Permit is
, CITY OF TIGARD MECHANICAL PERMIT
�-` COMMUNITY DEVELOPMENT Permit #: MEC2013 -00120
:TIGARD: 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/05/2013
Parcel: 1 S135CD03200
•.. Jurisdiction: Tigard
Site address: 9630 SW LEWIS LN
Project: Steward Subdivision: RUTH Lot: PTS 3-4
Project Description: Installation of furnace and heat pump. Placement of heat pump unit must meet 5 minimum side yard and
approved rear yard setbacks.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: STEWARD, SAMUEL A & LINDA K
19300 SW 118TH AVE 9630 SW LEWIS LN
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 807 -9590
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/05/2013 $46.75
Type of Use: SF Heat Pump 03/05/2013 $61.06
Class of Work: ALT Type of Const: Fuel Piping 03/05/2013 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 03/05/2013 $14.64
Stories:
Fuel
Fuel Types:
Gas Pressure:
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..:Total $136.60 ,
Required Items and Reports (Conditions)
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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: Permittee Signature: ON 4 C<9"
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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.
03/01/2013 16:15 503- 691 -8556 OREGON HEATING PAGE 01/03
mechanical Permit A ficatiREC EIVED FOR OFFICE USE ONL1'
City of Tigard • MAR 4 2913 Dam/BY 5fft Permit No.: ' I lX
III R 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax 503.598.1p�, Date/By: Other Permrt
1 , ii A..t;, E) Inspection Line: 503.639.4175 C l l Y O F TIGARD Date Ready/By: hwi= El See Page 2 for
Internet www.tigard- or.gov BUILDING DIVISION Noti6ed/MetLod: soppiemeotai lnformatieo • • TYPE OF WORK • , , '1ri**E CIAL F'EE" S CHEDULE - : I.ISE (*CKId$1<
Mechanical permit fees are based on the value of the work
0 New construction Addition/alteration/replacement performed. indicate the valuo (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
UCT101Y Value: $
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!.'RF$ DP1.g L ' .QUIP NT / SYSTh 4XS FEES •
RI- and 2- family dwelling ❑ CommgrCialfipdustrial ❑ Accessory building ,Fos special ufannallon use checIdist
O Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea I Total
JOB SU' ND:'LOCATIOAi Heativg/cooling
5W L :e �!i l)� �. Air conditioning
Job site address: " 7 to �� .. (requires itioa sire plan showing Placement) 46.75
• City /State/ZlP: 0 � , Furnace 100,000 BTU (duets/vents) * 1 46 - 75 Li ■D :15
Furnace 100,000+ BTU (ducts/vent). 54.91
Suite/bldg/apt no.. Project name : [ ri.- G In sick, t1 Heat pump J 61.06 (p,1.06,
Cross street/directions to job site: Duct work - 23.32 ,
Hydronic hot water system 23.32
Residential boiler (radiator or
bsydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall in -du su spended, etc. 46.75
- Flue/vent lbr any of above 2332
Subdivision: Lot no.: Other 2332
Tax map /parcel no.: : Other furl appliances
DESCRY'OT!f ot:V () C' ::v Waterheater 2332
1.. . .. • -- . . : k .•z:'41r .., 1+•��..Sy Gas fireplace • 3339
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a J«. • • :0- • to a . • 1, . a ti a E ! . 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
M'
... Chimney/liner /ilue/vent 23.32 1
PROPER O TY. /T4E.R .' ::.� TEN1,t I!1'I`. °'.:: - Other . 2332
Name: ~i - fl ((. NN M E tavironmental exhaust and ventilation
�� Range hood/other kitchen
Address: CV4, 30 W LS W % 1n - _ equipment 3339
City/State/ZIP: T ,_ '11223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: tie 4 3 ') cis: c ; Fare ( ) toilet compartments, utility rooms) 2332
::.� :APPLICANT .... - fans
❑. CONTA Cx PER ' - • ; AttiGorawls ace 2332
Other: 23.32
Business name: Ore • - . Woof - Fuel piping
Contact name: 514.15 for first four; S4.03 for each additional
QC q l
Furnace. etc.
Address: 11,A0 . jh/ /adz 4,r Gas heat pump I
City/State/ZIP: T 4 4 o 91 _0 6 . wall/suspended/unit he ater
1 : ( ) Water heater
Phone: (Sag ) 6-q / - 9699 I Pax:
E -mail: Range
CONI�tACTOxt ; .. , Barbecue
Business name: Clothes dryer (gas)
Business //ea#, other. _
Address: Woo ,..5 MO / e ML(:Il lvlt'AL iER M1T i s* , . n l i 4
/State/ZIP: 7 o 9 / c Subtotal
City/State/ZIP: tY rrq�Ah� , , permit • t t _
Phone: 6"o3) 411 - 44 ,. Fax: ( ) plan review (25% of
CCU Iic.: 172 / 26 permit ... ,lo
TOTAL PERMIT FEE ►7r
This permit application expires if a permit is not o thin 1 80 Q
,,Authorized signatgre: - : days after it hies ban, accepted as complete- n , f, • Date: - * Fee methodology set by Tri -Cotmty Building Industry Service Board j 7
Print name: ,r �
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• Main Floor
• 10
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4
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10 4- ( 10 •
I . 1;
Laundry
Bed 1
Panel
K • eNLiving
• Bath
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Bed 2 Bed 3
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N
SW Lewis Ln
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Job #: Scale: 1!8" 1'0"
Performed for: Ore Heating & NC Pia
• Linda steward 19300 SW 118th Ave Right -Suite Residential
• 9830 SW Lewis Ln Tualatin, OR 97062 8.0.106 RSR39325
• Tigard, OR 97223 Phone: 503 691 - Fax: 503 91$556 2013 14:49:28
Phone; 503- 807 -9590 11ot �ao sbe�FOWarFted+recttonsltrnc ..
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