Permit REVISED
CITY OF TIGARD c4-.)_7. /� MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00115
T FC;ARL3' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013
Parcel: 2S104BB12000
Jurisdiction: Tigard
Site address: 13908 SW WALNUT CREEK WAY
Project: McIntosh Subdivision: WALNUT CREEK Lot: 37
Project Description: (1) NC installation 2/27/13 REPRINT to correct description to read: Must maintain 5' side yard setback and
approved rear yard'setback
Contractor: OREGON HEATING & AIR CONDITIONING Owner: MCINTOSH, ROBERT A & JADE H
19300 SW 118TH AVE 13908 SW WALNUT CREEK WAY
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 449 -9900
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 02/26/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/26/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 02/26/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
Total $100.80
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: C /j �1 1 // /1 6L , e. �— Permittee Signature: Op 4 P /C4 rr2
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.
02/26/2013 14:43 503 691 -8556 OREGON HEATING PAGE 01/03
Mechanical Permit A iica ' _ c Elv FO , FICE USE ONIa'
City of Tigard Day Permit No.;
It • 13125 SW Hall Blvd., Tigard, OR 97223 c� 2013 Phu Review
- Phone 503.639.4171 Fax: 503.598,1960F 2 6 ma Other Permit:
T I c : : Aa P. D Inspection Line: 503.639.4175 o D to Read RI See Page 2 for
1 Internet: www.tigard- or.gov TIGARD
CITY NatitiedlMethod: � Supplemental Information
PIRG mitsto . • f TYPE OF, . :. Y. ..... , , EE. SCHEDULE
v§E cCiaasT
❑ New construction Addition /alterati on /replacement Mechanical permit fees* are based on the value of the work
performed, indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY, 011i .0 Oly tTt 7C,l9N
:RE 0 1P4, EQU 1V7! / SYSTEMS TEE=
iv 1- and 2- family dwelling ❑ Commercial/industrial rial El Accessory building Far special arfornsafion use checklist
❑ Multi- family ❑ Master builder ❑ Other; � ...r.. Description I Qty. � Ea 1 T °ra)
. . , diva srrk iavroiiii ATION AlV' i IA3CATiOiv" , , ., lleadng/coo1iiag
Job site address'. Air conditioning
3 a . a 1 (requires site plan showing placement) ( 46.75 i AS
City/State/ZIP: � Q t ,,/ p� 227
Furnace 100,000 BTU (duets/vents) 46.75
`�/ Furnace 100.000+ BTU wets/veers) 54.91
Suite/bldg /apt no.: Project name: /102- 002r Heat pump 61.06
Cross street/directions to job site: I Duct work 23.32
Hydronic hot water System 2332
Residential boiler (radiator or
hydronic) 23.32
' Unit heaters (fuel -type, not electric),
in -wall, in- duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: — I Lot no.:
Other. 23.32
Tax map /parcel no.: Other fuel appliances
A0.scRIPTIo j .OF R'fsl ,- :; ' ° , , i. c`. ,. > .. W b ea r er 23.32
_ . , ... Gas fireplace 33.39
,.,.,.. 333 •
1 41#4/1 . A-,-,- Cad i f lane r . Flue vent for water heater or gas
fireplace 23.32 _
Log lighter (eras) 23.32
Wood/pellet stove . . 33.39
..� Wood fireplace/insert 2332 _
� PROP X.4WNER 0 "' Chiunbey/liner /tlttdvent 2332
Other 2132
Name: 0 LP ,t4& C .2 Environmental exhaust and ventilation
Address: /7 Range hood/other kitchen
en
O �" . t,✓ b✓aG�t cev. L4 equipment 33.39
City/State/ZIP: r a ere .71,2-27 I Clothes dryer exhaust 33.39
r
Single-duct exhaust (bathrooms,
Phone: (6.-°-r) L//yq - 99 Do . ]~ 'ax : ( ) toilet compartments, utility rooms) 23.32
. ' 'V APPLICANT ' ' • ;:,:. :' ❑'°CONTAGr PEiSON : cra P fans
'• �. Attic/ wi5 aloe 23.32
Business rtarne: ' f Otbct: 1 23.32
f)rlyodt C7 eat►nn Fuel piping
Contact name: G o t k �t - rt,� er- L on M 5114.15 for first four; 54.03 ler each additional
Address: /Q3o, silt Net 4,,,e, Furnace, etc.
