Permit v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00211
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/17/2011
Parcel: 2S103DB11400
Jurisdiction: Tigard
Site address: 11220 SW ARBRE CT
Project: SMITH Subdivision: GENESIS NO. 3 Lot: 63
Project Description: A/C and furnace installation. A/C unit must meet 3 ft. minimum rear and side yard setbacks.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: SMITH, R STORM & DEBORAH E
PO BOX 241 11220 SW ARBRE CT
DUNDEE, OR 97115 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 05/17/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 05/17/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/17/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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: � Permittee Signature: I
I
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.
Mechanical Permit Application RECE1'.:',2-'s
FOR OFFICE ISE ONLY
l T igard, OR 97223
Flu Review
, -
711 MAY 1 6 ttrr — i
CITY OF TI eliZi / U 0 - Permit Illy),EC ( ---( (
Phone: 503.639,4171 Fax; 501598.1960
Other Peinait:
Inspection Line: 503.639,4175
TIGARD luris. e see Page 2 for
Internet: www.tigard-or.gov PLANNIN 1=110 .. g , Supplemental Informatoo
—..-r
'TYPE OF WORK . . • 1 • ' • •Oft: SCHEDULE L '‘Vt I PXitciOsT • '
Mechanical permit fees* are based on the value of the work
0 New conOtICtiOn :111 Addition/alteratiou/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
Ei Demolition El Other; mechanical materials. ent labor overhead, and profit.
Value: $
1 0iiii*N:P4EQI*IVIPII'./ 0'44 i'Er,s4 : , .. •'
04 - and 2-family dwelling 171 Commercial/industrial 0 Accessory building
For special Information use checidist
0 Multi-farnily 0 Master builder 0 Other:
Description Qty. Ea_ Total
-- —
." .:::: :.,! .,‘...,,=' ,..: 4CiB SITE 'INFOR1V1„4 MN]) • toCATIOIV , ..L ": I , :''• Hearing/00hr%
.,
Air conditioning
Job site addreSS: il ga ( j4gb A e C-4. (requires site plea 6 . showing placement) / 4 7"
, .....'
City/State/21( 0 4 9 ...v .. Furnace 100,000 BTU (duets/vents) / 46.75 VW- / , ...1
Furnace 100.000+ ETUicluctsivects) 54.91
Suite/bldg./apt. n0-: Project name: 5n,..utp He. p
— t ump 61.06
_.„
Cross street/directions to job site: Duct work 23,32
— _
hot water system 23.32
Residential boiler (radiator oi
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
Subdivision: • Lot no.:
— — — Other; 2132
Tax map/parcel no.;
Other fuel teplhan
,—
2332
':,.:' ,,,i','.? ''`";".,..', , ,.',,f' . . ,., . ; :"::.' .:::.. OP : '•:,,': . /..:Y',..A!' :•V
''''' Gas fireplace , _ 3339
OM rif . (I (IAA_ a , - ell . • Ali ,4/ .- - Flue vent for watea- heater or gas
, .
fireplacc 23.32
Lo lighter (gas) 23,32
Wood/pellet stove 33.39
. .
Wood fireplace/insert 23.32
. ,:?.',: ' I" T . ',.:;')=11-ES 23.32
! . ;:- , ,.: : Other
23.32
, ,
Name: „
'h. .L. A di ...:Alt Environmental exhaust and ventiintio
Range hood/other kitchen
Address: //g.0 St( O. . 1 .2 1 b ( _ ,
equipment 3139
City/Statc/ZEP: q 7 . 3 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone:) " C2V/y Fax: ( ) _ toilet compartments, utility rooms) 23.32
0 '. 0 17 1J 6 . 4 *. ' :.: , • .: f '-. '.',:'.:„' ,' 0 coNT:44:?gsaN. :::r" ' Attic/crawis fan ' 23.32
Other: 23,32
Business name: CryZy i p t l e, j j ) a il / . Le3„ ,, , ,....., . Fuel piping„
-
Contact name: _ i - ./.. , 61 a $14.15 for first four; $ .4 03 for each additional
Address: ( "P. 0 . (.69 Furnace, etc.
i ()- c, 7 / Gas heat pump
City/State/ZIP: tOUri i tl e 0,e, 9 -2/As WIl/suseeridednin it heater
pho (55-6, Water heater
Fireplace
E La _ e avie ,„...# 4 ,,,, I. &A . . Range ,
2 ::::',:::::,:::;'.:::,:•':: ' . , : : ' : ":-.., •":. ...::: '.. , , 41-- ,.. , .• H : ... :.,. . ' - ''. Barbeme
BuS ,,,
iness name: ... iv.,c7„
other,_ . _
AddreSS: (.2 (5, IX :'.';'...':. '...,' . ' " ' .'ild646.4. tikk+iiiiii* ...' '.' • : 77 ' . '
City/State/ZIP: v9/2,e--kEl />e„ Q permit Subtotal 73,,Sa
fee (S90.00)
..,Phorvel) 9 p ax ) brQ/--ei',51 Minimum Plan review (25% of permit fee)
CC B lie.: / •7g27:94, State surcharge (12% &permit fee) /L.
k
- , TOTAL PERMIT ITEE /0 V,. 7.a
Authorized signature: A
.,,,IL, This permit applicetion expires if a permit is not obtained within 134)
Autho
days after it has been accepted as complete.
[Print name: ZgLegie_' icr
. 9-7.741--- Date: 3;76, --7 ' cm methodology set by 1'4 /Building Industry Service Board
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Kitchen /Nook Dining
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Laundry
Garage
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11220 SW Arbra Ct 7.1.25 RS U12730
Tigard, OR 97223
I a ° 1 8 ...leMSmIth S ay-14 10:12:33
Phone: 503- 59B -�d1 Sim & Debbie503-598-94113
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