Permit •
CITY OF TIGARD MECHANICAL PERMIT
• ° COMMUNITY DEVELOPMENT Permit#: MEC2009 -00288
T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2009
Parcel: 2S104DA20400
Jurisdiction: Tigard
Site address: 13058 SW PRINCETON LN
Subdivision: Lot: 0
Project: Mortenson
Project Description: Install a /c.
•
Owner: FEES
MORTENSON, ROBIN M Description Date Amount
13058 SW PRINCETON LN Air Conditioning or Heat Pump 06/17/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 06/17/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 06/17/2009 $58.50
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503- 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuan - - • . • spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. ose rul >: .re set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. Y obtain a copy of the rules
or d ect questions to OUNC by'•= ling -0.. 46.6699 or 1.800.332.2344.
Issu: d By: // l / Permittee Signature:�� S Il ► � f
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
•
- Mechanical Permit Application IF 1 1 r 1 1. i 1/44 . r i \ I
City of Tigard AWED Re Received
No.: r. 00 00 - S
13125 SW Hall Blvd -, Ti
' Phone: 503.639.4 171 Fax: 503.598.1960 y Other Permit �ll
U . V 0 • • 60. Q
. ! ,. ; .., l ,, i , Inspection Line: 503.639.41751., N 1 5 2009 Date rteady /Br B See Page 3 for .
Internet www- timed- or.gav Nm16ed/Method: Supplementallntorma$ea
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7rl4 v OII �,t�' �,• Addition/alteration/replacement r lEiCCrylep2 Mechanical (;�'. Sr r& `• y ��'e � - � v:� "' • ...,. ...... - •�.r
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ID New constructs Of Additl rep perm fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, •ui• labor overlie: • and . •fit
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r .' v / ?,:V.+J :a...�i is ....:.,. � �Pd *yc!:.. ::!!Sk4....,'. .N �•
- and 2- family dwelling Q Commercial/industrial ❑ Accessory building u,..r..'`'..
For special information use checklist.
❑ Multi- family ❑ Master builder 0 Other Description Qty. Ea. Total
°iCM" 1 i . { a " i Y'.. ^
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.� . .._.:; , a� � ' : r
= :, ...�, ^ ° . ' • condition' heal pump
Job site address: .-- $ l' • LL �`' re' „, . site •lenslwwln_ •lammed 14.00 / �l
City /Sta/CIZTP: (' `j � Furnace 100 000 BTU duets/vents _ 14.00
t j` I ` Furnace 100 000+ BTU ducts/vents 17.90
Suite/bldgJapt. no.: Project name: Gas heat . . `• 14.00
Cross street//directions to job site: Ductwork 10.00
H dronic hot waters . 14.00
Residential boiler (radiator or
1 • •nic III 14.00
Unit heaters (fuel-type, not electric).
in -wall in-duc : : • , nded. etc. 14.00
Flue/vent for , ..l of above 6.80
Subdivision Lot no.:
Other 10.00
Tax map/parcel no.: Other fuel a , • Minces
, ' vt'. - ,. l Vi . • f' ; ii:' a ' Water heater 10.00 • ' y may} A ea � + s + .i: t`r'�d '
c te.i - , :'`�x : - f ' a ::0.F ! :* i ' ;,
,.'u ,:s Gas fi • lace 1
a 10.00
1� s Flue vent t er water heater or gas
fi • lace 10.00
— M _ 10.00
W.... • 11et stove _ 10.00
Wood fire' Iacchnsert 10.00
10.00
: ; :WT. +.^^ ": Chtmn /liner/flue/vent
. >� . ' 1y .'',..., ,. ..... ' ;; ..:: rise' 5 e ;^, .( cr ' x e ,; :.. 1
. t +'yelY y; .+ry'�� w Y. -�'T� . � other 1 U.00
Name: ` .. ` , .f, " tA R `` - = J` Environmental exhaust and ventilation
Range hood/other kitchen
° �..� r �r / . e • 10.00
Address: ' • s- 4: _ �.
t s Clothes • exhaust 10.00
r Single - duct exhaust (bathrooms,
Phone ) rooms 6.80
( t a ' - 7, r "�. Attic/crawls • 1 - f toilet ro ns _ 10.00
d 'ail " 'r5 ,rj7E , y yx /E F
3 ::'y s e' . awivc ; �, A14R m:
O 10.00
Other
Business name: . _ ilk, F uel , . 1 1,' •
Contact nmee: AND AIR CONDITIONING, INC. MAO for first four $1.00 for each additional
1e1,. ‘le I - • - Furnace. etc, -.
Address: NEWBER d.: • r Gas heat „'
City /State/ZIP: C� c, _ Wall/sus. •, healer
Phone: (5-63) 5?) g- ( I Fa x:: ( , 3 g r0 / ( y- wafer heater
=�
E -mail:
> �" '' �� ... "r, :a.` t�:., Barbecue
1 ., ..t., .'�•h .:.. � ", ..' ,-.:..k.:';:-,' . �('•:...< • 8, n �i'+.' ` � „Y ; y i `,,`
•ii 7 ... "+'9t` : `: :� o '•f :: _t .. r °..5• .pr -
PO UR BEAU NE) HEATING Clothes ■ - r :•,,)
Business name: Other.
1 INDU IALPILIIY� _. ). r:� ;
Address: i_�,� -'µ , n' . - '�: 1 :,:;4'�' . . `� ! _.. , �,= -
City / State/ZIP: NEWBERG, OR 97132 Subtotal l y
Minimum permit fee ($72.50) * 7A . S
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee)
CCB tic.: 9 II S L State surcharge (12% of permit fee) $ { 10
TOTAL PERMIT FEE . , -6
This permit application capirta if a permit b not obtained within 180
Authorized signature: days after It has been accepted as complete.
E name: l li +2. il, Y' J I Dale: 6 r ` s - C? `l • Fee methodology het by T Building Industry Service Board
L•IBuiIdio oinanl IC- ParmitapP.eoe 01/19Am 44o- +nirr(uroa/coM/vea)
F00/00021 / Mid 80 60 800tESL /so
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A/C-HEAT PUMP--UNIT SITE PLAN
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. 91 . . � � �o FEET TO FRO .
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L MPRES: 13044 rt '7 z
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