Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00139
T I GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/15/2012
Parcel: 2S114BA09800
• Jurisdiction: Tigard
Site address: 16385 SW MEADOWOOD WAY
Project: PETTIT Subdivision: COPPER CREEK STAGE 2 Lot: 51
Project Description: Humidifier installation.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: PETTIT, JAMES K & GLADYS B
PO BOX 241 16385 SW MEADOWWOOD WAY
DUNDEE, OR 97115 TIGARD, OR 97224
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Other, Heating /Cooling 03/15/2012 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 03/15/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/15/2012 $66.68
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
Total $100.80
•
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.33
Issued By: _ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
03/14/2012 12:14 503-691-8556 OREGON HEATING PAGE 01/02
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Mechanical Permit Application.,\ f, \ • FOR OFFICE USE ONL);
.=‘, ' V Received
Da iffilLeMr=1111M
City of Tigard
I I
13125 SW Hall Blvd., Tigard, '',/. ' .,e , Pion Review
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- Phone: 503.639.4171 Fax 960 . N
Date/By:
TIGARD Other Pernate
Inspection Line: 503.639.4175 \\e' oc\CIF Date Ready/By: El S2a Page 2 for
Internet: www.tigatd-or.gov
, ° Z) c$ licitifientethod: MI Supplemental ltriformatiott
'•.' '. • : . . .1 , • ..- . : -... .:' '.. ... • . -:.
TYPE (
' ,w 1% .. .... .. :: .• . ..;„.: : :: : POlifii#1
0:4.. '::.FFX.Oria ..:VS.E
..• : ... , . . . • • ,.. .... . : .. ... ..
. Mechanical permit fees' NC based on the value of the wozic
1 New construction ,Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
ODemolition El Other: mechanical materials. equipment. labor:overhead, and profit.
., . Value: S
'F.'"" '''':: ....''''' '.' .:.':.: .•:::: C.Alt,G6ii* OF CONS1'RUCUON .' i'. . -: ::.i: .....:.:;:....: : ':: :.: .! .i .. .
. . - . .....:."....i*ni.014.:*.:($4040
gi- and 2 dwelling CI Commercial/industrial 0 Accessory building
For spscial Wormation USG dieddist
12 Multi 0 Master builder 0 Other Description I Qty. 1 Ea I Total -
''.. ..... ;.'.::' '''-' . ...JO. ..$11**F9**00141'ilt, LOCATION . : . : 1: 21 '; .. ' HeatiriWceeboR
Air conditioning
Job site address: 16335 Sit /14.41.i../../ 14/v &equines site plan showingplacement) 46.75
City/State/ZIP: 7 1 22 Furnace 100,000 BTU (dacts/vents) 46.15
7, . , at
furnace 100.000+ BTU muctsNan0 54.91
Suite/bldg./apt no.: Project name: 12 _ 0103 Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
, Ifydronic hot water system 23.32
Residential boiler (radiator Or
bydronic) , 23.32 _
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. _ 46.75
flue/vent for any of above 23.32
Subdiviaion: • . I Lot no.:
Other. 1 23.32 -2..r..7
Tax map/parcel no.: • Other fuel appliances
fn;....4 .'.,,EW4;1?I'O '(-_,-.::'''' L 23.32
Gas fireplace 3339
-Thsfo ji jimiviich Xer. • Flue vent for water heater or gas
fireplace 23.32
Lag lightcr (gas) 23.32
. ,Wood/pellet stove 33.39
Wood fireplace/insen 23.32
.,...... - ..• .-•..., ,..,.. Chimney/liner/Svent 23.32
ua
; " 4.* :.:''.%".•*-.7....•,..":;'...:.'1:*'14.417: . .
414 , ...7;';',7 .9 • :.•::.'':'', o ther .
23.32
Name: T 4 , 1 p Environmental exhaust and ventilation -
• Range hood/other kitchen
Address: / 6 JR'S" SW W
A equipment 33.39
City/State/Zfl': 7 , „ q7.2,2q aj I Clothes dryer exhaust 33.39
..
/ - Single-duet exhaust (bathrooms,
Phone: (S ) i‘ 0 - 0130 Fax: ( ) toilet compartments, utility rooms) 23.32 ,
00,11-36ii ." • • :::::.:'','" •• .; . OVTACT. PERSON '.•;.: •':%.'..::: Attic/crawis ' 2332
Other: 23.32
B n a r9ch ged, ..1 A/c Fuel piping . -- • • • •
Contact name: Z G.. fi 514.15 for first four; 54.03 for each additional
Furnace. etc.
Address: )/100 Sev nth Ave.
Gas hear Porno
City/State/ZIP: - Ta o. L 4 , og ql d r , 2 Wall/suspeotled/unit heater .,„.
Phone: c o_r) C' -761- Fax: : ( ) Water header
Fireplace -
E-mail: . Range ._.
coNrRAcrOR Barbecue
_ ..
Clothes dryer (gas)
Business name:
-• • — Other . .. . . . . . .. ,.. ., , .. . . .
Address: - SCline q.c a 40We ''' ' ,.,•:•;::••••.'-•':•:•.:::::•. MH gal:4)4./0,1 ititSfititEsci;• • .. --•• ,. ':. ' ' • ; ".
City/StaterZIP: Subtotal I 2412
• Minimum permit fee ($90,00) go. Qv
.
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: i 7 a /2 . State surcharge (12% of permit fee) I /ago ,
• TOTAL PERMIT loft /00.170
This permit application expires if a permit is not obtained within 180
Authorized signature: Ci days after it has been accepted as complete. I - 7' ( • ,- ... , I Mite- 7/./Za• lti I • Pee methodology set b) TriZetmty Millais industry Service Board