Permit p CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00561
T IG'ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/29/2012
Parcel: 25111 CC11600
Jurisdiction: Tigard
Site address: 10465 SW HIGHLAND DR
Project: Westland Subdivision: SUMMERFIELD NO.4 Lot: 167
Project Description: (1) furnace installation and (1) A/C installation. Run gas line to fireplace. NC must maintain 5' side yard setback
and approved rear yard setback.
Contractor: PYRAMID HEATING & COOLING Owner: WESTLUND, BEVERLEY
9409 NE COLFAX 10465 SW HIGHLAND DR
PORTLAND, OR 97220 TIGARD, OR 97224
PHONE: 503 - 786 -9522 PHONE: 971- 228 -8020
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Air Conditioning 10/29/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 10/29/2012 $46.75
Class of Work: ALT Type of Const: Fuel Piping 10/29/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 10/29/2012 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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: q,� PermitteeSignature: DM A f /y tre4jJO).
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
10/26/2012 FRI 9:25 FA CEIVEI)MID HEATING a 002/003
Mechanical Permit APPWIttoill29 2012 FOR OFFICE USE ONL1'
City of Tigard Date/By: I p e. Permit No. E , . �s(p4
13125 SW Hall Blvd., Tigard, O
I � ' T Received Plan Review I
Phone: 503.7182439 Fax: 503. MI Date/By: Other Permit:
T I GA RD Inspection Line: 503.639.4175BU
I G Date Ready /By: ii211 RI See Page 2 for
Internet: www.tigatd or.gov Notified/Method: Supplemental Information
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"" " M permit fees* are based o t he 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.
Value: S
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1 - and 2-family dwelling ® y g ❑Commercial /industrial 0 Accessory building For special information use cherkllst
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
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' !�= `�:� -"�.. - Air conditioning
lob site address: 10465 SW HIGHLAND DR (requires site plan showing placement) 1 46.75 46.75
Furnace 100,000 BTU ( ducts/vents) 1 46.75 46.75 •
City/ State/ZIP: PORTLAND OR 97224
Furnace 100,000+ BTU (ducts/vents) 54.91
•
Suite/bldg. /apt. no.: Project name: 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.: rn �y�y y�� �( Other fuel appliances:
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r INSTALL OF FURNACE AND A/C & RUN GAS LINE TO FIREPLACE Sreplace/inseheater ri 23.32
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
_ see• . P . '.-_ 4L- rl i :'40::,.V,�ar, rar __ 5 Chimney/liner /flue/vent 2332
, � - �.. ,: „- .,, -; . „.,;L_ ,.;;ar Other. 23.32
Name: BEVERLEY WESTLUND Environmental exhaust and ventilation:
Address: 10465 SW HIGHLAND DR Range hood/other kitchen
equipment 33.39
City/State/ZIP: PORTLAND OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (971)228 -8020 Fax: ( ) toilet compartments, utility rooms) 23.32
., L=ye::: � ate , �•�
.7j, �"�"_ � i = '�' `` AY� iIt �9 I37'1 - ` . �. -'- 3 �;] <CO�I;��CNCT p��R5�fi!h? Attic%rawlspace faros 2332
Business name: PYRAMID HEATING AND COOLING Other: 23.32
Fuel piping:
Contact name: LISA MILLER $14.15 for first four; $4.03 for each additional
Address: 9409 NE COLFAX Furnace, etc. I 14.15 14.15 14'1 'Ir
Gas heat pump
City / State/ZIP: PORTLAND OR 97220 WalUsuspended/unit heater
Phone: (503) 786 -9522 Fax: : (503) 786 -3432 Water heater -
Fireplace
E -mail: LMILLER@PYRAMIDHEATING.COM
Range _
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=; t7'?�d_t :FiL!rF4r>r =IA ksFy (( .��. t (( ��w7,•, {y � ► 1.,, n 4- gle T� - : 2 w:1 Barbecue
FZ •,?, • h • 11 " “t0Ni 1:1,4".4Yd -, -.. - ,r?''' - •' {I^'i- .• .°'. S' ?t�� Y .
Business name: SAME AS ABOVE Clothes dryer (gas)
Other: _
Address: r (ILIA , `4��f'M'' Hargett nn =a1 G /f /�
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City/State/ZIP: Subtotal 121.80 q 3. `
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 59382 State surcharge (12% of permit fee) 14.62 - I ,2„ ( er
TOTAL PERMIT FEE 136.42
Authorized stria ^, This permit application expires if a permit is not obtained within 180
W days after it has been accepted as complete.
Print name: \.,k 4 k ` I Date: 10/26/2012 • Fee methodology set by Tri -County Building Industry Service Board
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