Permit 71 - CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00417
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2009
T iGARD Parcel: 1 S135AA70111
Jurisdiction: Tigard
Site address: 8880 SW ELENA LN
Subdivision: Lot: 0
Project: Markiewicz
Project Description: Install a /c.
Owner: FEES
MIKE MARKIEWICZ Description Date Amount
8880 SW ELENA LN Air Conditioning or Heat Pump 08/12/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 08/12/2009 $8.70
PHONE: 503 - 691 -9699 Minimum Fee Adjustment - Mechanical 08/12/2009 $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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: _ al . , � : 11 • Permittee Signature: Q M ..
al / � •
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.
• /1
• Mechanical Permit Application OR OFFICE USE ONLY
City of Tigard 1 Datc /B , rr No �7 - ate 13125 SW 11OR y '
- Phone: 503.639,4171 Fax' 503.596.1960 B Other Permit;
st c:
TIGARD Inspection Line: 503.639.4175 AUG 1 12009 Dote Ready/By: AM.: EI Ste Page 2 rvr
Internet: www.fig d-0 g t1 iv thod. Supplemental at r. ov No f4ed le 7.- Sttpplero I
■
lrl OF T)(1ARD _
: '"'' .. vc ;;,.r; iF; ,'�,,';;`!' YP Cit'''I_ 1: ` t` N' , ' O'T4) fii'i t ; '" ; SO'ii.05 j]f; 4 *E+i(;ig1�
❑ New construction Addition /alteration/replacerrietit Mechanical permit ices' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ betnolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
is ., :yK,:, Pt r, ' V:
'' , / 1 ' � i i- CiA' i O 1 NsTRUCTIOly r ' i I • . J V � Value: I
yy,, , y y � 7�,y 1 ' 1
: �i / P .Tii?!� ` ti[,Z ,1 '/, ,. § h,: ,'f. .! !
.'.
AI_ and 2 -famil • dwelling ❑ Commercial /industrial
Y dwelling ❑ Accessory building
For special information use checklist.
❑ Multi family d Master builder ii other:
,. ., , ds,r .rug n,;: _ , .:G. r � .�.,, Description I Q E. Total
iq 1„�� i ` ' l t`.', 1' OB S TE 'iiYFQR14{1TXO i A :.,{t.,'O( TIOi� { ,,'tit ; , i V t'; Ti eatt cool
. w Air c Or h eat um p
Job site address: BSt �� (,,, 1 d P t �_"' (requires site plan showing plangent) 1 14,90
City/State /ZIP: Furnace 100,000 BTU (duct /vents) 14.00
....r 11.-4111
furnace 100.000+ BTU (ducts /vents) 17.90 M� -
Suite/bldg./apt, no.: Project name; _ Gas heat pump 14.00
Cross street/directions to job site: Duct work 10,00
Th'dmnio hot water stem 14 -00
_- ,. Residential boiler (radiator or
bydronic) 14.00
--, • _ Unit beaten (fuel -typo, not cicenic),
-- in - wall, in -duct. suspended etc. 14.00 .
Subdivision: Flue/vent for any of above 6.80
Totno.:
Pthar. 10.00
Tax map /parcel no.: Other fuel appliances
+:y !l I'1 i f , rw � R u i3 .y' t pr,x � +e,m.. rGi9'. (;" a t,, t- s,
r r . ti�111 a,1? rAI URIM rfrO ]�l� �r e `i % (2'j� j I l r Y ;ff$� 1{'S
, a � S li_ x�u�w 1 �R��R1�rG2A' tE' 1 ��i���i�ilr� i( �11k� .,Si.��li�I�,:�31',.i�'i.�lf.� @ ��;�GP,�,rt3
-'-)� Water heater 10.00
Gas fuc ] ace -_., 10.00
, Flue vent for water heater or gas
• fireplace 10 -00
- - - - - Log lighter (gas) 10.00
„„ Wood/pellet stove I 10.00
Wood fireplace /insert 10.00 w`
Vi° ; 1�� , r �,w 414 0. tr 'v,,r: :,r, �:: • tt�' t >rn.:1 •,: ,.; Chimney/liner/flue/vent /liner /tlue/vent
I w3 11" . A'f ;lt a: " s , rr•; d�. fl y it y }li , {s e r r r ,' l:r t y /0.00
t r. , :!,t .. s:,,� t I:: ! , t ; )' ::f A4 Y' � �� (p � 1) J; 1 �; r �1'' Othe _
. • � � ,�'� trs � i �;z I:i".2' f � X1.1 .�1 i kr „ VAF.,i:'_.,k h r
�� 1Q.10.00 Name: / i yUcur k . e__ - ?_.. Entdronrnental exhaust ant( ventilation
48� �? �
oA � / _ Range huutUo dies b�teltcn
Address: I, 3. " tee^ Vv` , equipment _ 10.00
Cit•/State/ZIP: 1- 1 - r , CL r • q. / 3 Clothes dryer exhaust 10.00
Phone: ) (Q ( (,�"- Single-duct lecompartments cha (bathrooms, t ty rooms) -tit, Fax: ( ) wiles compsnmenis utility room:) 6.80
4gi 1! 'v :e� {:, ,li.:.A���� " , ;,� r .w 'r.� : ,y'. �ln r „a, �', nx„..�,,, I; �'(� I
v" ,Igi i } ,� i {45' '1 l ,: :,;,; ?I "'1 ;'ll" I,b:.,,}, Attic/craaris ace fans
- ir,;,- ,,.eaart � :l , ) , i6l11! ', .sA nr i ,6x6'44 ' i1. ∎J.t{ „t i, 1, 'IO:..., P''P SQ:l ; : " ",IIIi P 10.00
eh I 10.00
Business name: C�Y� Pf � �� Fti et r P i to , --.
