Permit CITY OF TIGARD MECHANICAL PERMIT
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° , COMMUNITY DEVELOPMENT Permit #: MEC2009 -00177
T t GARO 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/23/2009
Parcel: 1 S133DB11600
Jurisdiction: Tigard
Site address: 11362 SW SYCAMORE PL
Subdivision: Lot: 0
Project: Lamb
Project Description: Install heat pump.
Owner: FEES
LAMB, PHILIP E & EVELYN C Description Date Amount
11362 SW SYCAMORE PL Air Conditioning or Heat Pump 04/23 /2009 $14.00
TIGARD, OR 97223 12% State Surcharge;- Mechanical 04 /23/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 04 /23/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 538 -2953
FAX: 503 - 691 -8556
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
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 -0100. You may obtain a copy of the rules
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Issued By: Permittee Signature: V Q 0
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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.
' 04/21/2009 10:48 503 - 691 -8556 OREGON HEATING PAGE 01/03
Mechanical Permit Applicati 0, II CE D FOR OF ICE USE ONLY
City of Tigard Datd Z • CO ■ I I �.
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I i 131 SW Hall Blvd, Tigard, 13125 OR 97223 -�fiAt q 7 p� -
Phone: 503.639.4171 Fax 503.598.19f fit l P R M 1 2009 Date/By: Other Permit
f [GAF D Inspection Line: 503.639 pT1 pate Ready/By: 9J See page 2 for
Internet �ww.tigard- or.gov CITY I l 1 OF TIGARD Notifed/Method: supplemental Tnforcaaaou
G DIVISION
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p J t l , j � �, 1 r, ,, ' xua v ^; e� t ll� ' T i t m 1{ P' 9 r7. tip If:jJLtnfP^�:Pytt@' 7 1 t'., 9I �`�19 Q.1 R (. l
0 New construction 1;t Addition /alteration/replacement Mechanical Pert fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
�, ❑ Demolition
�j�@ ❑ Other: mechanical materials, equipment, labor, overhead, and profit
1: 1.RilYl!)1faAi<I it l.IlUfl lI e tt: inTi, g R ; n 34D a .. t ., i ;I ' `r h; h t • # Value: S , r
��'I�i l�.,i.��, � '!9.R A •i: r ;�,, a Lµ�13uL ,Iy t� feu_a,��fU,rtU{, �Vt•
{m 1 - and 2- fancily dwelling 0 Commercial /industrial 0 Accessory building
L' 121 at9t a F INAt „`VFfTT'J>u'4�ii:i'{bt '�-,�ru. '.'L , tiiadu�m2,11 ill
For special information we checklist.
o Multi-family 0 Master builder' ❑ Other: Description I Qty. I Ea. Total
Mi r�((`11gft eu� v. to3, �} rr{t� 0,.. �p {•r}� y 1
�ti Iwit� �L 11 I , F. • 9 t�y i x e ; ,:' `z�`l,.tt *.pn1i!nt totln�wY . A I filli l k� R , ttE tleatlngirnolinat
Air conditioning or heat pump
Job site address: ii 4 : _ f1YY1 showing site plan show placement) 14.W y .co
City /State/ZIP: 1 lb • • i • Furnace 100,000 BTU (ducts/vents) 14.00
Strite/bldgJapt. no.; Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump . 14.00
Cross street/directions to job site: Duct work 10.00
1J ydrvnic hot water_„ys stem I4.00
• Residential boiler (radiator or
hydronic)' 14.00
• Unit heaters (fuel-type, not electric),
in - wall , in - the su
e, spended, c4:. 14.00
Subdivision: l Lot no.: Flue/vent for any of above 6.80 _
Other. 10.00
Tax map/parcel no.: Other fuel appliances
•
7 t ft' 1! !.+ i1 .. i l i t y , u! J' rpt u} ?p rt�ul t rt • aylur ti l� !E''� !f' 'f , il Water heater _ 10.00
}fa t i 9! l pp{ � i i , � d r t. t,Y t+{,�q�y t.�a l�glq f 1 `� � i�I ( �j alb. �
ell, {I� i�� y 1 4x14 1,t #I +t frltfL illlfl Rr ?6i{f7:t17 l: �f`ti l'1111g�h SII /V .t ii'rlli ti. �n�7 L; 7im�.I !r��u) -K I .� W l�.
Gas fireplace 10.00
'it a 4 % il, u >. Flue •vent for water heater or gas
. $U�e lace 10.00 Log lighter (gas) - 10.00 I
Wood/pellet stove 10.00 -
Wood fireplace/insert 10.00
. t , �� � t� a r $'� t �,,ur�t, r ,s r [� Chi�Cy/linef/flue/vcnt 10.00
il_jl. '* �� tTF Ij ; �tia )' , ti i? rill �i + �j j(I + : 5 W:lil;t JJ i r . A NEral .0 r gril i t{J�1 � I ,F
! m ..k..l tr.. mw ulu •� hui�a t: :sin; 11U t I i } • !t i 'i i! 1 iu� ,t rs rtcx _IJ ! !.- 1 Other 10.00
Name: ® b i ►i • • Environmental exhaust and ventilation
Address: L Range hood/otherlitchen
.t e ,. .. I. b M 0 . equipment 10.00
City/State/ZIP: 'yl a a:"3 '\c)a A Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, •
Phone: ( i ', . --1 9 - q' . Fax: ( ) • toilet cuuguirtments, utility rooms) 6.80 .
R t' ,: t' t ny;vr t�� ,. F }Y: 7 . Y Y { . tlt:lt' i ill!f l Attic /craw1S ace fans 10.00
�. �...d t a �[ x ut ' ! rj � t •., � -
�����ii�y(l�;ii� �tl�1i�1.''r�!;,5�! �;t ;:f���!!i.l#�� i�u11, !. � �!'�'i�u +,�!��,�n.�,;�.� ..itt.,.d:�..���c ` ,��!���[�.i
. • Other 10.00
Businras name: fb ii , . r ,- b -.,. 1 aist 1. C.- Fuel piping,
Contact name; 'Ra ei 11 . S5.40 for first four; $1.00 for each additional
Address: ' x a,i I Furnace, etc.
Gas heat pump
City/State/ZIP: [� t ,,o,p (11 I 1 5 Wall/suspended/unit beater ,
Phone: (5 j3) � • 1 _ . 1 Ci w Fax :: -r) f t „ e- • Water heater
Fireplace • -
E -mail: Re
!t i •' ItJ Iflf!t,Yl t� t li'L 'bit.' ;lid i1ca ctMiih�a<�?:{liti 1's It k�ESlt� '.Vii tpl ;tlil u. 2 Fri} f ai Barbecue
Business name: C)r G �r� � � 1 c KC_ Ot Clothes dTycr (use)
rr�� ff ' b�er; �1 „n,
Address: t1rif 1 ati1;)'?rt�111 net¢ r itt0>f5 }fir ii :1 i ,'il:� ', "iS�
City /State/VIP: Puri to P_ cn,1 Subtotal _ .l .. d0 _ r � Q Minimum permit fee (572.50)
Phone: (50'31 .• 1 - q 6• • Fax: (50Z) 'C� _ 1 i. S5 0 Plan ri:view (25% of permit fee)
CCB lie.: f a\ a 4 State surcharge (12% of permit fee) g , .7e,
TOTAL PERMIT FEE 81, 1 - �o .
Authorized signature: P I This permit application expires If a permit 1s not obtained within la
. ti. y...� _ r days after it bee been accepted as complete_
Print name: '-�s a ' i„. ,.'
„ Date: ` _ a s " fee methodology set by To-county Building Industry Service Board
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