Permit •
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00137
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/12/2013
Parcel: 25111 BD00601
Jurisdiction: Tigard
Site address: 9695 SW DARMEL CT
Project: Johnson Subdivision: DARMEL NO.2 Lot: 34
Project Description: (1) A/C installation Must maintain 5' side yard setback and approved rear yard setback
Contractor: OREGON HEATING & AIR CONDITIONING Owner: JOHNSON, KENNETH AND
19300 SW 118TH AVE DEBORAH
TUALATIN, OR 97062 9695 DARMEL COURT
TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 997 -2022
FAX: 503 - 691 -8556
FEES •
Specifics:- . Description Date Amount
Air Conditioning 03/12/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/12/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 03/12/2013 $43.25
Occupancy Grp: •
Stories:
•
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. att Issued By: ._ „/( // / l / f Permittee Signature: ® 0 41 '' , D - -
e-
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03/12/2013 10:40 503- 691 -8556 OREGON HEATING PAGE 03/03
Mechanical Per A licatiola FOR OFFICE USE ONLY •
City of Tigard Rec'eived ` Permitllo.: 3 .ea 31
III 13125 SW Hall Blvd., 'Tigard. OR 97223
MAR 1 2 2013 Plan Phone: 503.639.4171 Fmt: 503.598.1960
Date/By. Other Pt:mrt
t' I OAF.. 0 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: tuna VI See Page 2 for
Internet: www.hgard-or.gov BUILDING DNISIO Nohfredadethod: j 1 supplemental information •
:; Z"OMi)ftCL41• FEEL SCumULE U$!&'CAECIQ .
Addition /alteration/t eplacement Mechanical permit fees* are based on the value of the work
ID New construction perfbresed. indicate the value (Founded to the nearest dollar) of all
❑ Demolition ❑ Other: _mechanical mate equipme l abor, overhead, and profit.
C Ol• CONS)
: fRRucUor(. ,
....,.::.' Value: S
; : SXD ri`IAL EQ / SYSTEMS F
�
' 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special bfornn we checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty, I Ea I Total
JOB siTL:IIVFORMAT01!{';AND LOCATION. '' . , Healina/coollng
Job address: , 1 6 95 S i✓ Air drat t tia 1 s a
Job site address: A 1 [�fi (requires site�iaa showiagpla« meat) I 46.75 Agic
City/State/ZIP: Furnace 100,000 BTU (ducts /vents) - , 46.75
T. g i of? -• °— Furnace 100,000+ BTU (ducWvents) 54.91 _
Suite/bldg./ept. no.: Project name: .T0 Anra� Heat pump 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
:✓ Flue/vent for any of above 23.32
Subdivision: Lot no.:
V Other: 2132
Tax map/parcel no.: Other fuel appliances -
:<.. - WaterbKaler 2332
FSCRII!?T. 0001*:::: :;. . t ', Gas fireplace lace 33.39 ,
:1, n S #% _ . Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 ..
Woodlpellet stove 33.39
Wood fireplace/insert 2332
... )<! Chimney/liner/flue/vent 23.32
(�PROPERTX OWNER r : Q' . ...T: Other. 23.32
—
Name: e r �� o, Environmental exhaust and ventilation
Address: v e / _ �f / Range hood/other kitchen 9F� `�S Si. v9 /
equipment 33.39
City /State/ZIP: � � r / O 9 7 2 2'/ Clothes dryer exhaust 3 3.39
_ Single -duct exhaust (bathrooms,
Phone: (j .07) .- 2022 2 Fax: ( ) toilet compartments, utili ty rooms 2332
,,.
�.: APP)l.ICAId I . • , , ❑: CONTACT'. • PERSON . " Attic /crawlspace fans 2132
. -
Other: 2332
Business name: Q N, fe Fuel piping
•
Coumet name: 24,k G • _ o : Si4.iS for first four; 54.03 for eacb additional
Furnace. etc. 1.
Address: /c/,'ca Si✓ //8i Ara Gas heat pump
City /State/ZIP: 7 . 1. , a i 1 Wall/suspended/unit heater
Phone: (so )6"Q!_ 907 Fax Water heater : ( ) . – Fireplace
E -mail: Range -
cor )R
, . .. Barb�rrs
, .
Clothes dr yer
Business name: /! o es (gas)
Ore /7QaiY+9 Other.
Address: 7OC) .. SA' //t + J 4 #e MECPANiCAIL 1'ERM)f7l` 3• • ,
Subtotal 4't. aS
City/State/ZIP: r� pg 4G2 Nrmimum permit fee ($90.00) q0- "
— Phone: (5 ) CO– 1– i69rj _ I Fax ( ) Plan review (25% of permit fee) •
CCB lie,: :
/ 7 2 , 2 ig r State surcharge (12% of permit fee) / Q i'O
–
TOTAL PERMIT FEE inn, go
Authorized signature: e l r l S it
This permit Rpplieatloa t bas a accepted complete
not obtained aith[n LSD
days crier has been acc�led se mplot Qlete
�,
Print name: -_ k/ � �ll�a c..
D 2 O /3 • Fee methodology ea by Tri CouotyBuilding Industry Seevice Board
03/12/2013 10:40 503- 691 -8556 OREGON HEATING PAGE 02/03
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