Permit CITY OF TIGARD MECHANICAL PERMIT
II- c • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00406
Date Issued: 07/18/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S133DD12000
Jurisdiction: Tigard
Site address: 11896 SW 126TH PL
Project: Murphy Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 157
Project Description: Install 2.5 ton NC. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: MURPHY, PATRICIA
1637 SE NEHALEM ST 11896 SW 126TH PL
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 235 -9083 PHONE: 503 - 579 -1419
FAX: 503 - 235 -0454
FEES
Specifics: Description Date Amount
Air Conditioning 07/18/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/18/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/18/2013 $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.
...Z121 , i ,._________
Issued By: Permittee Signature: j a N _-7) G / 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.
From:5032350454 07/16/2013 15:24 #659 P.002/003
RECEIVED
Mechanical Permit Application FOR OF USE ONLY
City of Tigard JUL 16 2013 Received
Date,By: 7 /7 ., ' PennitNo.://E- .20/3 -eo /O
13125 SW Hall Blvd., Tigard, OR G /� A ±�pD� Plan Review
C Phone: 503.718.2439 Fax: 503.5� Date'By: Other Permit_
TIGARD Inspection Line: 503.639 BUILDING DIVISION Date Ready /By: FM 65 See Page 2 for
Internet: www.tigard or.gov Notified,Metllod: Supplemental Information
;�3Y "�:k X,.ys_ - '�;+:.; r _ _r`�g� y2E�s ,:a ;� = 1 y1 n::a - ' _3 ; `i a -4 .-` - �_sr^ A t ' f2 _
."sA4.'.,-VQ. 'z �C 4;' f _ -ttit ...z 4,/c,' O' ]� ./{� 9 N' ,3-y3 r t .tiK 11,3 y- a•Y '+=aY.', : :n .- .k i` - ;3`� 5 ' ,-� �/, [. : -q
. .`"�`. +-s ,<t n � h.. Y - �Fi: i3' ra.^ y- 1 �." �< •• -1c.' �rw�,'`,^��'.77 ,� � 1��:?�!# '�, `, `Y '1.WI4'a. �7- f >_
�s .. .�::u -R. - "�- -. %vim:.,:' �aa'��o3:2.�. �'.�, ��,- i- . ��c,�1
Mechanical pearnit fees* are based on the value of the work
❑ New construction ® Additionialteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S
le „ ?�o V :.i 4 ,Y 4 '+.n --c^1 ... 5, r , � �- KWn - -- ' '' z e < xe, 4
® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description
Qty. I Ea. Total
' °' ` Heatin8
Air conditioning
Job site address: 11896 SW 126 PLACE (requires site plan showing placement) 1 46 75 4
Furnace 100,000 BTU (ducts vents) 46.75
City /State /ZIP: TIGARD, OR 97223 Furnace 100,000+ BTU (ducts'vents) 54.91
Suite/bldg. /apt. no.: j Project name: MURPHY 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 an of above 23.32
Other: 23.32
Tax map /parcel no.:
Other fuel appliances:
"f-t ;;; '' .r1 �. ..� ^ Water
c¢ Wiz' Q �� heater 23.32
•
';:a,:' .; :" -� s�'�. ��-`° i� � ` ''':�..
INSTALL 2.5 TON AIR CONDITIONER. Gas fireplace 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
,. " 0 wit ar +' h" t 's- -- Chiron /liner'flue/vent 23.32
Other: 23.32
Name: PATRICIA MURPHY Environmental exhaust and ventilation:
Address: 11896 SW 126 PLACE Range hood/other kitchen
equipment 33.39
City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39
Phone: (503)579 -1419 Fax: ( ) Single duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
3;�- �r.._.�'� `, 3:- a ���N ='jFtDl�' '� ; :. .:'' Attic:'crawlspace fans 23.32
Business name: SKY HEATING & AC, INC. Outer 1 23.32
Fuel piping:
Contact name: TAMI HAGEMAN $14.15 for first four; $4.03 for each additional
Address: 1635 SE NEHALEM SP Furnace, etc.
Gas heat pump
City /State /ZIP: PORTLAND, OR 97202 WaWUsuspended'unit heater
Phone: (503) 235 -9083 Fax: : (503) 235 -0454 Water heater
Fireplace
E -mail: TAMI @SKYHEATING.COM
Range
xs.
.t =i.- _ ' ^°- °, > �- ' ' '';' ^ 'r x .�f :7 i tf � . t : ' 3 : : - . tea. s '- .. � 3a ' : Barbecue
Business name: SKY HEATING & AC, INC. Clothes dryer (gas)
Address: 1635 SE NEHALEM ST Other: K v- > fy5 r ay
City/State /ZIP: PORTLAND, OR 97202 Subtotal 46.75
Minimum permit fee ($90.00) 90.00
Phone: (503) 235 -9083 Fax: (503) 235 -0454 Plan review (25% of permit fee)
CCB lic.: 50244 N #491 t State surcharge (12% of permit fee) 10.80
• TOTAL PERMIT FEE 100.80 1--.."----- Authorized signature: / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: TAMI HAGEMAN Date: 7/16/13 ° Fee methodology set by Tri- County Building Industry Service Board
t.. Building .Permits'MEC -PermitApp.doc 09 440-461'T (II '02 WEB)