Permit •
CITY OF TIGARD MECHANICAL PERMIT
. •
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00430
• 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2012
T [GAP. I� 9 Parcel: 1 S133CD00700
Jurisdiction: Tigard
Site address: 11736 SW SWENDON LP
Project: Baker Subdivision: COTSWALD MEADOWS Lot: 5
Project Description: New heat pump. Three foot setback to outside unit required.
Contractor: SUN GLOW INC Owner: BAKER, CLARENCE H & KATHLEEN M
2428 SE 105TH 11736 SW SWENDON LOOP
PORTLAND, OR 97216 TIGARD, OR 97223
PHONE: 503 - 253 -7789 PHONE:
FAX: 503 - 253 -7693
FEES
Specifics: Description Date Amount
Heat Pump 08/16/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 08/16/2012 $10.80
Class of Work: ALT Type of Const: VB Minimum Fee Adjustment - Mechanical 08/16/2012 $28.94
Occupancy Grp: R -3
Stories:
Fuel
Fuel Types: Electricity
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: IA Permittee Signature: 561 Aut, sC./�T.�
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 'r' CJw
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 A licati
1 .012 OFFICE:. USL O
Resolved p No./1h. - 1 a, Q
II City of Tigard e A.J - 16 -1'Z
d 13125 SW Hall Blvd., Tigard, OR 97223 P lan Rovicw
o .. AU 15 2012 — other Permit:
Phone: 503.718.2439 Fax: 503.598,1960 DntoBy:
Inspection Linc: 503.639,4175 Date Ready/By: rung: la See Pap a for
1' I G A R D Internet; www.tigard- or.gov CPf Y OFTIGARD Notified/Method: Supplemental information
N
$[ DINGDMSIO - • �• 't�a'��'�����:��' '••o%• � .... .
;�-a. , ;.,,.. a,,, , ?'^ ,• 7 ,, . sA .', - � a'a • : :"-"""- .'' r. : rr Mechanic'! pc
ermit fees* arc based on t • - s�,'/�:i:b.�ra «., .. . • '' . ' ; : � � as he value of the work
❑ New constructionlkddition /allteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, ettuipment, labor. overhead, and profit,
❑ Demolition value: $ �,�}
'S^' c "� R V 3w • ' Ir v f% _ 41 • _7 ., '. 1 / ` N.4 . o.,l
1- and 2-family dwelling ID Commercial/industrial f orspedal Information use dreckllst ❑ Accessory building Description I I Ea. Total
❑ Multi - family ❑ Master builder ❑ Other: _ _ Din :
,,�... ,� ; f 3 ^+ wK g' Ilt:atin' Cott
�z � r l is a (� i t dl � 1 [V • fx�' Ai cite I ng
Job site address: howin i •lace
ss: 5 (.J re•uir
( � es
_ 1 �n �,r' Furnace 100.000 BTU (ducat/vents) 46.75
City /State/ZIP: —r 6„ ! 0 R q 1 a-3 3 Furnace 1 00,000.1 WFU (ducts/vents 54.91
Suite/bldg. /apt. no.: Project name: Heat pump — • ekes site Ian showin : .laccment 11111 61.06 t t•
Cross stir-et/directions work 23.32 to job site: — 23.32
Hydronic hot water system
Residential boiler (radiator or
Itydronic) 23.32
— Unit heaters (fuel -type, not electric).
in-wall : in-duct sus ended. ate, 46.75
Lot no.: Flue/vent for any of above 23.32
Subdivision: - — Other: 23.32
- - Tax map /parcel no.: _ Other fuel a' .lianccs:
aA �° > . ,' iffel ,' ek iV'7 zA • , e m's.;�- " ". 9 L � Water heater 2332
:: `'ki ;'Ma ,.. F.,f i' V • ; . ; - ifr :' :. 4 .V1614.• Gas fire, lace/insert 33,39
...r c (� t .� r,�..f� Flue vent for water heater or gas
�• •+�` = fireplace 23.32
as 23.32
I,�g tigtfter (E
Wood/ Ilet stove 33.39
Wood ti lace/insert — 23,32
,_ .,. „,. ChimneyAincr/flue/vent 23.32
cr 2a m 4+. .' .. r.e— ,•. •. . f'.
r _.,•' s • a ' t••..ilu .; ,� 23,32
v�� : L,�,' ,� ..,•'....:•• �,. .,, Other;
Name: e�yji„/ Environmental exhaust and ventilation:
Range hood/other kitchen
Address: I, l 5 1d.) S t , f. l • e ui.men! 33,39
r� Clothes d cr exhaust � 33.39
City/Stete/7.1P: - � , & ...4 ___C/a_____ "I ��' Singlc-duct exhaust (bathrooms,
Phone: (.503 ) ,s a� 3 a,-7 Fax: ( ) toilet cotn•artments. utili rooms 23.32
« _ M - ~ ,,,, .�`�'x ' as •.i, + , : _ At /cr'iwl pace fans 23.32
.� , � � �
e ` 3 ° ..k' A ' ?'d I� '�r as r : � ;: �" h: m .. ... �I • t 23,32
.. 'rr... Oth er
Business name: SUN GLOW, INC. Fuel piping:
Contact name: UN HEATING & AIR CONDITIONING _ S14.15 for first four; 54.03 for each additional
2428 SE 105th Avenue
_Furnace, etc.
Address: �' Portland, Oregon 97216 C is heat • um.
City/State/ZIP: (503) 253.7789 FAX (503) 253-7693 Wall /sus • nded/untt heater MI
Phone: ( ) Fax: : ( )
Water heater �
Fi lace
E -mail: C.h r 1 S 10 a 6 w .+ • Co Rune
{ !�i '. . , 1 jt , °„ hit AV.?. : 727,:',•.:,', ; Barbecue < , a s ..
sz`a"`'=;�.. ." k` ��i�s "a�'�j;���6 "»��a�+ `' �+".� • s�'; ' p :�,��h� .f,. . , ,:
_ _ —. - • - -. Clothes d r _
Business name SUN GLOW INC. Other: y�,yy;�'ii�d� .. �,,.,
Address: � HEATING & AIR CONDITIONING ;•; w �,, >.�.�,;.. •� ti . ,. <S __ x+" .
2428 SE 105th Avenue Subtotal b ,. S
City/State/ZiP LC 1T Portend, Oregon 97216 Minimum permit fcc ($90.00) Gj .413 Phone: ( V (503) 253.7789 FAX (503) 253-7693 Plan review (25% of permit fee)
CCB lie.: State surcharge (12% of permit fee) /0 , $ O
�J 1 TOTAL PERMIT FEE / 00 . 'SO
- This permit application expires if a permit is not obtained within 1R0
Authorized signahrrc: = t~� days after it has teen accepted as complete.
t � a J s ' 1 2. = ► roc methodology set by Tel-County Building Industry Service Board
Print name: � s t gQ 1 ( Date: O
I:1 au11AinglPmmitFlMF .C.PcrmitApp 07/07112
440.46171' (I1/02/COMnWSl)
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