Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2009 -00240
Date Issued: 05/27/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S136CA02206
Jurisdiction: Tigard
Site address: 7945 SW THORN ST
Subdivision: Lot: 0
Project: Holman •
Project Description: Replace a /c. -
Owner: FEES
HOLMAN, JEFF & JACQUELINE Description Date Amount
7945 SW THORN ST Air Conditioning or Heat Pump 05/27/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 05/27/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/27/2009 $58.50
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503 - 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: •
Gas Pressue
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N cation Center. Th.: - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
•
Issu d By: ' �/ " J Permittee Signat .q
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic> CEIVED 1 >K 0I 1 i( 1 I 1 (1.1.1
�
City of Tigard Received
II tx0 /By: 5 - / ' Permit No.: ee, si „le o?. (3
_ 13125 SW Hall Blvd.. Tigard, OR 972MAY 2 6 2009 Th tteview
a Phone: 503.639.4171 Fax 503.598.1960 Date/By: Other Pamit'
1 ; , , : 1/ 1 . ) Inspection Line: 503.639.4175 CITY OF TIGARD Date /By: RI see Page 2 for
Internet: www.tigard- or.gov Notified/Method: PM Supplemeotallnformradon
BUILDING DIVISION
Kn
d.: �,. 1. faa,„ ^ ., > ..:,t9.
• :�..r :. ,�M� �. . il�
. .: .- ��i; k;• i° iS%?i'' �F�' ,�.'
•��{': r...
.i,$'KPIL ._ir�•,. . ;h�1J'�D'� i ��f.'"' ='[: .. .
" Mechanical permit fees* are based on the value of the wont
ID New construction 54ddition/altcration/replactment performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Othen mechwtical materials. equipment, labor, overhead, and profit.
ai•' ;a 'y
I and 2-family welling ❑ Co mmercial/industrial El Accessory bui "" ' ` `
..
Y For special Information use checklist.
❑ Multi -family ❑ Master builder ❑ Other: Description I Oty,. I Ea. I Total
;;....,, . i:.:.� , ::\ :.. : ,'' 4:ia ''' r:; `; "'nq0 {�q , F , al' ay e_ Heating/coaling
/',..
:� :.
p a � 7��# T i :i,Srt'.'•''��?fR9 � '
.. Y� eA1ti»t.� - ,. • , . w:laar .. - I
Job site address: S 39 v . $ Atr conditioning or heat pump
(regu sit Pl an ah nq 1 1taceme4.00
Ciry /StateJZiP:+ q a �. q '� .� 3 -
Furnace 100,000 BTU (d, 14.00
� ) Furnace 100.000+ BTU (duets/veers) 17.90
Suite/bldg./apt. no.: Project name: yti, Gas heat pump 14 .00
Cross street/directions to job site: Duct work 10.00 ,
. Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in-dus suspended. etc. 14.00
Subdivision: Flue/vent far any of above 6.80
Other: 10.00
Tax map /parcel no.: 1� Other fuel appliances
, h:R �.. -. • ' , : °.i ^ �r " ' 4 4 'n.'.. ",iis,.' Water he ter 10 00
i� ,r' is ; a c • ° : .. r.'. ,; f. r Gas fireplace 10.00
1 e.1 :'!`: ". :14r;'�'�' i. n..: 71 ,: : ` : :'.: ' i�:V , pp . A { ' .,_ J '.i{bii . ..A 1. T
t1 1 Y /r ( r a 1 ) l\ Qom- _ Flue vent for valet healer or gas
fireplace , 10.00 ,
Log lighter (gas) 10.00
' Wood/pellet stove _ 10.00 ,
Wood fireplace/insert 10.00
• rr Chimney/liner /flue/vent ' 10.00
''. :; +} �- `� -. r'�l�+,ia�a' ��'.,..a.i. .as. a % *.,v Other 10.00 •
Name: .( `.e_ 4.. , e 4 WI 6th Environmental exhaust and ventilation
As
t l) loth_ f Range hoodlothet latchcn
equipment _ 10.00
City/State/ZIP: 'l jQ p r O R q 3 )_ �. 3 Clothes dryer exhaust W 10.00
.b 0 - - toilet compartments, utility roo
Phone: ( 6.80
rooms)
..::,., t? ap i (,� Auidcrawlapace fans n 10.00
;., ' ::' . yr? ¢, Q , :- i;: " :_':£:. �; !�y': ;p .. : x ' ,. , . ' ' „ �@
,. �. r.. ;, ` -� lFiJ ... '?� � :.7..,„:.,.-_,
. :! r •� Fax: ( . . t
r;' , ;ir.. � .. � �'' >F lli'.Ir'F � �l3 • ... ,,. r'�
Other 10.00
Business name: E SF4SONS HEATING Fuel piping
Contact name: AND AIR C0NDrONIWO, INC. SMO for first four; S1.00 for each additional
Address: 1005 INDUS i HIAL f'KW Y Furnace etc. -
NEWBERR OR 97132 Gas heat pump
City/State/ZIP: wall/suspended/unit heater
Phone: ( ) 1 Fax :: ( ) Water heater - ,
Fireplace _
E -mail: Range
+'. . r .. ., i .. • ` ,, .,.: y� ty ? ,_ c , , �� r: i ;'. •':. . i7. Barbecue
�K.. '• J + (r7: S ,c, , e P . .,. , :. - • o { "M .... � , . '.. ' .,,? '- : 14,, ri; .::, 7 p-, _, : rr,ri : , ,
Business name: FOUR SEASONS HEATING --
AND A1H C I iuNl 'tan .,..'•y' 1., • `
Address: 1005 INDUSTRIAL-MN G .,.. s ., °`= c : : „ '
City/State/MR NEWBERG, OR 97132 Subtotal
- Minimum permit fcc (5 - , s O
Phone: ( ) 5-6G-1 5 Fax ( ) Plan review (25% of permit foe)
CCB lie.. State surcharge (l2% of penrnit fee) . _7 0
' TOTAL PERMIT FEE I,g_e) ,
. Authorized a'ignaturc: -.-- A- a
"-
'Ms t apyliesro aflsr application t h
h a e been a parro t a oct plate. wtmm 1so
gt w areaptad as complete.
Print tee: ` 1 •_ N' ,2 se e k V-- Date: . 5 - , _ ai , • Fee methodology set by VI-County Building fedua y Service Board
i.
L1 &Jtdlig4Pum; Paa e1/19ro7 1404e47rplroveobvWGat
C00 /C00E Kb'J 8Z :O1. 600Z /9Z /90
grkylitt At,. —u.rAie. ioutilasi :0:
•
A/C-HEAT PUMP—UNN SITE PLAN 4.....1.4, 2.
• .-.
FEE BACK ONOPERTY LINE Vd
44 1 M1 44 ‘ "11
,
1 _ S
1 4.....)
FEET TO SIDE PROPERTY LINE
1
P
/ I
IVO
- C)1 Ili
• FEET TO FRONT PROPERTY LINE So?
1 r ................ L tie.s....zga44. a .0.11ti0 404h4kki • • 2
ADP O
REPs:
PLEASE REFAX APPLICATIpN 1 FITH SITE PLAN
fa , E 2