Permit (56) 1,4 ,„ CITY OF TIGARD MECHANICAL PERMIT
m COMMUNITY DEVELOPMENT Permit#: MEC2017-00602
TL ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10/2017
Parcel: 2S 111 CC09500
Jurisdiction: Tigard
Site address: 15730 SW GREENS WAY
Project: BARRETT Subdivision: SUMMERFIELD NO.2 Lot: 123
Project Description: Replace(1)A/C unit. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: ARROW MECHANICAL Owner: BARRETT, MARGERY F SEPARATE PROP
10330 SW TUALATIN RD 5471 PASEO DEL LAGO E#B
TUALATIN, OR 97062 LAGUNA WOODS, CA 92637
PHONE: 503-692-1565 PHONE: 760-815-1418
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Air Conditioning 08/10/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/10/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/10/2017 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0.x:0. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.23,1987 or 1.800.332.2344.
Issued By: /. /I/ '
Permittee Signature:
//11
"'C Call 503.639.4175 by 7:00 a.m.for the next available inspec on date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard DatRecee/By.ived 1 //� �'/
13125 S W Hall Blvd.,Tigard,OR 97223
111 4 Phone: 503.718.2439 Fax: 503.598.IVE1) D e9P
Other Permit:
TIGARD W(
Inspection Line: 503.639.4175 „, Date Ready/By: Juns: H See Page 2 for
Internet: www.tigard-or.gov 'I { Notified/Method: Supplemental Information
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',aa �' ,'�`" f K- ,,.', a,,c �O 1� „ter -- -s- :x:r M" -f. 7 ;xl
yy Mechanical permit fees are based on the value of the work
0 New construction KAddition/alteittk e r
q�, ���� �, performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: BUILDING l �' mechanical materials,equipment,labor,overhead,and profit.
..�=:�� .� ���.1��, .�, yam..:. ::�.';:�<: Value:$
„. s -. ,.,.4.,,, .....<s",-,-*bti:;� ='-''..�::... z--- - ,.s. .3 y-ax .�, ` iJ-i>„' —
r_5-119l-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For.special information are checklist
0 Multi-family ❑Master builder
0 Other: Description Qty. Ea. Total
-- -- `�', • .vag i .. s, r. ,.r... ..r. .. J, .r., Air co Heating/cooling:
` _ I Air conditioning i 46.75
Job site address: ' 5 730 51-4 62z t�S e Pr Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T i G Qs R/, 62 , 9 / Z Z Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:
Heat pump 61.06
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(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other:
Subdivision: Lot no.: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
t^>.,..,..�s WW:-sem . :' 5 t- « , .. �..&
' .i-= . - a .sy F,k_A.,_ . " J , -? _ ,•:%� _ �' Gas vent fireplace/insert 33.39
E. a Flue vent for water heater or gas
ktPL -c-£ Q,J 4 /4 ii, c..04..0tri 0A7 1 -P4 E Sv' fireplace 23.32
A COO' r Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
[- �-� ` ` -°' .� - $ r „ 4 Other: 23.32
:. s � �� .. f ?, ;s Environmental exhaust and ventilation:
Name: ,/VI �I GE. A ni t. sir Range hood/other kitchen
Address:: 1 S'-7 3 a i,,,� V k E LAS w
equipment 33.39
' ( Clothes dryer exhaust 33.39
City/State LIP: " t RI) y "' Single duct exhaust(bathrooms,
Phone:( G0 «- { Fax ( ) toilet compartments,utility rooms) 23.32
• 0115. w!space fans
23.32
y a WA,,, .s4 it_ other:
��r ` n , / � - 2332x...17. :..$ ; ;. ,,F::�.n. ,.:. >�,. ..� ,,..-, �
Business name: ,4 VC 0y4 , /6 l # f C ! CC) r Fuel piping:
/ t �+-v11 CA-L. w $14.15 for first four;$4.03 for each additional
Contact name: Fe M > (NO y Furnace,etc.
Address: ti 3 30 SW I-lid 41,1,k. T I-J j� Gas heat pump
"r" Wall/suspended/unit heater
City/State/ZIP: "rt)Me#4-,, ,,,a.) f 1 e," Af' ,Z, Water heater
Phone:(SI AA) /n,., a t i�' 7!^ Fax::(.5itj) �f.. J p',�' .Fireplace
E-mail: f Vet W /11 t1fl�/J -etorierr'�J�. ,. c64A, �e -
S�z$'h5...�'r :. el--=> �, 5s^ ::,��:y.:s•:" �iEi::� ::Yz, v� Barbecue
�zno�s ,..i.-sem :::�% - .`n�,"f z' €w';' t•'�..�`"`:^�-" ---w •� -.,- =,. ot.-
Otz%.z; ,�,- ``.< �-''�9x.�:-,� , ,, a 2.450 t's:f.F r>V /,,x:-G; ,,, `,--.va ?,wi Clothes dr3�(gas)
Business name: ( R�0 V' �'i te.1 A4 I/ .�,,, k. Other.
,/ e►�j,�l/ /4 `� II/j os gam " '. y t.sy /t„ ,
Address: i 3c, 5r" J V '� t`Ve .. � y £ ,.. �r.: y. :,,.,
Subtotal'
City/State/ZIP: Mt*' i 04 t 9`7 06 P1• Minimum permit fee($90.00)
61‘ ) C p?"� 1, -4,e( F� ,sA Plan review(12%of penult fee)
Phone: f®C , rJ (,)`� � l r �' State surcharge(12%ofpennitfee)
CCB lic.: 51 93 g//.i/i i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: + Fee methodology set by Tri-County Building Industry Service Board
Print name: AFF ols_L-4c9 4 Date: es 9 , I
I:lBui1dineemits\MEC_Pemjtpp_040113.doc 440-46171(11/02/COM/WEB)