Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00287
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/22/2011
Parcel: 2S112BA05400
Jurisdiction: Tigard
Site address: 14465 SW 80TH PL
Project: INGRAM Subdivision: WAVERLY MEADOWS Lot: 2
Project Description: A/C and furnace replacement. A/C unit must meet 3 ft. minimum rear and side yard setbacks.
Contractor: DR HVAC INC Owner: INGRAM, LEROY S & ANNA RD
PO BOX 1290 14465 SW 80TH PL
MCMINNIVILLE, OR 97128 TIGARD, OR 97224
PHONE: 503 - 474 -9891 PHONE:
FAX: 503 - 474 -9897
FEES
Specifics: Description Date Amount
Air Conditioning 06/22/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 06/22/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/22/2011 $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: J: - • - rmittee Signature: w ^
Call 50 % ' 5 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.
Mecha.nicat Permit ApolicatioitIOISIAICI ONICIII • r()R ()1?1.1(:E USE ONLY
CI 11 AO A.LIJ
poi City of Tigard Received
: ..-_,, , , 13125 SW Hall Blvd., Tigard, OR 97223 110Z I g Nflf Plan Review
' ! Phone: 503.718.2439 Fax:. 503.598.1960 Datell3y. Other Permit
'I' 1 GAR D insPection Line: 503.639.4175 Date Ready/13y: 63 See Page 2 for
Internet: www.tigard-or.gov agAlapall Noti&ri/Metlioci: t SuoPlemeatal Inform
' .
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ir Mechanical permit fees* 2= based OR the value of the work .
0 New construction F.! Addition/alteration/replacement performed. Indicate the value (rounded to the Inquest dollar) of aii
EJ Demolition • . Other. • mechanical materials, - i •ment, labor, overhead., and •rott.
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P I I '' and 2-family dwelling 0 Commercial/inclustrial 0 Accessory building For special information use chodclAx
• Multi-family • 0 Master builder 0 Other , IpeeriPli°/ 1 QtY- Ea- Total
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Job site address: 1/6 6 to Ro 4 4e , .4 ace .. 'rex site den showin- .lacernerit 1 46.75 1605
City/State/ZIP: 'V . &d A Furnace 100,000 BTU ductE/vents MI 46.75 Eatil
Rrnace 100,0001- BTU duets/vents) MN 54.91 MI
Suite/bldg./apt. no.: Project name: Heat pump
.. . - site .Ian showing .!cement 61.06
Cross street/directions to job site: Duct work 2332
H • • nic hot water sYgcm 23.32
Residential boiler (radiator or
• •
h. . 'e 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, sus.— ed, etc, 46.75
Subdivision: Lot no.: Flue/vent for a • of above MEI.
Other: 2332, .
Tax map/parcel no.: • Other fbel a • 'Duces: •
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Wood. -.1ace/insert •
. • 23.32 MIMI.
s,... '."..1:Pc FolcAril..ri. Chi= diner/flUe/vent 23,32
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Name:
ti.D. .., ' gnvironmen : 4 . , . 1 D It ; t 1 •
Address; ' & S14,1 -- Pate Rangohood/otha kitchen
33.39
City/State/ZIP!
•/1‹... clothes . cr exhaust 33.39
,.. / Single-duct exhaust (bathrooms,
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Other: WM 23.32
Business name: -
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Contact name • . .. ._
' _A'' f It $14.15 for first four- $4.63 for each additional
Address: ' S' $ V6 VI'N- 4-. Fiume etc. , .
City/State/ZIP:. ittl (At-A L .- / J ` 7/ r. I , Wa11/51,1S ■ . clod/mit heater"
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10111
Phone: 6a 5) 7 —,,i'q ESME42211=11 Water heater
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E-mail:
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City/State/ZIP: 6.4a
/ • v - Ot. . 5. 7 - - , Minimalist perm Subtotit fee ($90.00)
MEM
Phone: 0 ) 74,--5 gl ( Pax;( ) . ) - e f- --c r 7
Plan review (25% of penult fee)
CCB lic.: 10 a- 3 ( • ' A . , • WAN1111.1111.111111111111 State sin-charge (12% of permit fee) rifek-,2!
• / TOTAL PERMIT FEE MEM
• appliesdion expires if a permit is not °Wined v.ithin 180
Authorized signature: ‘ 7/)1P-.4. / eze7vie This permit days after it has been accepted as complete-
Print name: / /47 e,.:14/ Date: 4 - e Pee methodology set by Tri-Cotattyl$nilding Industry Service Board •
1-AncilarsTermitamEC-FeriatiApp.aoc 09/09/10 440461Tr (I 1 /02/COm/WE) S •
800/1.00 d 120 9 Z# 3VAH t:I 0 LB 8 8 17LI7E0 c C17 Ol L LOZ/LZ/90
06/21/2011 10:43 5034749897 DR HVAC #2604 P.002/003
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