P g
Contact name: i ,
W� �r� � $5.40 for first four; $1.00 for each additional
Address: rr�� Furnace, etc
} X «L� Gas heat pump • City /State/ZIP: ��? C v r .,6, e 0 1 ` a / Wall/suspended/unit heater I
Phone: () ..,pi I
k l - C9(3 C7 Fax:: ( .3) �,1 - 8-556 Water heater
E-mail: t ' Fireplace _
Range
h' i t , 'i , 'i'.., "} r t.r 1 ,1 M i i r•i�' `" d
r.;t,-,�ly aM1', '�, i %,'.� !� ,e. ,, ylm:..,: {. .V Q rTRAGTA I 3 , I i 1 r, , i i V tl ..A ! - ----"- _
i
,,, ,.i } ,1 i.� f ..,.�. , I,.aa L 1 „J , Sr..7, ,n, ,� c „ �„ � i S i ;" .... c -._
x S , T . 0
Business name: 0 � � �_ S • . Clothes dryer (has)
S ^ Qthcr:
"
w Address: ' i trey �7F fe�; �fij.'�-tii,,: "„ ,-ti , . y .. , : 1' . 1 /'r . t ., .
1 l�Y ii',i.'" of ! 7 ; �!, Ni + . .... � , 1: t{.' i{ ii,24 .' L
y{p: 6 e.i� ii,: � K" . ,;Y *."Y���.'^1., 1 �; ., 3. ^;'iii{' � nN.. I S i %
City/State/ZIP: ,., .. r . Av .',.Y4,1,;a;
(, n 1 e r 9111,5 Subtotal
f Minimum permit fee (572,50
Phone` (1;505 l c 1l - Q c, � c Fax: (50' b ? . \- 5 + Plan review (25% o£Demur fee)
CC13 lie.; ... '7 t a (' v State surcharge (12 %of permit fee) lilfr
� TOTAL PERMIT FEE EOM
Authorized signature: al 4 • Tbls permit spplicsttoo expires if n permit is not obtained s5 bin 1S0
.a • clays after it has been accepted as complete.
Print name: o f . bate : `( s Fee methodology set by Tri- County Buildi Ludusiry Service Board
d:\Beilcriez\PemiclhrEC -Pet Ane.doe 01/15/07 .11r (Ilm>/N /WPM
CO/TO 39dd BNIIt3H NOB3J0 9SS8- t69 -E0S TE(60 600Z/it/80
03
• 09 -0309
m
First Floor
W
H
Attached
cn
m
W
I
cn
LD
co
U1
U1
01
•
Oak St Elena Ln
Main Floor
0
I m
0
1 0 + Jurisdiction - City of Tigard
10'+
Jab : Ore on Heating & sale:1 : 85
Performed for g 9�
Mike Markiewicz & Jessica Wifkosz Page 1
fs � Box 3$71 992 Hwy 99W RagM:SuFte Residential
8680 SW Elena
Dundee, OR 97115 8.0.119 RaR285$6
Tigard, OR 97223 f'hQr - e - 503 2009-Aug-04 09:02:42
Phone: 503- 922 -4819 0raligl�oregor?heating.00m C:th1ly booumenfsMdght I4VACL. m