Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00372
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23/2009
Parcel: 2S110BB02100
Jurisdiction: Tigard
Site address: 14390 SW HAZELHILL DR
Subdivision: Lot: 0
Project: Joel
Project Description: Install A/C Must maintain a 3' rear and side yard setback
Owner: FEES
JOEL, LESLIE B & LORI J Description Date Amount
14390 SW HAZELHILL DR Air Conditioning or Heat Pump 07/23/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 07/23/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/23/2009 $58.50
Contractor:
SUN GLOW INC
2428 SE 105TH
PORTLAND, OR 97216
PHONE: 503 - 253 -7789
FAX: 503 - 253 -7693
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: ! akt Permittee Signature: ' • K/
Q
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.
, Ale konieall Permit plicato n. :11;f_f K0 VIIIC:lt.;
.
City of Tigard RE CEIVED Pe
Received • , , , , , . . •
. , rg, 1112S SW Hall Blvd.. TiOard. Olt 97223
II/ Date/By: ntit No.: est(n)i- 0031 P-
. ; .. • phcirie: 50,94171 Fam: ;T3..590.1960 ii
2 20.09 EN11111111111= Other Penn&
i .JUL 2
Date Rapdy/By: illE Z seernen Z for
ltfetiqe0Mothoti: StrapIlementak friforrnof=un
CITY OF TIGARD
.. • '' .,!.:''''..:-.-. ::-..:',.'',, :•.** :'"•.:•-: -:: •rwE . 04M4141 1 \ 10 Inv ISM- ' •-. ''',:-' ...,.' ..-; .-::-, `1.01102 ScHEDIULZ, 4115i, CECECICLIBT.
0 Now conStruction ;11 Addition/altoration/roplaectuent Mechanical permit fing* are based on the value or the work
performed, Indicate the value (rounded to tlic nearmt dollar) of all
0 Demolition 1:1 Other: mechanical materfals, labor, overhead, and profit,
. ..
'''.' : - 2 .• : . :• ' - :F:"' ' "';'.... '';'':''.'' '' CATtGORY OF COMBUCITONJ ' : • : :, ' ' . ,:-, .• '''• ';:i -"‘.: .;T-' Value:
• - „:k, •
0- and 2-Family dwelling 0 Cortncrcial/industrial ID Accessory building
For .7pecial Irrfirmolon rac checkArr,
0
mufti-dimity El Master builder 0 Other: , --
Dosed ■tion Qty. Ea, Total
TO 'am rffoRmArtiorr AND LOCATION
. .. ... .. ...
, —
Air
addres conditioning or heat pump
Job bite A: ILA -9 0 s (.,_) k ‘.1 I.1 ,...1-- (engulf& sire Om onw■es p cement /4.00 Ma
Al, 4
CitY iSbOCIUP: - a.- Ft,nole ... 1 . 00,0004 1 , 1 19 14.00 IIII
---- Furnace 100.00a# BTU ,ductstverirs 1 .90
Suite/bldg./apt. no,: 1 Project name:
- -- ... - - Cii!S heat pump 14.00
Cross street/directions to job she: Das!, work 10,00
FT • ronie hot water s stern 14.00
— Residential ttoiler (radiator or
hydron lc) 14_00
------- Unit heaters (fuel-type, not elec(ric),
in.wall, in.cluet., Auopended. etc. 1
Flue/vent for ay of above 6.80
Subdivision: Lot no_:.
— ,-. Other: 10.00
Tax map/parcel no.; Other feel syphoned ,
':--,:....',...:'. '. •; •:: :•;:•;'.;. •:,:.: .
DESCRIPTION OF WORK : ' - .•-,.. ' ":,'"',: " '" ' : ' " Watc; 'matt* / 0.00
111 10.00 NI
C.,_.• .. . 4 Flt v ac t': wafer beater or gas
___....,—
— - Arc , lacc
10.00
, „ - - IA, lil ter .as Milli 10 . 0 0 NM.
_ Woodt• cite stove I= 10,00
Wood fl - lace/Insert 1.111 10.00 ME
• . Chimney/litter/flue/5ot II. 10.00 al
OWNER '. , , - - , - - - - ID , 'MANI': ,,' - ' - .: --.
1■12117_1:_i_
tnvironmental axltaust aod m01111011
-----,_
Range hoott/other kitchen
Address: 1 1_139 D 56 - 44, 'Dr , g ui quern rosio
.
cityistocarp: -- , , a * D , c--
i.) .- - Clothes d er exhaust 11100
4 — $in s e-sruct exhaust (bathmorns. „
Phone: (6 3 0 (,_.,.., Fax: ( ) toilit cournarmtents gait); morns) 6,80
. .._ —______„,
I, •• .. "• ' •;:?..-:: IR ••';':''' :'• •::•:. • ' :,'• , : -', 1:1 coNTAcir pEosora .... Attic/cm* nee fril 10,00
,____,.. Other: 10.00
Business natV . .. .
SUN GLOW INC, rue; ;Lthr
°mulct nurtt sun for first four; $1.00 for each additional
Heating & Ai , r Conditioning ---
Addrus; 2428 SE 105th Ave. Porlland, OR 97216 — Furnace, etc.
(503) 253-7789 FAX (503) 253-7693 Gas heat .urn. MEM
City/Stow/ZIP
- . Woll/susmded/trnit hat' ME
Phone: ( ) I Fax: ; ( ) Water heater
.. Fireplace 1111 .
E-mail:
• ''• ' ' ' '.., '• '':: . ,': :"+^ ':::;:.' '':i ;, • CONTRACtOW.,.:, ': ' : ': ' • ' : " ' - • . - : ..::• . Barbecue NM
.. • -
B Clothes dryer (ps)
usiness name:
'4 A SUN GLOW, INC. ' Other:
Address:
Heating & Air Conditioning -' PIRMIT FIZM*,. ' : -".: :. : • • •
citestaterzipl 2428 SE 105th Ave. Portland, OR 97216 Subtotal
' (503) 253-7789 FAX (503) 253-7693
Mlnimuns permit Ibe $7150) , ,S 0
Phone: ( ) —
_ .. . . Plan review (2S% of pound fee)
CC13 lC.: _ State surcharge (12% of permit foc)
,
TOTAL PERMIT FiiiiE '1,, . , 0
Authorized signature: 0 _ \I \ _.k...so .-------- :CI ,,...Q._0 Iv, permit opputtuan !sotto tt puma i no t o bt a a w;th;et My
day; offer It has bee" Geekined na
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