Permit 711 4 CITY OF TIGARD MECHANICAL PERMIT
I - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00189
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011
Parcel: 2S109BA08100
Jurisdiction: Tigard
Site address: 13646 SW LEAH TER
Project: Ailshie Subdivision: DAFFODIL HILL Lot: 7
Project Description: Install ductless mini -split heat pump. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: AILSHIE, STEVE
13150 S CLACKAMAS RIVER DR 13646 SW LEAH TER
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 557 -2220
PHONE: 503 - 579 -3547
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Heat Pump 05/03/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 05/03/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/03/2011 $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 1.800.332.2344.
Issued By: /CC
Permittee Signature: ,49/f 6¢_7 70
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.
APR -29 -2011 01:19P FROM: TO: 50359E31960 P.
Mechanical Permit Application E i V 1 1 uit ()i l ll 1 I ,, I t■i
City of Tigard Q PR 9 A �°
v a :, Pennic .
13225 SW Hall Blvd., Tigard, OR 97223 1 st y' z 7/- DO�4°41.. ( Pla Re iew
Phone: 503.639,4171 Fax: 503.598.1960 y , J Other Permi
Inspection Line: 503.639.4175 o
Internet: www,tigard or.gov AIL LN fl BAR • No u iadA4 h od: 0 See Pagel
Bupplemeniji eotat information
1 V 15 701,
TYPE OF WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑Other: mechanical materials, equipment, tabor, overhead profit.
CATEGORY OF CONSTRUCTION Value; S
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES'
Q Multi- family ❑ Master builder ❑ Other: For special Information use checklist
Description I Qty. I Ea. ( Total
108 SITE INFORMATION AND LOCATION Headtsg/eooliot;
Job site address: Ib(v' - p 8■1\I Leah T-�� r C 6 Air conditioning
(requires site plan showing placement) 46.75
' � j �+ `^���
City / State/ZIP: 11 8Qf(' a 4 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace no.: Project name:
100,000+ BTU (ducts/vents) 54.91
Heat 'urn, 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 map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
y � ' t4 4 ` ik ' 4 (n I . ' , l 1 Gas fireplace 33.39
r l I I 1 Flue vent for water heater or gas
, - I pump yyt p fireplace 23.32
1JtA i Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplaceiinsen 23.32
'PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
((�� p
Other 23.32
11 i
Name; C i TAI k h 1 i Environmental exhaust and vendladon ,
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Phone: ( • l ) q - � ? Fax: ( )
Single-duct compartments, exhaust (bathrooms,
toilet compartmentss , utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/erawlspace tans 23.32
Business name: Same as contractor
Other: 23.32
Fuel piping
•
Contact name: Diane Mason $14.15 for first four; S4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City/ State/ZIP: WalUsuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Ran _e
CONTRACTOR Barbecue
Business name: Tri County Temp Control
Clothes dryer (gas)
Other: ,
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES"
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
(ti / CCB lic.: 72623 State surcharge (12% of permit fee) i c�y �flb n0 „ f
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit Is not obtained within ISO
� �rM J 3/r days after it has been accepted a campkte.
Print name: VI QnCC M( On Date: 6 (, 1 • Fee methodology set by TO-County Building Industry Service Board
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EPoon .too i4App. 1NOl i9 440- 4617T l)O COM/WEn)
APR -29 - 2011 01:19P FROM: TO: 5035921960 P.2
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