Permit CITY OF TIGARD MECHANICAL PERMIT
....
"' 2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00082
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2012
Parcel: 2S115AA05400
Jurisdiction: Tigard
Site address: 10981 SW CHATEAU LN
Project: WILLETT Subdivision: REBECCA PARK Lot: 11
Project Description: furnace installation.
Contractor: PYRAMID HEATING & COOLING Owner: WILLETT, RONALD & SYDNEY TRUST
9409 NE COLFAX 3862 WOODS RD
PORTLAND, OR 97220 SEDALIA, CO 80135
PHONE: 503 - 786 -9522 PHONE:
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/14/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/14/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/14/2012 $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, 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. `
Issued By: �---- Peririittee 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.
02/10/2012 FRI 10:59 FAX 503 786 3432 PYRAMID HEATING Cj001 /002
Mechanical Permit Application FOR OFFICE USE ONLY
ceived
City of Tigard Da By: Z M ��� permit No.: L� 01
l 13125 SW Hall Blvd., Tigard, OR 97223
.�° Plan Review
Phone: 503.718.2439 Fax: 503.598.396 DateBy Other Permit:
T I G A R D Inspection Line: 503.639.4175 ^ O \� Date Ready /By: El S Page 2 for
Internet: www.tigard- or.gov i%.% l• Notified/Method: ER Supplemental Information
r iXtRA .'0 "Ir7» � w. i ° .. M ` 'Nqi a r,, al i a'Y a ` tr v is ? tat r t;r "'e ,
ais i��.t- �i'?p, $, � ? j "'' -ti- �.r '�° #�, 4 U) <' C�s'...'u'�,� �! t ,a- �; a�. i.« w.: a...... .:`ra.�u....•d.........rr,.v.,- s � sz.,..,.,.tu 3;u.,:.x g
c „�� - ^' -'j ?.‘ ' "` . :.: i ' L " flk J° Mechanical permit fees* are based on the value of the work
❑ New construction gAddition/alterati t • aa derhlai t J performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: •\V mechanical materials, equipment, labor, overhead, and profit.
`° 2 '- "� a' S �t E+ i b i f I t o ad 7 u � � c ' LL -` 41,x a s� f
., Win.. _ �. e. � � lit..... . .� tt� .......:119 .,fi € e -h
('�,;1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
, DI Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
` k a: t t ) to s e f t l a z 4` e rrt r Heating/cooling:
coolin
M : :.. a er .. °+ ,, ,,S ..., r Air conditioning
Job site address: i 0. S pri (requires site plan showing placement) 46.75
City / State/ZIP:
Furnace 100,000 BTU (ducts/vents) 46.75 (, ?5
e r J a i Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: imaltanimi Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic 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: Lot no.: Flue/vent for any of above 1 23.32
Other I 23.32
Tax map /parcel no.: Other fuel appliances:
Li _ .-x- .; ,i`} , a : t S 1 Water heater 2332
.�� aa fireplace 33.39
� t.I . � � : (rl Gas 1 Flue fir vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
, r 4 . � , � Sr iai ; a � � Z Chimney /liner /flue/vent 23.32
z:.,.:; . l !' ,. �. ice .:: 1. >.,1•Z -L:,�. X21, -Ito r -x,I 4 , •u,::: Other. _23.32
11221M ymix/ ' NEI I►� t Environmental exhaust and ventilation:
" / Range hood/other kitchen
Address.
�' t' �7/ I equipment 33.39
City/ State/ZIP: lt,I IERMr f Clothes dryer exhaust 33.39
'` 3 1 0 1 Fax:
Single-duct let compartments, exhaust (bathrooms,
Phone:
(a t) a i� ( ) toiletcom artments,utili rooms ) 23.32
- : , rFARI"U��""t'.f' ' SZADE rt e M r-, I t b h i s l EM Attic/crawlspace fans 23.32
t�".a�sr,.,.a...�� i '�i:..ut.:�°��22 empsarz :,�>'€i"�:e • �F���..s.n, 2s,�rsu.� zz 3�`�es�'�'.d =t . .s.. .zxrf; �"
��LI'u' S ? /.�la A al k! _ Z� i� Fuel 23.32
Contact name:
t Fuel piping:
' . , `�r
�� $14.15 for first four; $4.03 for each additional
, • , Furnace, etc. 1
Address:
Gas heat pump
City/State/ZIP: to . J` r 01D-C.) Wall/suspended/unitheater
Phone: (` ) / R t - • 4. 4. M Water r heater
Fireplace
104 �A ' ► a/K i iLt� `�
� s1"pt�eh"� Range
5 'il � l: 5 s . u ",all t ` .r ,, ; fi g ,t t; N . M Barbecue
� xa .,.. �..:.. 3 �sv�"' .�- �.� =1� a:ak'�1:' _. �wi�: .��T.. 7.t,..,�,��,.;la:,«d a�
Business name: %���� t , , '-• Clothes dryer (gas)
Address: .trat�idirr 4 :rgt' fi `i? ; '. � ,� 4 :a i a
• �'a�" Sa>: v .rv w d ,f � ,,.,it! • - - + - W -4' R.. M'. N,.' . �^ �ea'e3 K.n=
City/ State/ZIP: Subtotal /
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) (-)
Plan review (25% of permit fee)
CCB lic.: 5 7 3 ffe)_ State surcharge (12% of permit fee) /0. 5
T PER MIT FEE l�nt
Authorized signature: ���� This permit application exp if a perm is not obtained within 180
days after it has been accepted as of obtained
Print name: 1lv'I S_.)(1 Date: e y f a- This
methodology set by Tri County Building Industry Service Board
I:' Buitding1 Permits U�C- PermitApp.doc 09 /09 110 440-1617T (1 l /02/COM/WEB)