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Permit CITY OF TIGARD MECHANICAL PERMIT a' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00448 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012 Parcel: 2S109DAl2500 Jurisdiction: Tigard Site address: 12969 SW KOSTEL LN Project: Shinde Subdivision: SUMMIT RIDGE NO.2 Lot: 114 Project Description: (1) A/C installation 4 ton Must maintain 5' side yard setback and approved rear yard setback Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: SHINDE, HARSHAVARDHAN C 1637 SE NEHALEM ST 12969 SW KOSTEL LN PORTLAND, OR 97202 TIGARD, OR 97224 PHONE: 503 - 235 -9083 PHONE: 503 - 793 -2688 FAX: 503 - 235 -0454 FEES Specifics: Description Date Amount Air Conditioning 08/27/2012 $46.75 Type of Use: SF • 12% State Surcharge - Mechanical 08/27/2012 $10.80 Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/27/2012 $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. Issued By: Permittee Signature: 01 ' /1 ' c-1 i c!44 T7CL l Call 503.639.4175 by 7:00 a.m. for the next available inspection date. �1 P/ `-r"� ! C/ L 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. From:5032350454 08/27/2012 12:08 #116 P.002/003 Mechanical Permit Applicatio I � I Y E i FOR OFFICE USE ONLY Received ^,� City SW Tigard Data By: g a- o- s� Permit No geed/ /�eb • Ili 13125 SW Hall Blvd., Tigard, OR 97223 AUG 2 7 201 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: inspection Line: 503.639.4175 Data BI T I G A R P MAR CITY OF AR � Date Ready /By: turis: 65 See Page 2 for Internet: www.tigard nn Cr DIM otified/Method: / Supplemental Information BUILDNG V ltd • • Ste/ _ .:^ - yb' " >.'£ �- re :_ � - - 2ssri- - :-a�': . �3 y., � _ 'ate_ • --�; : *.r - _ .. '.`_ ;. 1 1, � �? _ - .e Srait, _,.;�., - '0 -,Y 3`C -- R1C''f15,YtJZ:I� -- - :5� - =a J,y _� -'��'.,��'r;S;.��, v� %yE *��. .r:.�. -.d. �: v "� "._ `�'3 - '.a Y�7� x��.j� •r��. Ca: �'4i. >: err, �+, ` �r s:> :'!.'; t�,` �"::,"'-' i.-.= . =?.�Y +.YZ %�,� ,, a?r- w✓ +.�. �- :+- >.t:za ? ?i�:i H ^s-' ,�.s -Yip_ 4u`�'Y3°.-e"�+ '. 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit - Utift �. :'fix _ yam .+ " �_. Value: $ .�� gilt t..fi 3 : ,L , RrO n�..4'_5 - -' ,,-; . -. ryil`ia %,,,f V ic q r i' rISEM. ® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For spedal information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea- I Total Lei'` `� y ' - . ;,1404 JB.,:S L 17 -,e_ -:r a - p' ' i44- 37 - #6" Air conditioning �, -,.. _ �, �,zs -- =- <�.a A - �.?a'a+ fl�ir^d =.:.�rfi Air conditioning g Job site address: 12969 SW KOSTEL LN. (requires site plan allowing placement) 1 46.75 46.75 City.rState/ZIP: TIGARD, OR 97224 -6124 Furnace 100,000 BTU (ducu`vents) 46.75 Furnace 100,000+ BTU (ducisivents) 54.91 Suite /bldg. /apt. no.: I Project name: SHINDE 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: Lot no.: Flue /vent for any of above 23.32 Other. _ 23.32 _ Tax map /parcel no.: Other fuel appliances: 5- fra ::,-_- f .4 P rA3 Water heater 23.32 �� s-, „ = �� w,"=�: �u �?��,;�, � � '.�° r�x ^. � :;,� � 3yi:�. _'tea.. .;�• ��„ aF?�- ,w�� _ �v;��"= ��=:y INSTALL 4 TON AIR CONDITIONER. Gas fireplace 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 Fz. " : e - 1 ^ = T: `r�r4 ` =�- ,' y , „ 4p; *__,'; 1? r. Chimney/liner'flue%vent 2332 Other: 23.32 Name: HARSHA SHINDE Environmental exhaust and ventilation: Address: 12969 SW KOSTEL LN. Range hood'other kitchen equipment 33.39 City /State/ZIP: TIGARD, OR 97224 -6124 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (503)793 -2688 Fax: ( ) toilet compartments, utility rooms) 23.32 • C' 3 23 *1-� - 1 @ rt Attic %Fawns ace fans 23.32 Business name: SKY HEATING & AC, INC. Other: 23.32 Fuel piping: Contact name: TAMI HAGEMAN $14.15 for first four; $4.03 for each additional Address: 1635 SE NEHALEM ST Furnace, etc. Gas heat pump City /State/ZIP: PORTLAND, OR 97202 Wall/suspended/unit heater Phone: (503) 235 -9083 I Fax: : (503) 235 -0454 Water heater Fireplace E -mail: TAMI@SKYHEATING.COM __ x s Range '^. - �. > >r �,':As- '�'�: -.:t "` � rl' - -r s�'�,.n'�� wx?.-'.�. �:�^�'.,�ox','s,o-m'r ':-��, ��a.� ✓;: �,.'r ,.,� � =r a��.-!l?'��i�� _ rr''% h� , �- 3�, -,'. a� >�' "sf� Barbecue Business name: SKY HEATING & AC, INC. Clothes dryer (gas) Other. Address: 1635 SE NEHALEM ST = ir, ,: � _ City/State/ZIP: PORTLAND, OR 97202 Subtotal 46.75 Minimum permit fee ($90.00) 90.00 Phone: (503) 235 -9083 Fax: (503) 235 -0454 Plan review (25% of permit fee) CCB lic.: 50244 State surcharge (12% of petnit fee) 10.80 TOTAL PERMIT FEE 100.80 This permit application expires If a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: TAMI HAGEMAN Date: 8/27/12 I • Fee methodology set by Tri- County Building Industry Service Board I: Building ■Perrniu,MEC- PermitApp.doc 0909110 440- 461T1' (1 I,0LCOM,WEB) From:5032350454 08127/2012 12:08 #116 P.003/003 l A CITY OF TIGARD MECHANICAL PERMIT a' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00448 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012 Parcel: 2S109DAl2500 Jurisdiction: Tigard Site address: 12969 SW KOSTEL LN Project: Shinde Subdivision: SUMMIT RIDGE NO.2 Lot: 114 Project Description: (1) A/C installation 4 ton Must maintain 5' side yard setback and approved rear yard setback Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: SHINDE, HARSHAVARDHAN C 1637 SE NEHALEM ST 12969 SW KOSTEL LN PORTLAND, OR 97202 TIGARD, OR 97224 PHONE: 503 - 235 -9083 PHONE: 503 - 793 -2688 FAX: 503 - 235 -0454 FEES Specifics: Description Date Amount Air Conditioning 08/27/2012 $46.75 Type of Use: SF • 12% State Surcharge - Mechanical 08/27/2012 $10.80 Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/27/2012 $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. Issued By: Permittee Signature: 01 ' /1 ' c-1 i c!44 T7CL l Call 503.639.4175 by 7:00 a.m. for the next available inspection date. �1 P/ `-r"� ! C/ L 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.