Permit n CITY OF TIGARD MECHANICAL PERMIT
. . It CO MMUNITY DEVELOPMENT Pe rmit #: MEC2012 -00079
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2012
Parcel: 1 S133DA03300
Jurisdiction: Tigard
Site address: 12635 SW GLACIER LILY CIR
Project: Eaton Subdivision: AMART SUMMER LAKE Lot: 55
Project Description: Heat pump installation. Unit must meet minimum 5 ft. rear and side yard setbacks.
Contractor: OREGON AIRE INC Owner: BANK OF NEW YORK MELLON, THE TR
7715 NE 33RD DR STE A BY RECONTRUST COMPANY
PORTLAND, OR 97211 400 NATIONAL WAY
SIMI VALLEY, CA 93065
PHONE: 360- 423 -1966 PHONE:
FAX: 360- 423 -1978
FEES
Specifics: Description Date Amount ,
Furnaces < 100K BTU 02/09/2012 $46.75
Type of Use: SF Heat Pump 02/09/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/09/2012 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within .180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
IIIIP Issued By • _ _ / —off ` Permittee Signature: _" 1
Call 503.6 •175 by 7:00 a.m. for the_next available_inspection_date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RE
c.. • -••• I m () f Rr/C ry - - T s.•, r-w v-' ' r
Mechanical Permit Applicat FOR on• t 711 ESE ONLY
IN l 3 lZ5 W T igard FEB - ' 9 2012 ft c e ived / - T
• a PeimitNo.: s
13125 SW Hall Blvd., Tigard, OR 97223 1 � ��'-
Plan Rev;w
' • Phone; 503.7182439 Fax: 503.598.196h , Date/13y:
Other Permit:
Tti ,\KD Inspection Line: 503.639.4175 �� 1 i OF TIGARD u;fteftetd /$ In s ® SccFage2for
I nternet: www,tigard- or,gov ]j' U11- liVAIO Notified /Method: •r^f j Supplemental Information •
fYPb OI WOR : CO111M RCL4L 1LE+ sc u�� uSE iti CKLISt
❑ New construction .... ®Additi .... ....... ..
Mechanical 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 profit.
C 'A'1k. OR7l' Olt' C�3NS,tRT;IC."r "X(N $1L ST
m
RUC'
El l- and 2-family dwelling ❑ Commercial /industrial Q Accessory building For specialli(/orrnalion usecllecklist
� T
❑ Multi- family ❑ Master builder ❑ Other: Description - _ � _ Qty. Ea. i Total
:JC3R SST' ' iNFORi�'rAtTION AND w Of Hcating/ioolinat -
..w.. w..M.L� A cond
Job site address: 12635 SW GLACIER LILY CIRCLE (requires gile plan Ahuwing placement) 46
.-. . ..�.._ :......,.. -- __,,,_ .,.. ,,,._,.,�, -__ Furnace 100,000 BTU ducts /vents? 1 46.75 46.75
City /St.fiLeJ7,IP: PORTLAND OR. 97223 Furnace 100,0001 BTU (duets/emits) 54.91
Suite/bldg. /apt., no.: I Project name: EATON Hat pump
,.-:_.,..__, ... .... ..............,_.._.._ -_- - __._.._.._. -. (requires site plan showing placement? 1 61.06 61.06
Cross street/directions to job s ite: Duct work 2;1,32
hl drone hot water system 23.32
• -- • Residential boiler (radiator or
hydronic) 23.32
- •• -"•- Unit heaters (fuel -type, not electric),
in -wall, in -duct, Suspended, etc. 46.75
Subdivision: f of no : Flue/vent for any of above 23.32
' Other: • 23.32
Tax snap /parcel no.: Other fuel aCmlllianee's: - --
_ l ?LSi, .rP I"1OOI . OT:;. WOI,iT ................... ...... ... . .. . .. . : : .- :i, Water heater 23.32
INSTALL L GAS FURNACE AND HEA'l'p ...... ::.........
Gas fireplace 33.39
�_ ,. _ ,.- _ MP
Flue vent for water heater or gas
fireplace 23.32
•
Log lighter (gas) 23.32
,,,, -„ ,_- Wood/pellet stove 33.39
Wood fireplace /insert 23,32
®1,RQPaRTY 0E ,
Chimney/liner/title/vent 2
' . TENArvT ,,^ Other: 23.32 2
Other: 3.32
Name: DONALD EATON Environmental exhaust and ventilation:
Address: 12635 SW GLACIER LiLY c1R(:LI. Range hood/other kitchen
equipment _ 33.39
City /State/LIP: PORTLAND OR. 97223 Clothes dryer exhaust _ 3139
Single -duct exhaust (bathrooms,
Phone: (50.)246 -5191 _ „_ ,,
Fax: ( 1 toilet ,, m
.
;,: 1 Lei w �, i�1'PI'.I(AN .; [] Ci7�NTi�t, "Y' PI�R'Sl)N Att �/ o l � cc fans 23.32 _ - v morns)
_ � _, -.. 23.32 _
Other:
Business name: OREGON -AIRE INC:.
.,., F'ucl piping:
Contact name: RON STRONG $14.15 for first four; $4.03 for each additional
Address: 7715 NE 33 DR. STE A Furnace, etc.
....._ -._ • •.._,- •,.._- __...,.__ Ciuu heat pump
City/State/ZIP: PORTLAND OR. 97211 wall /suspended /unit heater
Phone: (360) 423 -1966 I Fax; ; (360) 423 -1978 Water heater
..... - ..,.. _.,__,.. . -- , .,.__._... ...... ....._. _._._. Fireplace
fi -mail: rstrong@oregon- airc.com
Range
.'.i ". .. . ..('' (]1tV ' - : " :: Barbecue
Business name: OREGON -AIRE INC. Clothes dryer (bas)
Other;
Address: 7715 NE 33 DR. STE A
' MEC'1IANICAL PERMIT FEES' ' :... :.. .: ; . •
City/State/ZIP: I'OR'I'LAND OR. 97211 Subtotal 107.31
Minimum permit fee ($90,00)
-' I
Phone; (360) 423 -1966 Fax: (360) 423 -1978 ! 1?l an - review (25 °1„ of permit - fcc)
!
CCl tic.: 64235 ' _ State surchan„e (12% ol'pemmit fcc) /2Z' ,
i - L _ TOTAL PERM I'I " F'I.4: „ 1.Z.(1-4 7 - 4- 7,1.0 .75
I I' as perm application expires it pt +Emit it not ubtaintul within IRO
Authorized signature; days nf0er it has born xcccpted as complete.
Print name: RON STRO: '13 1 Date: 2/3/12 4 Fee methodology set by Tri- County Building Industry Service Board
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