Permit e
fr
I
a CITY OF TIGARD MECHANICAL PERMIT
''7 a' - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00282
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/11/2009
Parcel: 2S104BB09400
Jurisdiction: Tigard
Site address: 14191 SW WALNUT CREEK WAY
Subdivision: Lot: 0
Project: Hutchings
Project Description:
Owner: FEES
MATRIX DEVELOPMENT CORP Description Date Amount
12755 SW 69TH AVE #100 Air Conditioning or Heat Pump 06/11/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 06/11/2009 $8.70
PHONE Minimum Fee Adjustment - Mechanical 06/11/2009 $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 $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if nrk 's suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility cation Cente . hose 3 les are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100 You may obtain a copy of the rules
or ' ect questions to OUNC •i cal n. 33.246.6699 or 1 800 332 2344.
Issued By: K I / Permittee Sig •lure: I , / ��/
C all 503.639.4175 by 7:00 a.m. for an inspection that busi ss day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Mechanical Permit Application, rO1: (ii i lc l I ;i• (••,1 1
n
a�=
1 1 \J I � • � i ' 0 ' Rooelved
City of Tigard � ! - J, may Co It 27 Pmt No : 1 ,✓ # - 00.. .
M 13125 SW Hall Blvd., Tigard, Ott 9•7223 p' Review
P hone: 503.639.4171 Fax. 503.598. N 1 ¶¶ 2009 D uey Other Pennir
• )) )< 7 Inspection Line: 503.639.4175 U Da /B 1u FE Sec P. 2 for
Internet www.tigard.or.gov Notified/Method: t'a Supplemental Information
, .a•a,;.$ 7a, ._ :` •,n• •? Alt' v,, '
,!,.. : ..,S ''..4`i' `f7n A4, fr1 ,', 4! , zM P.•. S„ 1 ?lv+F.,7•trlg' ,
Li New construction v4 Addition/alteration/replacement Mechanical permit gees* arc based on the v of the work
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition 0 Other: mechanical materials. equipment, labor overhead, and profit. -
, C'` • .,•:,'� ' :; awc�, i .,, , , „ c ,; Value:$
k � '�;�.,�;�:� ' .. � �d�.'iY':,�' I : : �► M f : • :: L 1 h����� ,, , ' �' ��' .,.r. i l.. �,,. r ..,• ��
,'4 i and 2- family dwelling 1:1 Commercial/industrial El Accessory building �° l V. '-'°a T ,,
For special treormarron use checklist.
0 Multi- family ❑ Master builder 0 Other: :: (�}J��� Description Qty. Ea. Total
.. r, , -* . ; " , , : ') '1 1 A • , ■ 1 tn.:.•„ .,4 Heating/cooltng
� Air eonditiomng or heat pum
Job site address: w • t � • Z . Irea i es tee plan ehowingDIseement) 14.00 1
Ci /Statc/ZIP: Furnace 100,000 BTU (ducts/venu� 14.00
ry T Q 1 R -t Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no I Project name: On . %. 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 -duct. suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances —
jjys „ .rwa „;, a 1 „1,• a :� • A ,Y; , a Water heater 10,00
n �,�o,.?y,y_S /.Y. ��',�'r�� { • ✓'7,7 i� t, 1 ��" ;. ,+•,x..,\••d, Z"``,, `•�.'i,'�.'-h r. 10.00
'�+.� ,i • a'ri+YlC'rt!1rr41�::J!.'�;. re
Gas .IflCC fi
♦ 0, ��� �1�,i� L, `ia� Flue vent for water heater or gas
fireplace 10.00
Lo li ter (gas) 10.00 ,
W.... llet stove 10.00
Wood fir lace/inscrt 10.00
Chimney/liner /flue/vent 10.00
�p �;,;
�v3Aaa:uw�4..t4MEt'iida� • '� 'Fwd' A ; +wu.Yw'.0 l( .� 4 (�}��. 10.00
` I R� ' a t Environmental exhaust and ventilation
Range hood/other •
kitchen p
Address: L, • 0 ♦ r ( Jf J r . equipment 10.00
City/State/ZIP: - I i 0 q - 7 ' r]"-- Clothes erexhau 10-�
Singlo -duct exhaust (bathrooms,
Phone: ( S156 7 - 3. Fax: ( ) toilet compartments. utility rooms) , _ 6.80
l .'ter
' Attic%rawlspacc fans 10.00
Jii ,iailA.t� iris HEATING f•
`.;; ;,1. -:a.r. t,tw- s.=':k ), Oilier: 10.00
Business name: _ UN SEASONS Fuel pipin
• • a • - i a' ` a •' ' ' , 1 ' . $5.40 for first four; $1.00 for each additiona
Contact name: 1,1 ►,a Y1: • :a .4 •
NEWBER OR 97132 Fug,
Address: Gas hent_pump
City /State/ZiP: Wall/suspended/unit heater
Water heater
Phone: ( ) Fax: ; ( ) Fireplace
E -mail : f Ran
' Barbecue
a o v*w�
a 1 . 4 . .,. • -, Clothes dryeriges)
Business name: , , , ■ • e •,. t L ► L Other;
Address: 1005 INDUSTRIAL P °�'' ti^ �:,l+p'>liy4.'
Subtotal
City /State/Z1P: p �-� Minimum permit foe ($72.S0) . S
Phone: (,�) tt �� 4 � j e Q Fax: ( ) �t 3 — ( ( � `� Plan review (25% of permit fee) _
J� State surcharge (12%of permit fee) �p'? a
CCB lie.: — TOTAL PERMIT FEE $ I I. w5"
®� This permit application expires if a permit is not obta" within 180
Authorized signatu .--� l days after it has been accepted as complete.
\ Date , '-0 * Foe methodology set by Tri Building Industry Service Board
Print namc t h- �. t R
lA dinaW.dasuo2r- ranesppd 01/190/ , 44o-461-IT (tuo�iCOnt�vv6s)
170 0/1 0 IA XVJ 81.21 600Z/11/90
°
O '
. .
° A/C-BEAT YOWL—UNIT C SITE PL
• BACK OF PROPERTY LINE 4
. . vit.. 71 5.--"mme'..------(4j
• - "� ;
wg FEET TO SIDE PROPERTY LINE
1
a
_ FEET TO FRONT PROPER' TY LINE
•
,pp 1 6 . a .
X
� SITE P Fav�
co ‘ . Q3os`k p E A �►PP AN AIR � Dfrol rwe
•
O
N -
CO r i''
O