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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00293 Date Issued: 06/17/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 . Parcel: 25 110AA92821 Jurisdiction: TIGARD Site address: 10789 SW CANTERBURY LN 102 Subdivision: Lot: 0 Project: Deporter Project Description: Install A/C Unit Owner: FEES DEPORTER, KATHRYN L Description Date Amount 10789 SW CANTERBURY LN #102 Air Conditioning or Heat Pump 06/17/2009 $14.00 TIGARD, OR 97224 12% State Surcharge - Mechanical 06/17/2009 $8.70 PHONE: Minimum Fee Adjustment - Mechanical 06/17/2009 $58.50 Contractor: OHAC INC PO BOX 241 DUNDEE, OR 97115 PHONE: 503 - 538 -2953 FAX: 503 - 691 -8556 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue: Total $81.20 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 -0100. You may obtain a copy of the rules or direct questions to OU calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. 'o a • IVXecliaiiical Permit Applica � .,,7 CEIVED , : : ; �' ` `1 'FORii 1 E ° ,` j , ,, � t':,' ,,-_. . City of Tigard . Received / y1 Permit No.: M E c Log._ o0 223 , . IN 13125 SW Hall Blvd., Tigard, OR 9722 UN 16 2009 Doten3y: K- J II . , :'• Plan Review Other Permit: Phone; 503.639.4171 Fox: 503.598.1960 D Tl G AR D Inspection Line: 503,639.4175 CITY OF TIGARD Date Ready /Dy: luris: El See Page 2 for Lritemet: www.tigard- or.gov Notified'Method: Suppie.uental informatio BUILDING DIVISION d .rip, ,m. f , .� „ °•tl : "Sr } , t � i i�;,p: ,p . - 't!'ib`.gf ^; i1T:,� i I :? ? "r(ind•r +; 1l rr' -u ra�q 'q u rr9T.ti d'it ":'t F•tGCrmm �,t: �otjom n r,. 1 r. ,.•! : 1 d ,#� ?. adi . "� d k , p ip � } �. r i l .� 1 i , � , t 3 !) tt 1 d .6 y�,p �y�,+ �..; ,'�.!� � rf,, � ' i }9,` �u . ';< �,f'{ Jc j,01110111101,01'110 ,f' (41,, S � ; .. Z 1 i ) I f JJ f _ �'�.���``. 0,�( If f 1" �;�i C' ` Saq° I�.�! ' ; � „1 ” niiE1�41iEiJ 1�1� 411; t121., �41t4JtYE ,. ,. �i..: inn ,.,IR'r „,.�d(r4i,C��d�H�u;�3„1 Jli PN �t�t;.� #(:r,;�dfR���1i,i�'�it�i lili }iC��lli �9r�G7” l; t;.; l7I�{ ��y��.,, drC�c,�y>q`,fir;,.i,�lU•.f3,�,. _�1 �� 0 New construction dditiorr/alterationll eplacemerrt ivla:itatucal 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, labor, overhead, and . ofit. i 1,g1: ' Si ;g,�{er'� li;ij; "F ,ii "'jia ^ii'r ' °ew..o. ,.r ,, ; .if , rira'1lt,Tff % ;;c„ „ ' r ,,• i y , rlE) ' ii „i`+# i ; !i dl l 1 01 4 ,1 Value: $ i'! i ? .;,.. �`:.7't�• ri1,141; i ,1 is ; {tltN ll !,;t`rf.•`r:i1 7ti1 i, sl:i ”, s tR:, ',;vh'11�0: ?� It�Jii,!tt,. fr. Jl!i,-U 1i.iAf,J. ,, r , . �.tc:t,n,61.r:. y. gtjly,l; ar,rl:;d�trfrrdr aitrtnr .F4i io �t#:011,1,,tC v T u t 2 7, , a c �, 1 ' e�i; I! „Lr i,r l 'fur ^'t 1, Wa. i rIg51 ? ;FX; 14N;i§n�C�iti a 0 I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special it fer7r,ation use ehecklut. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty, Qty. Ea Total Dzsc - " q .., , yct , �,m -, r:,., : f z r ° t ! i -t , t , t f l i iIt" ri .i�4 l.. 1. / tt� ..� A i {i 9 Mo a J i i'. ' ;',;..,„, ;�- i t F, P1 He ti cooling _ n�t,.4,r7if.i,� d, .,�1�• t r,. 1„rr� l�I��r +. t� rflTa:mrFt!'17;�QS,i.t.id. dJ14,:. ,J.;,��t1 E1 J {1 q Air conditioning Of heat pump J Job site address: I 0 7 3 / 5 LAJ Ca-0 ' J- b u i -'2 '° / (require; site plan showing placement) / 14.00_ i ' 0 City /State /ZIP: / L w c 0.R.. 97 z--;2_4-- �( Furnace 100,000 $TU (ducta/venta) 14.00 Furnace 100,000± BTU (ducts/vent) 17.90 Suite/bldg. /apt. no.: Project name: �� _ - 10 �- Q _Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hvdronic hot water system 14,00 Residential boiler (radiator or • µ” h ironic) 14.00 , • Unit heaters (fuel - type, not electric), in - wall, in -duct, suspended, etc, _ 14.00 Subdivision: Lot Ile.: Flue /vent for any of above 6.80 M Other. 