Permit •
' IL CITY OF TIGARD MECHANICAL PERMIT
`• :` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00278
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 06/11/2009
Parcel: 1 S133DD02800
Jurisdiction: Tigard
Site address: � 12910•SW- WINTER_LA- KE,DR -�
Subdivision: Lot: 0
Project: McCarthy
Project Description: Replace furnace and install heat pump. •
Owner: FEES .
MCCARTHY, JUSTIN C & MICHELE M Description , Date Amount
12910 SW WINTERLAKE DR
TIGARD, OR 97223 • Air Conditioning or Heat Pump 06/11/2009 $14 00
Furnaces < 100K BTU 06/11/2009 $14 00
PHONE. 12% State Surcharge - Mechanical 06/11/2009 $8 70
Minimum Fee Adjustment - Mechanical 06/11/2009 $44.50
Contractor:
AIR PRIDE, INC.
18603 WILLAMETTE DR
WEST LINN, OR 97068
PHONE: 503 -655 -0556
FAX: 503 - 655 -0534
Type of Use:
Class of Work: 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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: li1(� l V JJJ Permittee Signature: Q
A
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.
J a • Mechanical Permit Application
1. , ? 1(Ulti∎W elf• - < , ,
- City of Tigard �' RECEIVED _ A permit No. a a I _ P eAA , CAI" I g
i lhi
13125 5W hall Blvd_ Tigard. OR 97_ 1 Plan Review IA_
Phone. 503 639.4171 Fax 503.5981960 Other Patna: et u.uenry•.
.1.1G A it.tj Inspection Line' 503 639.4175 JUN 0 2009 uarc Itcady /Ky: See Pate 2 for
Internet: www.tigard- or.gov Notified/method: k m Suppkmen(l lnfurmutioo
CITY OF TIGARD
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Mech mtall permit fees" arch based on the value of the work
❑ New construction ® Addilion/alieration /rcplacmcnu
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition I: Other: mechanical materials, equipment, labor, overhead, and profit.
il "�� If��' '� it�I !l 1 l,�' l i' -'n °�' ; �- .m,_,,.,.,..
.... �c I:l,i;:dl5G! ,��'Jg 1 + ! Value: $
i i y� ,..1i1 ' , t0Ott b (�}!1; ritt to I I 4 , .n..
® 1 - and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building
For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
1 Description I Oty. I pa. I 'Inuit
r1 ' 1 !.alt kll'I<JOB1s>�'r_ `, 9 ^ : r , 0QNJp ` I D, . ,, . 0,.f. 1ui r ^ . 1 Hcatin cnnlinR
Job site address: 12910 SW Wintcriakc Dr. Air conditioning or heat pump
(require, silo plan •.hrnvmg pitccmem) 1 14.00 14.1111
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 14.00 , _1_4.00
Furnace 100,000t BTU (ducts/vents) 17.90
Suitc/bldg. /apt. no,' t Project name: (ias heat pump 14.00
('ins ntrect/directionS to job site, Duct work 10,00
---- ---- ..---- _--•-- - -- .. -. --- H drnnichntwatcra stem I4.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in-wall �in- tluci,uy+ended etc. 14.00
- - - - -- ....- - --
Subdivision: I Lot no Floc/vent for any at above 6
10,Iq)
yTaxx map /parcel no.: 1 Other fuel appliances _
'I�yal' } ' n `` 1 y _ i , l .' OR . � .I > � � � , , t ',Q ' i i;, l' AIL J�' (G • 1 " �i. . !'�_ z aL�li rt ; iI h
/ catc --- 111.00
d r_,
Ga.s fireplace___ 111.1)1)
_. flue vent for water heater or gas
Replacing Furnace, adding Heat Pump Laplace _ 10.00
_ .. - --•• - -- - - -- -- -- - . ..- Log lighter (gay) 10.(10
Wood /pellet stove 1000
Wood fireplace /Insert 10.00
'_� ". " -4- I A t 1' t'' 1 rs �, 1 v Chimney /liner /flue /vent 10 00
'; • t >n '.RL '.T ' tiv , a4 .: 0 io i
: )+ ,18 l §r I`) ' .. '� I�I ea�� P '1 ABE
l Other: 10.00
Name: Justin Mccarthy Environmental exhaust and vcn_ntiun
til
Address: 12910 SW Wiatcrlakc Dr. R an ge hood/n
ood / kitc �'
equipment 1001
City /State /ZIP: Tigard, OR 97223 Clothes r'cr exhaust 10110 _-
-- - -- - - - - - - -- Single -duct exhaust (bathrooms,
Phone: (503)579.8110 Fax: ( ) toilet compartments, utility rooms) 6.80
7 1,. ;41 ';:e "'t }' ,r' y . ,: it ..7. ,. ,.,_, : 'I ! I+ d Ls ace fans 10.00
,l ' Ia� � ,,.... ;.•( ;:! ' �%,.
� �,..,.� ;.. `!�d�'' ;�'� �ti' Allic /truw
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Other: 10.00
Business name: -- - - -- - -- - .__. -,
F'ucl_piping
Contact name: $5.40 for first four- $1.00 for each additional
FE211-5, Fl.(- t.
Address: SEE BELOW - - - - - - � -- -. . _.. _.. - -� -- - .._..---
Gas he:21mm_L
City /State/7.1 P: Wal I /suspended /un nheater
Phone! ( ) I Fax:: ( ) Water heater
- - Fireplace
E- mail: Ranee
r 1 �'('+ d ti' �L,9a7 , }2 f • �yr , _. P ^t alit 'FP � L Barbecue
C { � ii lf,ifll i j l'�I,., �.. ",� _ O l' 1' t (>< Q'L� 1 IM,1 li i t 14 { 1 i I } I
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t - r, •iln') ml b 1 �{ 1 l N N af �. , e c H ■ l�
Business name: Air Pride Inc. Clothes dryer (gas)
Other.
Address: 18603 Willamette Dr. - ..,._... ;1•Iillil�_utaN 'ai "i�Al 4 l i ,' h :04w: E W
� tom,.'
City /Slate /ZIP. West Linn, OR 97068 - Subtotal 28.00
Minimum permit fee ($7250) 72.50
Phone: (503) 655.0556 I Fax: (503) 655.0534
Plan review (25% of permit fee)
Cell lie.: 154359 (9 • 1 4 , 1, -- _- State surcharge (12% of permit fee) R.70
TOTAL PERMIT FEE S81.20
Authorized signanire: This permit application expire if n permit is not ohlnined within 160
-_ days unrr ii has 'ten accepted e., complete.
f Prim name. Alicia Adkins j Dale: (Q lalUCI • Fee methodology set by Tri- County Building Industry Service Board
I:Uluddtr \J'arrn.uMrt.i4nnirApp.,6n 111.0 *07 440dn tiT(II 2/COMJWI.11)
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A/C, or H/P Sate Plan
Customer name
Customer address ( 2•-c` I 0 S N 1Ll'L IAic� l/ ft_
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Respectfully submitted by :
72 Degrees Heating & Air Conditioning
Air Pride Inc.
18605 Willamette Drive
West Linn, Or 97068
503- 655 -0556
CCB#154359
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