Permit CITY OF TIGARD MECHANICAL PERMIT
•
COMMUNITY DEVELOPMENT Permit#: MEC2012 -00423
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012
T r (; A I?. -I�_ g Parcel: 2S114BA13000
Jurisdiction: Tigard
Site address: 16475 SW COPPER CREEK DR
Project: Budrow Subdivision: COPPER CREEK STAGE 3 Lot: 95
Project Description: Funace replacement
Contractor: PYRAMID HEATING & COOLING Owner: BUDROW, NANCY E LIVING TRUST
9409 NE COLFAX BY BUDROW, NANCY E TR
PORTLAND, OR 97220 9770 SW RIVERWOOD LN
TIGARD, OR 97224
PHONE: 503 - 786 -9522 PHONE:
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 08/14/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/14/2012 $10.80 -
Class of Work: ALT Type of Const: VB Minimum Fee Adjustment - Mechanical 08/14/2012 $43.25
Occupancy Grp: R -3
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure: High
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: ifkAV Permittee Signature: GA A p I, _A T.2 �✓
t_Sc�
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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08/13/2012 MON 8:39 FAX 503 786 3432 PYRAMID DATING Z001/002
Mechanical Permit Applica E /E- FOR 01• ;CE USE ONLY
City of Tigard � . �J VV 11�� Received � ^ � I 04 Pent No.: , L xt1 -oo ti a.
i11A1 G ° 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 1 ) 2012 Date/By: Other Permit:
T I G A R Inspection Line: 503.639.4175 Date Ready /By: Jura: 0 See Page 2 for
Internet: www.tigard- or.gov CITYOFTIGARD Notified/Method: Supplemental Information
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k ` ` d �` - Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Othhe mechanical materials, equipment, labor, overhead, and profit.
r a;; s5 - "'- --:b .,<a~...,,k.�:,� _t r . F x� :_.:..:rm y:r.:l2;- Value: $
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mr �:- - =-- -' °."- ` -'---_ lac•, !� m • ���.a,,
® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Fa. I Total
�� 4 %!�� '„r- `'�"1 i;� am.:mau 4 .s "' Heating/eoolinR:
._ ;= ,5`a.:., - - .: ,..,. _,,;, .. _ �- _ _ �k � Air wnditioning
Jo site address: 16475 SW COPPER CREEK (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
City/ State/ZIP: TIGARD OR 97224 Furnace 100,000+ BTU (ducts/vents) 54:91
Suite/bldgJapt. no.: I Project name: Heat pump
(requires site 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 no.: Flue/vent for any of above 23.32 _
Other. 23.32
Tax map /parcel no.: Other fuel appliances:
- %. __ _ _ _ _.0)I VY )RIf T : m �' In •_ _. -�� Water heater 2332
:: � hCt N¢= R�cc= ^ = f�Y�4 ��6' x'� ^...s; ^ti^� '- :_.. -� ... =^ �tAn .1:i�Inln,ivlYi..,•.�.R�JSAh •�.rM1�1- ?tr_. T,.���-
INSTALL OF FURNACE z Gas fireplace/insert • 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
_= y �" ^,_�-- lie, s_c -� ' •,� a •a Chimney/liner/flue/vent 23.32
i, s ERT1"UR' E F .... • , _ - . g g- ; ,* , a a :�:„rt
j ' ' a: " " "° s °' Other: 23.32
Name: MAINLANDER PROPERTY MANAGEMENT Environmental exhaust and ventilation:
Address: 16475 SW COPPER CREEK Range hood/other kitchen
equipment 33.39
City /State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Phone: (503)635 -4477 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
� �, gl",•' - _ - .0 41 A w .0 �,� ' ' Att;c/c aw ce fans 2332
'1- -.. i=. _ r. -C r j` .: .F..x:w Q ' ,, � � 'A T
Business name: Pyramid Heating & Cooling Other. 23.32 Fuel piping:
Contact name: NE St. $14.15 for first four; $4.03 for each additional
Portlortl OR 07 and, OR 07220 Furnace, etc. Address: F .
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Phone: (503) 786 -9522 I Fax: : (503) 786 -3432 Water heater
Fireplace
E -mail: LMILLER @PYRAMIDHEATING.COM _ Range
'r :?_ac:ee. - �.aei��'a'a��i' : �� R[3, - 'C6'* �l� jti��,� `��,ti,! t ,•y �� Barbecue
Business name: 9409 NE Colfax St. Clothes dryer (gas)
Address: Pvttlatld, OK y/0 Other
0 V .x4.': 5'': er( 7 L .3..?I ••= Rit
City/State/ZIP: • Subtotal M 46.75
Minimum permit fee (590.00) 90.00
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 59382 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signatu " A1♦�/ I 0 / This permit application expires If a permit is not obtained within l80
/� ll, �J `V`� days after It has been accepted as complete.
E=Ir LMJM Date: 08/06/2012 $ Fee methodology set by Tri -County Building Industry Service Board
LlBuildiag \PamitsUMEC ' amitApp.doc 03/07/12 440.4617T(I1/02/COM/WEB)