Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00367
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 2S104BB11800
Jurisdiction: Tigard
Site address: 13924 SW WALNUT CREEK WAY
Project: Sherwood Subdivision: WALNUT CREEK Lot: 35
Project Description: Install A/C Must be within 5' side yard setback and approved rear yard setback
Contractor: SUN GLOW INC Owner: SHERWOOD, CASEY
2428 SE 105TH 13924 SW WALNUT CREEK WAY
PORTLAND, OR 97216 TIGARD, OR 97223
PHONE: 503 - 253 -7789 PHONE: 503 - 577 -0490
FAX: 503 - 253 -7693
FEES
Specifics: Description Date Amount
Air Conditioning 07/16/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/16/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/16/2012 $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. /� r
Issued By: )1itiAlby J Permittee Signature: D � A 1 ,Q PL1 q- mi
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.
• Mechanical Permit Application � ]�'� FOR OFFICE. USE O,NI.,v
City of Tigard �� ` �.s� Dat e; y: r Permi r av e1 3
., Tigard, lt Plan Re (�O l l I O
d` n 13125 SW Hall Blvd O
Plan Review
Phone: 503.718.2439 Pox: 503.598.1960 Uthcr Permit: DatcBy:
T I G A R D lnspcction Line: 503.639.4175 JUL 1 6 2012 Q� 2 Date Ready/By; Lvh; ra Sec Page 2 for
Internet: www.tignrd- or.gov NotifiedMlethod: '11 SupplementalInfotmntinn
CITYOFTI ARn co 7
' , : m; F M .,' e , lit; < o y 4 . .r. r M. 4 t 1iVI _E sAi , SiL :;: 7 /9>iS tirrs�fl=?H
Mechanical permit f cs" arc based on the value of the work
❑ New construction ddition /alteration /rcplacomcnt performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; r, mechanical materials, equipment labor, overhead, and profit.
.. .1:., ii....,1 +7 %,,,,':� ;'�a �4,,cy4'ri '.TMy•o w Ciroikeliityk �y: 7�. r ��[#i r • ray{
Value: $ �
:.}�. 11,•,`' ..� .' . ,, - - Y.: 046. Lae,,. 'N7:104r w r a .rr ,� ,, . ' ,
:1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description [Qty. I Ea I Total
i ,x; 1, s i :, a ' Hcafi rnnii
z ,.i ,, e��sr -5 � =A` i --- ' ... - 1 1'f -�O -A ,[( NYI` '0 %•- ' '; Y "�/ nR:
���.Y.' .; ., . <.. ,. M .,� .. . :- ,,�..r.�;;�::�',o: <x >�`��?`` rte.: t. Air conditioning Job site address: 139 'a 4 5 u.) Lj 1 n�-� �c _ke 1 (rc ul= site plan showing nlneement) I 46.7 - 75
UL�u,�, ' - Furnace 100.000 BTU,(dnota /vents) 46.75
City /State/ZTP: --r a R - ' �-a,, Q
�� � - Furnace 100,000 +BTU (ducts/vents) 54.91
Suite/hldgJapt. no.: Project name: Heat pump
- r. (renaires 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 (fhel -type, not electric),
in -wall, in -duct, su ended, etc. _ 46,75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other; 23.32
Tax map /parcel no.: Other fuel appliances:
ri w . <'< , e,.. �,�3'�• Water heater 2332
� x' > S�'W i S: s.: �:' a' �k :i,i 4.d'3Y c-:,
1_�. h`�„ ..J..F ",r.%.W:�...✓, �l i 3�
Gas fireplace/insert 33.39
n S �' t l p1 Flue vent for water heat or gas
fneplacc 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
j.�y,�*;Ny 1, :,:!` -'>'� y , .� �„•p }f '� S 5 , ;,,,,� ,� ;,,.. r:• ,., Chimney /liner /flue/vent 23.32
L�t;Wr>xali d�. ia„ . tokt fwe °, M' M aws ".. i'r r ,�
"`` " x,. �,. °',". �,., _Other: 23.32
Name: _e 5 y urea d _ Environmental exhaust and ventilation:
Range hood /other kitchen
Address;
3q ay t ..) w 0.- 1 v.u.- -1- C -4 t.k-/a` equipment 33.39
City /State/ZIP: �` A_ t a & q •7 � a--3 " � Clothes dryer exhaust 33.39
- CS Single -duct exhaust (bathrooms,
Phone: (503)) 1) - O 4 C 'p Fax: ( ) toilet compartments, utility oo )_ 23.32
-.,, , Y4 ...,
.t 3 "d�4 .. . :: % , ` • ')�� ry i w AttIC/CImWI aCC fans
rooms)._
�., � r�� � �' 23.32
Y
• , Other. 23.32
Business name:
SUN GLOW, INC, -- Fuel pipingI
Contact name: 4fUN HEATING & AIR CONDITIONING $14.15 for first four, $4.03 Ow each additional
Address: 2428 SE 105th Avenue Furnace, etc.
4 m� Portland, Oregon 97216 - Gas heat pump
City/State/Z1P: (503) 2534789 FAX (503) 253 -7693
Wall/suspended/unit heater
_ -- _-
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
y � „. ��� Range
:f 9egwe?4�1»'r . 't .l mm b 'f _ r a y e; ,..: t > r . Barbecue
Business name: ` Clothes dryer (gas) -
SUN GLOW, INC. - Other:
Address: ItfUN HEATING & AIR CONDITIONING y y a rf
2428 SE 105th Avenue
City/State/7,1P: LOW Portland, Oregon 97216 - Subtotal , r
(503) 253.7789 FAX (503) 253.7693 - Minimum permit fee ($90.00)
(
Phone: Plan review (25% of permit fee)
CCB Ho.: (422_ I State surcharge (12% of permit fcc) i p .%0
TOTAL PERMIT FEE I OD. ''''Il
�i^ . -0� /� 0,s_.9.- This permit application expire Ira permit is not obtained within 180
Auth(n'i7ed signature: V V1 � 7�' drys after it has been accepted as complete.
Print name: (J r t 5- ,,,, l( Date: ' / / fp i z ] • Fee methodology set by Tri- Commty Building industry Service Board
t: u; uitdingTermiMMEC- POrtnitApp.doc ai /ny /12 440.441 (I trovCOMIWEBI
•
•
ItirrALLATION AtDR!i FSt ,
•
rnoptt'rk� xxrz .1,
` � blQ l�
...tsr , •
•
-_• ,
•
•
•
•
• r
•
?ROnan LIM •
_________12,rattIT),..-.„........---, TT R E EI: , . .
ti ,
f
•