Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pem,it #: MEC2012 -00288
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/05/2012
Parcel: 1 S125DA01601
Jurisdiction: Tigard
Site address: 6770 SW TAYLORS FERRY RD
Project: Layton Subdivision: KINGS VIEW Lot: 1
Project Description: Replace electric furnace and heat pump Must meet minimum 5' side yard setback and approved rear yard setback
Contractor: TRI COUNTY TEMP CONTROL INC Owner: LAYTON, DAVE
13150 S CLACKAMAS RIVER DR 6770 SW TALORS FERRY RD
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 503 - 307 -4107
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Fumaces < 100K BTU 06/05/2012 $46.75
Type of Use: SF Heat Pump 06/05/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/05/2012 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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: L ied Permittee Signature: Oki u C {�71 Oki
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 Application
1, mil( r I'.�r, uwl,1 O
City of Tigard . Datelay Permit �. r D ,
iew
• 13125 SW HaII Blvd., Tigard, OR 97223 JU 0 1 2012 Plan Rev
.. ' II Phone: 503.639.4171 Fax: 503.598.1960 Dateluy Other Permit: ,
1 11.; nit 1:1 Inspection Line: 503.639.4175 CITY OF TIGARD Date Read /B mi ® See Page 2 for .
' Interne www.tigardoY.gov BUILDING DIVISIO r Nolified Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USECJIECKLIST
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❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
Performed. Indicate the value (rounded to the nearest dollar). of all
. 0 Demolition ❑ Other . mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
• 1- 2-family dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS FEES"
® y g ❑ Commercial/industrial ❑ Accessory building
❑ Multi- family ❑Master builder ❑Other: For special ulfo rrrtarta, use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: tpril O W Tai l0 Au conditioning
_- - i (requires site plan showing placement) 46.75
' City/State/ZiP: pd (;( g, �! l+-:/ Furnace 100,000 BTU (ducts/vents) , I 46.75
1 Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump l 61.06
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Cross street/directions to jolt site: , • Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) . 23.32
' . ' Unit heaters (tuel -type, not electric),
in -wall, induct, suspended, etc. 46.75
Subdivision: Lot uo : Flue/vent for any of above • 23.32
Other: . _ 23.32 .
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
F t Gas. fireplace 33.39
pl ' • 'KfYI) uMr e 4 c 1 a Ffue vent for water heater or gas
hat PUMP fireplace 23.32
��j�1 A ! �IJJ l og lighter (gas) 23.32
Wood/pellet stove 33.39
. ' Wood fireplace/insert • 23.32
Chimney/liner/flue/vent . 23.32
.At PROPERTY OWNER I ❑ TENANT Other. 23.32 _
Name: ' Da e l n t J f O n Environmental exhaust and ventilation ,
Address: �
5njne �'�^6 'Ran hood/other kitchen
equipment 33.39
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City/State/ZIP: ' - Clothes dryer exhaust ' • 33.39 -
p�� Single -duct exhaust (bathrooms,
Phone: () 4I ' ( Fax: ( ) toilet rooms) , 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace flats 23.32
Business name: Same as contractor Other. 23.32
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: Furnace, etc: .
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Oat heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E -mail: ; Range .
CONTRACTOR Barbecue
. Business name: Tr i County Temp Control Clothes dryer (gas) •
Other: .
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
• City/State/ZiP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557 2220 I Fax: (303) 537.0919 Plan review (25% of permit fee)
t/ / CCB tic.:' 72623 State surcharge (12% of permit fee) r
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' TOTAL PERMIT FEE . J /
Authorized signature: ' This' permit application expires if a permit is not obtained within 180
n �r1 ' days after it has been accepted as complete., ,
• I Print name: vane, e, moon n • I Dut (.4 I [ f t. • F ee me net by Tri -County Building Induetry Service Board
I: Viuildiaa \P°nnliAMEC- Pern'iApp.d°e 10/01/09 440 - 4617x(11 /02/COM/Waa)
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Address:
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