permit:
Date/By;
T I G ARD Inspection Linc; 503.639A175 CITY OF TIGARD Date Ready/Dy; kris: RI See Pace 2 Air
Internet: wwvv.tigard-or.gov
BUILDING DIVISION Notinowathod; ener Supplemental Information
...______ ' tygoeft ..mwowil,
_ - ' '''' '6 ' :' ''''A' '6 ''• ''' ... ''' ' ' . c.• -- .' ' . ''''• • ' Z. '.• ''..... ''' '.. ' : ''' ' Mechanical permit fees* are based on the value of the work
11 New construction ddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
Cl Demolition CI Other: mechanical mater fith Ill Ilw_...__,,mpA!E,mor, overhead, and Tot,
Value: $
pgArP,4),',110y(fat.W..4—:,....415..' RombyptwittitaippwirWmint' t
IR and 2-family dwelling ID Commercial/industrial 0 Accessory building For special information use cheeldist
0 Multi-family 0 Master builder 0 Other: _Description r Qty. I Ea- I Total
L -1,„. . N , . _ let W: ' ' ' d i Kirittiii5 , piffiTA:704% . H
,,., ...._ ,.._,., Air conditioning
Job site address: I ip L. 1 , 60 5 u ..) i s a- A J.Q.., . _(nquires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vow , 46.75
City/State/ZIP: —7 , 0 R. qi ----a--.- Furnace 100,000+1371J (doeui/veato 54.91
Suite/bldg./apt. no.: Project name: Hest pump
(requires site plan showing placement) 1 61.06 63 I. No
Cross strxt/dircetions to job site; _Duct work 2332 _
Hydronie hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
— Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc, 46.75
Flue/vent for any of above 23.32 ,
Subdivision: Lot no.:
Other: 23.32
—_________________,______
Tax map/parcel no.:
Other fuel appliances:
';',.T.:,;',97,1424FKIIX:WrAFIllifirgiatt,tigMlingW.P.,,4„..0r#,,E1020.,g /A heater 23.32
LLTisLc 1., Fr+19' ',.' ' •'4:•.W i K... • .- ,,,,..'■ 'e .7. ^ . ".7 ' ' ' 't , " - r — - 4 . 4...0 . ''''' '
Gas fireplace/insert
33.39
,. r1 s-\re 6,kk. V•c2--=e_ .... Flue vent for water heater or gas
fireplace 23,32
1..og.lIhtor (Ras) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23,32
p rog t offloo ,,,___, : itigE.E.,,, ,,,,,; :v co i l w, 466..w. , ,. Chimney/liner/flue/vent 23.32
Other: 23.32
Nam d ckf 9szt. 10,* (-- — Environment:II exhaust and ventilation: _
Range hood/other kitchen
Address: 1 ae s .) Gantt- 11,..-12---, equipment 33.39
Cit)'/Statc/ZIP: - i e l s ......._ "c 1 . ....a--:?.. ) Clothes dryer exhaust _ 33.39
Singlc-duct exhaust (bathrooms,
Phone: (5 S ..../ Fax: ( ) toilet aernPartmcnts, utility rooms) 2332
7zi,, ; .1: MIN14 2 ;WAW67017FRNirq KippaiitiiRFAVPi tiditirtrin Attic/crawlspace fans 23.32
.- 1,, . kl , .... 4 KT? , 7.
..4 ...■ :as • .. i... ...,.,.t.•.. ,..
-.. Other; 23.32
Business name: _
SUN GLOW, INC, Fuel piping:
Contact name: HEATING & AIR CONDITIONING 514.15 for first four; $4.03 for each additional
Avenue Puma etc.
Address: VOVIT 2428 SE 105
..., th
Portland, Oregon 97216
Gss ht
(503) 253-7789 FAX (503) 253-7693 ea pump
City/State/ZIP:
Wall/suspended/unit heater
Phone:( ) Fax: : ( ) Water heater
Fireplace
E-mail: C_ k az. 443,1r .
Range
:*10.11041/Vittris-Mig„..4.„ . Clothes dryer ( -
aarbowo
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Business name:
SUN GLOW, INC. Other
Address; — HEATING & AIR CONDITIONING k.,TCgrataLkEMNMtt.C:.
2428 SE 105th Avenue
Subtotal
City/State/ZIP: LOW
Portland, Oregon 97216
(503) 253-7789 FAX (503) 253.7693 minimum permit fee ($90.00) CIO. rx)
yhonc: ( )
Plan review (25% of permit fee)
CB
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Z )1 C lic.: 4,76is Y
_ State surcharge (12% of permit fee) )0 .90
TOTAL PERMIT FEE 1 I OD.
Thhi permit application expires If If permit is not obtained within 180
Authorized signature: C.....),(\r‘.....,c.--__. sack dive after It has been accepted as complete.
I Print name: C_ Ar\ r• ,-... Date: t4 IA.3112... I • Fee methodolOgY set by Tri-County Building Industry Service Board
mau arnmwermitamEC-PerniltApp.clo a 01/07/12 440-461 TT (11 n)2/CONVINUD)
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