Permit o CITY OF TIGARD MECHANICAL PERMIT
``1 COMMUNITY DEVELOPMENT Permit 4: MEC2013-00520
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Date Issued: 09/16/2013
Parcel: 1S134ACO2618
Jurisdiction: Tigard
Site address: 11235 SW WILLOW WOOD CT
Project: CAMPBELL Subdivision: ENGLEWOOD NO 3 Lot: 175
Project Description: Gas furnace installation.
Contractor: PYRAMID HEATING&COOLING Owner: CAMPBELL, CAROL 0
9409 NE COLFAX 11235 SW WILLOWOOD CT
PORTLAND, OR 97220 TIGARD,OR 97223
PHONE: 503-786-9522 PHONE
FAX 503-786-3432
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 09/16/2013 $46 75
Type of Use: SF 12%State Surcharge-Mechanical 09/16/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/16/2013 $43 25
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressure.
Total $100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232 1987 or 1.800 332.2344
1
Issued By: • ••rmittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
09/13/2013 FRI 9: 15 FAX 1 002/002
Mechanical Permit A li ' I OR t:ll i i('a: 1.itir;OiNI, '
City of Tigard EI�1ED M . Parmit No.: -oar,
III
4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review u: Phone: 503.718.2439 Fax: 503.598.9,46m 16 2013 Date/By: other Permit;
i I t.^R I; Inspection Line: 503.639,4175 Date Ready/Uy: HI Sec Pagc a for
Internet: www.Ugerd•or.gov CITY OF TIGARD Notified/Meilod, IIM Supplementallnformafion
' T,�r AC�'I',� •'(s, ;),t. ii irq' jI �:r ",gq"r;,yc��/' r ,`�+ ,�q ,7�l(��Jvrrr �{ ' ty7gw; � ititti�ig -rr,,Tr.,i luc •itri�tli�9m�iy�Dtiy�l�.m�,�G],��� ,[K..`
i .M1 ,,5�'9 �, alp., ..f.i �, r Ji r� �`�AF.-a 1,MYlta �s i� r'rf�S'.Iti#M1rAiri !h'.'ll�i f71'.i a�n.. -- tI.!�- d'' C i"n' ..c''. `^'i7. ..--`.Li41.
k' a ' Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed,Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$a lfi 1 s r 441; 4W W R{ l ii55{ 7191 28 y Ai ,.,-4V1WArbn aP13 91c-0!T I
g J
ggi-TRiff a rg6AV
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® I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For speciallnJbrmallon use checklist
❑�M�uulti-family ❑ Master builder ❑,Other: y $, Description Qty. I Ea. II Total
.:•. ME le�°,,,: j ,'li _��a ° 1.) ,�° Xr Za��A 6• TE 1 � .R EM $WfiiR Heatingic conditioning 46.75 j
Job site address:11235 SW Willow Wood Ct Furnace 100,000 BTU(ducta/voma) l 46.75 46.75
City/State/ZIP:Tigard OR 97223 Furnace 100,000*BTU(ducts/vents) 54,91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32 _
Residential boiler(radiator or
hydronic) 23.32 _
-
Unit heaters(lbel-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
Other fuel appliances: _
Tax map/parcel no.: Water heater
23.32
HEWy i k rin gri f C . u Mia «4'r.r e .Gas irolaca/lnserl 33.39
Flue vent fbr water heater or gas
Install of Gas Furnace fireplace 23.32
Log lighter(gaS) 23,32
Wood/pellel stove 33.39
Wood fireplace/insen 23.32
;y �p�� 1 Chimney/liner/fiue/vent 23.32
$' �`.� `"�.l,C:wl krJL�•0:3t�'iy d • >.,,,;u.,�, ��/ �. A r. s, {;,' Other: I 23.32
4 -.L '' Environmental exhaust and ventilation:
Name:Carol Campbell Range hood/other kitchen
equipment 33.39
Clothes d
Address:11235 SW Willow Wood C dryer ryer exhaust 33.39
City/State/ZIP:Tigard OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:
(503)590-2928 Fax:( ) Atticcrawlepace fans 23.32
_ (rtwikle . � p , „ iii;i e a bg:ar a ills
Other: 2332 ,
Fuel piping:
Business name:Pyramid Heating&Cooling $14,15 for first four;54.03 for each additional
Contact name:Lisa Miller Furnace,etc.
Address:9409 NE Colfax Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland OR 97220 Water heater
Phone:(303)786-9522 I Fax::(503)7116-3432 Fireplace
Range
E-mail:Imillerc
pyramidheating.com ,
Barbecue
11r4 -��' ' , 4v RAW S :.R.Ra '`(t i, } 0 4.i,
. Clothes dryer(gas)
Other:
Business name:Same as above r. �, �R ,1 `RI RFA''.
Address: a Subtotal 46.75
City/State/ZIP: Minimum permit fee($90-00) 90-00
Plan review(25%of permit tee)
Phone:( ) Fax:( ) State surcharge(12%of permit fec) 10.80 /
CCB 1ic 59382 3 Alf if ■ TOTAL PERMIT FEE 100.80
This permit application eapires Ka permit is not obtained within 180
days after it has been accepted as complete.
Authorized signal • • Fee methodology set by Td-County Building Industry Service Board
Print name: LLA 04. U.t U QJa-. Date: / II/ 1'
I:5uIIdtn4VbrnirelMEC PonnApp 0401 I3.doe 440-1617TOliW/COM/WEB)