035 heat Lump
City /State/ZIP: 7 q l og 0, 1 Wall/suspended//unit heater
Phone „ I Fax Water heater
CS 3) �9l 9 G99 ! ( ) Fireplace
E -mail:
Range
' : CONTRA lt01C :;: Barbecue
Clothes dryer (gas)
Business name: 0, /1
�/
ahem
Address: /
709 j , /it'd i ve MECHANICAL) 014 FEES'
City/State/ZIP: 72 Geer f hA , OR 9 7 Subtotal . q a y'Z$” _
^ Phone: ( oj) cc- em Fax: ( ) AX
Plan Minimum permit fee ($90.00)
review (25% of permit fee)
CCE3 lie.: 172126 . S tate surcharge (12% of permit fee) fa. S
TOTAL PERMIT FEE /O o. 8'0
This permit application expires if a permit is not obtained within ISO
Authorized signature: days after it has been accepted as complete_
I Print name: .,Z c fr 6Tn 1+, [Tate; . 2/2 -
2/2. " Fee methodology set by Tri-County Building Iadushy Service Board
02/26/2013 14:43 503-691-8556 OREGON HEATING PAGE 02/03
RECEIVED
First Floor
10' FEB 26 2013
CITY OF TIGARD
10' E • BUILDING DIVISION
5-
•
-1302-0025 •
•
First Floor
(1)
Garage
Jurisdiction Tigard
SW Walnut Creek Way
N
Oregon Heating & NC Scale: 1/8" = 1'0"
Performed for: Page 2
Robert Mc Intosh • 19300 SW 118th Ave Right-Suite Residential
.0
13908 SW Walnut Creek Way Tualatin, OR 97062 6.108 RSR39325 2013-Feb-21 13:37:38
Tigard. OR 97223
Phone 03-449-9900 Phone! 503 Fax: 503 11ohac-sbs1FoiderRedirectionsUme...
• : 5
FAXED
2/2 r
•
n CITY OF TIGARD MECHANICAL PERMIT
Ilt COMMUNITY DEVELOPMENT - Permit #: MEC2013 -00115
T EGARD• 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013
Parcel: 2S104BB12000
Jurisdiction: Tigard
Site address: 13908 SW WALNUT CREEK WAY
• Project: McIntosh Subdivision: WALNUT CREEK Lot: 37
Project Description: (1) A/C installation
•
Contractor: OREGON HEATING & AIR CONDITIONING Owner: MCINTOSH, ROBERT A & JADE H
19300 SW 118TH AVE 13908 SW WALNUT CREEK WAY
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 449 -9900
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 02/26/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/26/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 02/26/2013 $43.25
•
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
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: /f [{ Permittee Signature: (0)J f / L.47N &pi
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. •
1
02/25/2013 15:10 503 691 -8556 OREGON HEATING PAGE 01/03
I
Mechanical Permit Ap p1icati ECEIVED FOR OFFICE IiSE ONLY .
City of Tigard ivy. •= ,tp PermitNa.:
13125 SW Hall Blvd., Tigard. OR 97243 FEB 2 5 2013 p�ke '� 1 3 - Oo(
• Phone: 503.639.4171 Fax 503 - 595.1960 ma y . Other Permie
Fro 1 .i: c, e ti 503.63 .4175 CITY OF TIGARD Da a Readynay: Jut El See Page 2 for
BUILDING DIVISION
NotifiedRvlethod: r 1 fC S Itmenml Iaform'doa
TYPE OP .WORK: ;0**RC4 'IEEE* SCHEDULE ,• USE CHECKLJST
New construction 'Addition/altekation/replacemcnt Macbanrcal 1> fin are based 011 the value of the work
i . performed. Indicate the value (rounded to the nearest dollar) of all
O Demolition ❑ Other i mechanical materials equipment, labor, overhead, and profit
. CATEGORY O1 1�.,C • [ 7 S RUCIUON : , y.. :, -
'} .. :: value: $ .
