Permit ,, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00074
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/18/2011
Parcel: 1S136AD01700
Jurisdiction: Tigard
Site address: 6875 SW PINE ST
Project: BLUME Subdivision: Lot: 0
Project Description: Heat pump installation.
Contractor: PYRAMID HEATING & COOLING Owner: BLUME, JULIE E & HENDRIK A
5699 SE INTERNATIONAL WAY STE A 6875 SW PINE ST
MILWAUKIE, OR 97222 TIGARD, OR 97223
PHONE: 503 - 786 -9522 PHONE:
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Heat Pump 02/18/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 02/18/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/18/2011 $28.94
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 2.2344.
c
Issued By ,' Permittee 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.
02/17/2011 THU 12:03 FAX 503 786 3432 PYRAMID HEATING RI 001/003
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ,' Received • I . '4 1 3125 SW Hall Blvd., Tigard, OR _9722 .. t• J DDate/Ely: 7 J� /1J 1/
- . + Plan Review
Phone: 503.639.417( Fax: 503Y-598 .1960 ? ` ` ' Date/By: Other Permit
TIGARD Inspection Line: 503.639.4175 VV...... ` pi '1.Q1 1 -
Internet: www.tigard- or.gov �� Date Read •r By,
C Notified/Method. a See Page 2 for
Supplemental Information ,
F RO
r r
r- : , s , :. , , - = :.;;: -,. - �.-;, L ..:.::-..- .. ,, :...
- - i ., :i .. •._ - r-' - T.XEC ; : O ,)< : ; ,- . : OR1�;: ;', ,, , : :_s>F, a F,_., .. , . .. » CQMh4E iFEE *_SCHEDULE.' ! , USE)GHEC L.
s•- Mechanical permit fees are based on the value of the work
111 New construction Q Addition /alteration /re p
IZV1i performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and piofit.
`:CATEG Value' S
r ..:; ::..,,,. :..,:.:,,. ..... Ol` iY� ,OF:,CQNST[tUC;T�ON;' ;:;:�;�_`;ii %: - ;: - -r
�l -and2- family dwelling RESII)ENTIAL:E UIPIYI ENT. /SYSTEMS_PEES * .. 1 . <�'
❑ Commercial /industrial ❑ Accessory building Q ''
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
. :.: , ,.. STTE;' INT;ORlvIAT,ION, LOGAt['LON:' : 'i' � � s >''.; ; ; :< : `
�,. ca
Job site address: f r p rte ,�
(requires conditioning
II (requires site plan show placement) 46.75
City /State /ZIP: 1 /I . Furnace 100,000 BTU (ducts /vents) 46.75
"� Furnace 100,000+ BTU (ductsivents) 54.91
1/lm� Heat pump Suite/bldg. /apt. no : I Project name: S( 1 61.06
Cross street /directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydmnic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Subdivision: Flue/vent for any of above 23.32
Lot no.:
Other: 23.32
Tax trap /parcel no.: Other fuel appliances
23.32
..;::.; . -- ". ........:.:...:... .. _.:_ -LL' D�SCRIPTIU�fr -Q�; WORI�::.::-:::.:. -: _ ;t..:.;v.�:: ; ,_:.w.. '
Water heater
/ /�'n ' ( �I��� r 1 n Gas fireplace 33.39
—'/ I N /t- 5(1 l �i � e r� I In e, Flue vent for water heater or gas
filace 23.32
F��`�1 f "/�
___,J____ L ` f ' rep Log lighter (gas) 23.32
Z b 5t I.cS 0 Wood /pellet stove 33.39 23.32 .
:; . ..:. ::..:...... — fireplace/insert
Chimney/liner/flue/vent en
: . . .. ... . ..... Chimney /t 23.32 32
'' ...;?.; PJ OPER,TY;; O `NER:.,:';::: >: ....._ • :'- " : ` =' ; 1 : +❑` `I ENANT- ° ' :a e
Other: 23.32
Name. /� r • t 6 4 4 _,.... pA , e 191 . Environmental exhaust and ventilation
SGT L�/ Range hood other kitchen
Address: equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
;::' ®s +PPLICA/QTs ,-, l ',,' ' " - :'; :4- ':;>r= ' =.; '::- Atticicmwlspace1airs 2332
. � ...: ,, ...,.. - , : . . •CONTACT;:tP�RSON i • -:i � ° =_
Other: 23.32
Business name: PYRAMID HEATING AND COOLING Fuel r m
Pp g
Contact name: MEMORIE BROWN $14.15 for first four; $4.03 for each additional
Address: 5699 SE INTERNATIONAL WAY STE A Furnace, etc.
Gas heat pump
City /State /ZIP: MILWAUKIE OR 97222 Wall/suspended/unit heater -
Phone: (503) 753 -9522 Fax: : (503) 786 -3432 Water heater
Fireplace
E -mail: mbro)vn@pyramidheating.com Range
- :CONTRA - Bar becue
C : O�ti='.
T
Business name: Pyramid Heating and Cooling Clothes dryer (gas)
Other:
Address: 5699 SE INTERNATIONAL WAY STE A C, ER P:.ER'NI
_- ;' :' ",_''.;.;;. IVIRCR?�NI FEES.* ;; s -il ` "` = '' -:;:
City /State /ZIP: MILWAUKIE OR 97222 Subtotal i OP
Phone: (503) 786 -9522 Minimum permit fee ($90.00) CI `I
( ) Fax: (503) 786 -3432 ��
Plan review (25% of permit fee)
CCB tic.: 59382 State surcharge (12% of permit fee) j 4D
TOTAL PERMIT FEE O b(a $O
Authorized signatur
This permit application expires if a permit is not obtained within 1811
days after it has been accepted as complete.
Print name: MEMORIE BR N Date: 2- g �� a Fee methodology set byTri- County Building Industry Service Board
•
I: Buildi2 •Pennits.MEC- PnnutApp.doc 1001.09 440.4617:(11: 02.COM -WEB)
02/17/2011 THU 12:04 FAX 503 786 3432 PYRAMID HEATING a 002/003
MECHANICAL SITE PLAN
LS D
p
t !t
rnusallibila61~7 F� IS
Job #: Pyramid Heating & Customer Information
Cooling, Inc.
Julie & Rick Blume
5699 SE International
Performed By - Way, Suite A 6875 sw Pine St.
Milwaukie, Oregon 97222
Tigard, OR 97223
503- 246 -6120
PH: 503- 786 -9522