Permit CITY OF TIGARD
11/1 MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00203
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/16/2007
PARCEL: 25111 BC -02700
SITE ADDRESS: 10380 SW CANTERBURY LN ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 005 JURISDICTION: TIG
PROJECT: MILLER
Project Description: Replace existing A/C with heat pump
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PAUL MILLER • Description Date Amount
10380 SW CANTERBURY LN
TIGARD, OR 97223 [MECH] Permit Fee 4/16/2007 $72.50
[TAX] 8% State Surcha 4/16/2007 $5.80
Total $78.30
Phone: 503- 684 -8513
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO
PORTLAND, OR 97239 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -0611
FAX 503- 234 -0439
Reg #: LIC 161085
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: �) Permittee Signature: �/ ! i ` .e% L
Call 503.639.4175 by 7:00 a.m. for inspections that business da .
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 12 07 11:15a p.2
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1VIe�hanecal Permit pplic I ,� . .!;(R OF'F•FI( t Sr ONI.\- ...
City of Tigard h � ' R Dived P ermit N o.: a
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13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639,4171 Fax: 503.598.1960 APR /b-„ ` Date /Bview Other Permit: /y1
* rw ,) I DateBy: tI/Sl ,R _4 Zg Plan Re
Inspection Line: 503.639.4175 t � I Dat ReadvfB : Ions
t - Y 121 See Pale 2 for
Internet: w vw.ci.tigard.or . us
IJJ t/ ( � Notified/Method: Supplemental Information •
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New construction Mechanical permit fees* are based on the value of the work
El : ®Addition alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit,
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0 I - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty, Ea. Total
_JOB SITE -INFORMATIONi ;AND ILOCAT ION ` = -:` ; ' =F< °tii ' "'.,,-.. <<'". Heating/cooling
Job site address: Q a -- . %' (f iwr ,� !'' /. ,, ), tw , � d Air conditioning or heat pump t , .
l✓ r - r i�'i r „r z.( '! t k` 14.00 + {'
(requires site plan showing placement)
Citp /State /ZIP: -fl ? t f -- 1 . ?i,7 Furnace 100,000 BTU (ducts /vents) 14.00
i Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: i(; 1 ji: e- Gas heat pump 14 -U(1
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 10.00
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1 Flue /vent for ally of above 10.00
I Subdivision: Lot no.:
Other: 10.00
1 Tax map /parcel no.: Other fuel appliances
•. I)
Water heater
10.00
f
Gas fireplace 10.00
ii S1! t. t. i e k'? Flue vent for water heater or gas
fire , lace 10.00
Lo lieh ter (gas) 10.00
Wood /pellet stove I 10.00
Wood fireplace/insert 10.00
���. - ; �; _ Chimney/liner/flue/vent 1 0.00
P O E
T2 P OW
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-. .:: -:. �. .... ... :. . .: .. . ... : :. :v t...,, ..,. �..,... . �, ,... - , ,.. 3'.r.. .... ...e , -_.. ....,..s,. .. Other: 10.00
Name: 11-)1•x•7.?.. n II ti: f
Environmental exhaust and ventilation
Address: a t ,. �_;'' "� 3 } l , 1 L't ” ' . ' Range hood/other kitchen
. Cal"' i • i'' t.: equipment 10.00
City /State /ZIP: • - .1 fit r; 3 : -.) <,1 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (;:J,.' ) by '' incl. ' . Fax: ( ) toilet compartments, utility rooms) 6.80
;( ;`� >I' ^' ; r Attic% ace fans 10.00 rawls
__.. I�`:�1P.PtTCi�N'I's '� ,,M` ,,Ply '9G� " ,, GT`:� . , .t.. w .;,,, p
Other: 10.00
Business name: Fuel t to
Pp g
Contact name: S5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water healer
Fireplace
E -mail:
Range
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Business name: Sunset Heating and Cooling
Clothes dryer (gas)
Other:
Address: 0607 SW Idaho Street ~ 4u„:'• ,•.,y3,., - ....tv."'''
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City /State/ZIP: Portland, OR 97239 Subtotal d u
Minimum permit fee ($72.50) -3 2 i t,
Phone: (503) 234-0611 Fax: (503) 234 -0439
Plan review (25% of permit fee)
CCB lie.: 161085 State surcharge (8% of permit fee) /<, `p„
`~ ^ ,.. TOTAL PERMIT FEE -' r '
' / � ,�t�,, This permit applicat expires if a permit is not obtained within 180
Authorized signature: % �_ days after it has been accepted as complete,
„ t • F ee methodology set by Tri- y g Industry Print name: Shauna D'Ambrosia Date: 4,1 l� j �,; � FY Y Count Huildin Indust Service Hoard
i3Building\Permits \MEC- Permit App.doc 12103 4404617T (l t /02/COM/WEB)
Apr 12 07 11:16a p.3
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'Air% Sith Plan
Sunset
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Name:
Address: /1)._._0
HOUSE
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