�'1- and 2- family dwelling ❑ Commercial/Industrial ❑ Accessory building :*0044#4 EQtJ)UP)Y t�'I SY57>.1►SS '
[] Multi For special information use checklist
❑ M aster b uilder ❑ Other: Description ( Qty. I En Total
. JOB sat INFOItMA'IY0C.'A LOCATION Heatiag/eooliag_
Job site address: _/ / Air conditi0nmg
13 el o $' Si r+ /41 VILA btu t ( : r> (requires site mina sho vinp plaecanom tf ) a6,75 _ 7 L: _S
City /State/ZIP: 7 rei oR 4 l .22� Furnace 102 POO DTU (duets/vents) 46.75
l Furnace 100 BTU1dvcts/vents) 54.91
Suite/bldgJapt no.: Project name: J702 - 0025 Heat :,_./L
61.06
Cross street/directions to job site: Duct work 2332
` - I�ydronic 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 2332
Tax map /parcel no.: Other fuel appliances
DESCRIPT Ott .d E. i fU ; : - 'y 1''''^ ; Water heater 2332 -
1 , Gas firroplaee 33.39
. n, f ai i . A C t,Ji f anj r _ , Flue vent for water heater or gas -
fireplace 23.32
i Log lighter (gas) 23.32
Wood/pellet stove 3339
Wood nreplace/knsert , 2332
.. . . _ Chimney/liner/flue/vent
)pROPER'TX owiiER - ,G' 4:40.1 ;
•
23.32
� ..:-I . . , ..._ Otter: 2132
Name: r 2 Environmental exhaust and ventilation
o Range hood /other kitchen
Address: s: � !
� Q $ , S W / i n4 ; Ceeesik fr4 ► equipment 3339
City /State/ZIP; Clulhes dryer exhaust 33.39
T.9 4 � e o� 9 _ . - Single -duct exhaust (bathrooms,
Phone: (6 114,1q - fie? Vo lax: ( ) toilet compartments, utility rooms) 23.32
.- v I ..• ... : .: VI APPJ1CANT . .: [1 COl!iTACr PE$SON"
Attir/crawlspace thns 2132
Other: 2332
Business Hama:
O 112a1 ring Fuel plying
Contact name: o o 11 ,/ Qr. o � 5 14:I5 for first four S4.03 for each additional
Address: //ro � .' Furnace, etc.
jilt /( Gas beat pump
City/State/ZIP: 7 441afih i U/c' g i¢d2 - Wal /suspendedhmitheater J
Phone: (5, ) Fax: : ( ) Water heater _ -
3 �9l - ff.,' Fireplace
E -mail: Range
- _ CON'i`IhAf OR.,•. Barbecue
Business name: Or �e ,� Clothes dryer (gas)
Address: Woo jw // i4 .4,e Meg: , ME($AN IC.M 1'ET *r 1FEE .
Crty /Statie/ZIP: '7 (, p • 17 o• Subtotal (p Z5
Phone: (' 7 \ Gq 1- �6 Fax: ( ) _ Mini mwn permit fee ($90.00) Qp
Plan review (25% of permit fee)
CCB lic.: /7'2 /26 State surcharge (12% of permit fee) /O- $
TOTAL PERMIT' FEE . Jo o. n,
Autlrorizad signatare: This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete.
Print name: ,r k Cx� l _ . , Date: ' » p * Fee methodology set by Td- County 13mlding Industry Service Board
02725/2013 15:10 503- 691 -8556 OREGON HEATING PAGE 02/03
First Floor
10
10
4— I
3
1302R0O25
j
First Floor
Garage
4•1•117 QMIMUL,
Jurisdiction Tigard
SW Walnut Creek Way
N
Job #: Oregon Heating & NC Scale: 118" = 1'0°
Performed for: Page 2
Robert Mc Intosh 19300 SW 118th Aye Right-Suite Residential
13908 SW Walnut Creek Way Tualatin. OR 97062 8 - - 106 RSFt3
Tigard, OR 97223 2013- Feb-21 13:37:38
Phone: 503 e: 53"691 -9699 Fax:5 69 1-8556 1 1FomerRedirectionsuma..
•