10.00 Tax map /parcel no -: Other, fuel a,pliances — .,., " t ¢ $. 1 ' grid ' t z ' Water heater 10.00 .1..'",:,'T iNi .FE',VP ' i , ; ,? llt i . t l... Gas fire lace 10.00 ‘ l' \ '"S ; ( — Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/. ellct stove 10.00 — Wood fit- lace /insert 10.00 N . a Clvmn. !liner /flneJvent 10.00 :,tab: i .,. „., r ., •.. . ilri , ; i I °,. i 4 L ;11 ®i ../ . 1'. t� , / ill s a Other. 14.00 Name: (--', ! .G 5 Environmental exhaust and ventilation - l L1 Range hood/other kitchen Address: ) b S u.C� t equipment — „ 10.00 City /State /ZIT: '"�0i�; a (?) t' C)'1 • _ Clothes et exhaust 10.00 r 1 Singly -duct exhaust (bathrooms, Phone: (5t &) ��y Y �(� Fay: ( ) toilet compartments, utility room,+) 6.80 tplttl' 1 ' §' , 53 , t� v i t c 7 °`t f- , 1 n , t �mr e i'.m.tTCS 1`S' i mal ti /Crswlapaee fans 5 10.00 ginli lit, , ' I ! g'�l , i rt � 2 i . X4 i ;(g� �i�� �;�';,, '' S ' Iif 11f ttiG y tr r 4, , ,fl 1 , ,, , 1 5�-,rlD� �Y ,r, '+ur� .,'t'r. lvt., :, ,� • l }, , Other 10,00 Business name: _ C?C31t1 H�fl�l( KC.„ Fuel ,i,ln; Contact name: 'F 't :F 85.40 for first four; S1.00 _for each additional Address: _t TIC') DIA Furnace, etc ,-, Gas heat City /State /ZIP:. uQradez on ( 1 5 WaWsuspendrxi/tnrit hearer Phone: (5(13) K 7'" 6 I — t_6 C0 1 Fa :: ( �) 6 1 —, 35 4 2 [aserheater I. Fire lace _ - E -mail: Ran -- jIli1•i 'i `i llr; ,rp yi..i, iit.til � 1 d,�tl'.,s }'rr �,,xa�, ri� , ' 4 �yil l - r' �i�i i7� l i t 1 ��+31ti9 iliti I�} ¢' i ;•agq {q $srbc ..._ -„ tea &q ��!f ..I 11,4E „; ;,,.; F L; i, t,; ?VF�lal • , t. , ';; i ' P. , , , .,isldB I. d'fir, ^ lt.4: �, &.0.1101,,13. i,•l � „ . ,,,. • �.,. - • Business name: t ' 1t;'Jr; 1 {� t ok 1Y� C� c. k C— Other: esdryer( €a .,.� ttJJ l ��{ I n I §r, „ud9r61 i !!�rr;Sd�, m , s ndrir ., {” d i 7iv Address: yy ;Ip , `satttY `, # 17 u y);! , ll�� �:�ii r� l t_ 1 d ; l �t) Il .lit +, 91;E:1p;5 's.uF "r !`f`".44A ,,. , I'tt i! { , h ,. City /State /ZIP: ill °C1.1 J l5 — Subtotal ( .. . (50 1 �� l� 55 Minimum pert fee ($72 -50) - 7,,l, — '1 Phone: ( t �[ G( 3 ax: J " Pl an review (25% of permit fee) CCB lic.: 7 �,� State surcharge (12% of permit fee) ' -) p / TOTAL PERMIT FEE permit EE A. r , / application expires if a permit is not obtained within 180 Authorized signature: a / CU T ( L d days after it has been accepted as complete. Print name_ (tf , j \et( f Date: �� P`j d ' ' Pee methodology set byTri- County Building Industry Service Board t:\Bvildieg U`tamiu\!, C-F maltAondoe OM 9/V7 440 (11/07/CnnihvEB) Z0 /Z0 39Jd 9NIld3H NO93N0 9SS8- I69 -E05 6Z :80 Eli /9I/90 t. O9 ii 0225 t i i e r i" ,J, A,- � 1 x"`00 -7) First Floor 745 cfm M. in Fl ►or • �• - 157 On157 cfm ,71 s Job #: Scale: 1 : 71 Performed for: Oregon Heating & Air Con Pam 2 Kathryn Deporter PO Box 397 / 992 Hwy 9 Right-Suite Residential 10789 SW Canterbury IA #102 Dundee, OR 97115 8.0.79 RSR28588 Tigard, OR 97224 • phone: 503- 538 -2953 Fax: 50 -691 -8556 zoos- dur- 1013:a7:3e Phone: 503. 956 -6681 WWW,oREGONHEATING_COM Kir @oregon : Pro}ettl,rrp TB /T© 39dd ENIld3H NO93d0 9558 - 769 -E05 112:89 600Z/9T/90