Permit 1,11 a CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2012 -00250
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012
Parcel: 1 S 135CA10100
Jurisdiction: Tigard
Site address: 11394 SW 96TH AVE
Project: Lanier Subdivision: SOLERA Lot: 10
Project Description: Install NC Must meet 5' side yard and rear yard setback requirements
Contractor: PYRAMID HEATING & COOLING Owner: LANIER, SCOTT
9409 NE COLFAX 11394 SW 96TH AVE
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 786 -9522 PHONE: 503 - 863 -8361
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Air Conditioning 05/16/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/16/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/16/2012 $43.25
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: 47(1 A pPLI4T) 1AJ
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.
05/15/2012 TUE 14:49 FAX 503 786 3432 PYRAMID HEATING Q001/002 S7 ----
Mechanical Permit App ;1 t FOR OFFICE USE o��> Nx
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City of Tigard R eceived s PermitN
13125 SW Hall Blvd., Tigard, OR 9I 1 5 2012 Daffy' SI EC,�D� DDS
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Plan Review
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Phone: 503.718.2439 Fax: 503.598.1960 p Other Permit
Inspection line 503.639
T I G A R D C l 0� ! �� s! T - Date Ready/By: iii2i H See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
N
u,��f- v` F ,� Z { Ct .,.�: F. °n' ;14jlll�t�.fi {JQ F �` ' '�"'','— `.�V- = 1 '\�a)5I�� <E 'nJL Rl :r!:{C ',�:117[,i iZv ,_�= _7h:,�i�cCU il9i ¢i Pt -
. z ..: , -- a . __�. .: Mec permit fees' are based on the value of the work
❑ New construction 0 Addition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit.
— > - - �:_ �. ;F- Value: S
Erv 6 B i - N , - ,i:i':4g Lil't7 I w_-`'`� Ss:. -- - _ = 7-.
.w _ _ 1r .-.: - I - itFU 1_"o t'i;�i a @ t'r }T c{;�,,��
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
- �_r....-r - -n „ ; ;.. . - ._u[::j�rr'' -- - - - - _ - - - -- 2r - - o,
Job site address: 13 ( (requires site plan showing placement) I 46.75 tP ',
,� Furnace 100,000 BTU (ducts/veets) 46.75
1 [
City/ State/ZIP: r) ad3 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: I) m r Heat pump
((equires she plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic 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
Subdivision: I Lot Flue/vent for any of above 23.32
Other 23.32
Tax map /parcel no Other fuel appliances:
. 4K , 1 ,. - .._ .1,f1,--,:17:(-..,:.)-:.-,...... .3 � t C e # : Y� i 2 -~...,:,...'� 7 Z r -L.. t �� y Water heater
_ = 23.32
t ,� p — Gas f replay nsert 33.39
LI ll V t� C s Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood frreplacefnsert 2332
— II ,: ; : ,,,, s = 7 Chimney/liner/flue/vent 23.32
- -.,..,,.n,..... ,jiaB.�1.,.! I -I ( i` ... -. o :,._... Y .i 'i E..� i.. iit, ----
O
' • °.�� ” ?L s :. .. Other 23.32
1 i
Name: - y i Environmental exhaust and ventilation:
Address: I 1 ,3 ! W /'AI
S • 9 / t L Range hood/other kitchen
r equipment 33.39
City/ State/ZIP: ''.' , 1 °) (3 a-1 Clothes dryer exhaust 33.39
Q � . ) iO Single-duct exhaust (bathrooms,
Phone: , b Le -' 1 / Fax: ( ) toilet compartments, utility rooms) 23.32
c - i " C : ? r,�v . t 1 ..,1,.._,.....--...-1 .,,. - .. .. � f _ ;` Attidcrawlspacefans 23.32
Business name: 4� Other 23.32
1 L�La ■. r. .' 1 V Fuel piping:
Contact name: 1 . , 1 . 1 ' V\ $14.15 for first four; $4.03 for each additional
Address: q f c c �-- . Furmace, etc.
f 1 V �""' �` -��`�
Gas heat pump
City/ State/ZIP: 0k I [ r'�[�C� WaWsuspeaded/tmit heater
Phone: (6 I ' n/ (�� /sax. Fax ) Pig/„. (. .../3 1 A ,_ J Water heater
t�vv Fireplace
E-mail: 1L4 t , NA ( r. L .r&„, ' .' la, ;pi. Range
r
-?.-7:::: n• ; i c' a ,i c 'r � 4 .5 �.
' ..• � '` � 1: 'L ,i ..._.... ,'� :.., . t
.,�.a1 ��.„c
�. . _� .: Barbecue
Clothes dryer (gas)
Business name: Other
Address: Ni , -�/6 '757 v 1 tf1I rt i s
City/State/ZIP: Subtotal ' h
' Minimum permit fee ($90.00) -. 0 "-'
Phone: ( ) I Fax: ( )
Plan review (25% of permit fee)
f lie.: 013..4 d` z I O t \ 3 State surcharge (12% of permit fee) /
/1 TOTAL PERMIT FEE p��1
This permit application expires If a permit is not obtain within ISO
z _ j
Authorized signature: jr /l / t /
days after tt has been accepted as complete.
Print name: , - "�C I Date (6`,15- I A • Fee methodology set by Tri -County Building Industry Service Board
I ABuildiag4PamrtsVMEC- PamitApp.doe 03/07/12 440.4617T(II /02/C0M/WEB)
"19y/l6 / r1 7
05/15/2012 TUE 14:49 FAX 503 786 3432 PYRAMID HEATING f 1002/002
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