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Permit ,, CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00410 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2011 Parcel: 2S104CA11300 Jurisdiction: Tigard Site address: 13683 SW TAMAWAY LN Project: Holland Subdivision: HILLSHIRE Lot: 113 Project Description: Installation of a/c unit NC unit must meet minimum 5' side and rear yard setbacks. Contractor: A TEMP HEATING & COOLING INC Owner: HOLLAND, ELAINE T 16000 SE EVELYN ST 13683 SW TAMAWAY LN CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223 PHONE 503 - 650 -5014 PHONE: FAX. 503 - 557 -2990 FEES Specifics: Description Date Amount Air Conditioning 09/13/2011 $46 75 Type of Use: SF 12% State Surcharge - Mechanical 09/13/2011 $10 80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/13/2011 $43 25 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 k is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utdit otification Cen ; r. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -111 -0090. You may obtain a copy of the rules or rect questions to OUNk .y - ' g 503.232 1987 or 1.800.332 2344 Is ed By: Oa, I r / � ` ` ' Permittee Signature: 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 licatio ¢ _ 0,,,„.N. ,-,,,,,,_ v City '� 13125 SW Bull Tigard 97223 SEP 1 3 2011 �( _ W Bull BIvJ„ Tigard, OR 97,E 2 0 1 / PermitNo.. lifea ....-ere, to Phone; 503,639.4171 Fax: 5 03.595.1960 Fes" Rrv,c Inspection Line. 303,639.4175 1 =/�Y other Permit Internet: www.tigurd- or.gilv a r , tc Dut:Resely/Sy a +Page2for J9E�tn,n r;� NvurlCda letnod, _ C DIVI vl IO t i Suppleturnw[ L,formatlon b TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 0 New construction ` A.dditron/altera • . P p Ye lac , .., t Mechanic) permit tees* are based on the value of the work ❑ Doru011tictn El Other: performed, indicate the value (rounded to the nearest dollar) of all mechanical materials, en at meat, labor overhead, andproftt. _ CATEGORY OF CONSTRUCTION Value; S -, Al 1- and 2-fHmily dwelling D Cotttmercial/industrial ❑ Accessory building - IZESIDENrIA'L EQUIPMENT /SYSTEMS FEES* 0 Multi - family © Master Wilda E] Other Far �pecip! Information use checklist. ` JOB SITE INI'ORMATION AND LOCATION UoBCaiption Lctt Ea. Tot Sob site address: I I Heating/cooling - • , u (I !l Air condition - 1 i . . r I I ..0.. T� ( uuaeze;4n plan s4owu t ptacnment I 46,75 ' 6 ,i,J 2. 2,E Furnace IOO BTU (ducts/vents) 46 75 ' Suitr/bldg. /apt. no.: Project uttme Furnace h40,0OU1 BTTJ�dactx/veras) 54,91 ki\ Cross stmt /directions to job btu; ! A rat puma _ 6106 — —_—_- Duct work 2332 _ 1-1 drone hot water stem 23,32 - ,___, Residential boiler (radiator or -- - hydronic) 23,32 Unit heaters (f ie1 -type, not rlecq is ), - in in - duct, sus. • ded, etc. 46 75 Subdivision' Flue/vont f a n of above - Lot no,: 23.32 Tux slap /parcel no ; - = Other: 23,32 Other fuel a' , ea - DESCRIPTION OF' WORK Water X81 A ._ 23,32 h Gov fire. lace 33,39 f ' re p vent for water healer or gas M� L Lil o ii _h - - t li-ltter a a �� MEIN Wood/pellet stove Wood fireplace /insert _ Mil 0 PROPERTY OWNER CI TENANT Cltimny /linrrltlue/vent 23.32 Name: Other: Q l 23.32 Environmental exhaust aced ventilation Address. - -C Q W q 1 r Rangehood/otherkitchen City /Statti /ZIP: - � ,,utpmcnt 33.39 1 L r l Cloi6og dr er exhaust 33,39 Phone; ( ) Pax: ( ) Single -duct exhaust (bathrooms, toilet uumpa anttutility room 23.32 Mil . ' • PLICANT ❑ C'ONTAC'T PERSON Attic/crawlspaoe fans 23,32 IIIIIIIM Business name: ()these: Contact Mama; R , i.,,. i Such plpht � I;IA C apTyrt qt. $14.13 for first four: 54,03 for each additional Address: faCkfialaS OR 9701$ Furnace, etc. l 1 Gas heat pump Cray /Slxtr/Zllu: __ Wall/suspended/unit heater Phone: ( ) - Fax :: (7 - Water h eater E -mail Fir .lace Ranee CONTRACTOR Barbecue business name: M Clothes rat � — � lr...lrl' .1 _ k ;X10 I. 1k f 7. Other: - Address: 16000 SE Evelyn St, j C /state /Z MECHANICAL PERMIT FEES" Subtotal Yhcte `� �. ��� Minimum permit fen (.'90.00) ` f 0 LCl3 lie,: 4 Plan review (25% aperitif fee) State surcharge (12% b r� '" �._ 8 ( of permit fee W ?'t Authorized ' mature: JV + Tl,: TOTAL PERMIT FEE ( 3 . , 1► � permit npplioutien expires lr a permit is not obtained within 180 Print name' t may after It h on as ham accepted as complete_ try o rs ' Fea methodology ear byTn -c: aunty Building Industyserv ltoard i.,$ y$djnq�F'c[Yt;i ,,mEC. pe.....d. 10,6 1 /09 440-4617T (2 IA VC06t/'W k Al) p9 39 d ElNI1b3H dW31 d 066ZL55E05 5Z ET TZaZ /ET /68 eating & Cooling, Inc, SITE PLAN Prepared by :, , �� Date: g /r Customer Name; . ire / - v ' Address: 11642 , 1-1 et). Customer Phone:�K i5) Property Boundary Line (J • • 1: ••• cf • [PK House CO 39Vd JNIlt73H dW31 d 066ZLSS£OS SZ :£T TTaZ /£T /60