Permit CITY OF TIGARD MECHANICAL PERMIT
1,
a._ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00148
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21/2012
Parcel: 2S102CB04000
Jurisdiction: Tigard
Site address: 13485 SW BARNUM DR
Project: KOCH Subdivision: BARNUM PARK Lot: 1
Project Description: Heat pump and air handler installation.
Contractor: PYRAMID HEATING & COOLING Owner: KOCH, VIRGINIA L
9409 NE COLFAX 13485 SW BARNUM DRIVE
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 786 -9522 PHONE:
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/21/2012 $46.75
Type of Use: SF Heat Pump • 03/21/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/21/2012 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
Required Items and Reports (Conditions)
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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: '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.
03/21/2012 WED 10:09 FAX 503 786 3432 PYRAMID HEATING Z001/003
RECEIVED
Mechanical Permit Application Foe order USE ONLY
City of Tigard MAR 21 2012 D eceived 0.) arIMIIIIIIII
II q 13125 SW Hall Blvd, Tigard, OR 97223 ' :k4 '
Plan Review
C . Phone: 503.718.2439 Fax: 503.598.0M( ' OF TIGARD Date/By: Other Permit
T1 G A !Z D Inspection line 503.639.4175 BUILDING DIVISION Data tlY/BY^ ® See Page 2 for
Interne: www.tigard or.gov Notified/Method M. I Supplemental lnformadon
1i' J .! _...T.1. '� t �3.. � ` 1 y " y, ` tr; .. -, 7- 09'e� -
ff i i h1 7 r i ^ 4'i � 62 "' e �C' :
t � .�.. _� —_. �..:. .. a. —�_... � ,:_....:� t ....,. � t� � � � Y : t r � _ ..__ the .... _._.c
❑ New construction Addition/alteration/replacemcnt V N Y Mechanical rmed. Indicatet fees*
he value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
....c- , ,, � c , a 't. C r u d t rod � i l- ` ; , , . r
� and 2- family dwelling ❑ Commercial/industrial El Accessory building LL For spedallq(ormadon use checklist
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. I Fa I Total
r Y 1
n -. ti a J it 1 Y a c� "i V i ci-r t 0, GY r a rr i t. `r .. r :, Heating/ciwling:
net . o N ng
�L' - _J�z 1._:r�.a_� �_ ..._. - __ . . .... .u4. 3 r7 �_. �x�� ... � ... � J! ♦���•iOWra
Job site address: (requires site plan showing placement) 46.75
J L•`r 1,..V , i
City/ State/ZIP: \ Furnace 100,000 BTU (ducts/vents) i 46.75 114, ; e. «i 1 _ ♦ • _ _ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite /bldg. /apt. no.: Project name: ta�-1 Heat pump /"� 00
iii (requires site plan showing placement) l 61.06 (A
,
Cross street/directions to job site: Duct work 1 2332
. 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 23.32
Other. 2332
Tax map /parcel no.: Other fuel appliances:
,; 'e' Water heater 2332
■ i�lI,� l� Gas vent f cdinsea 33.39
/ t% . u �.� �; :. r I_' �aT� Flue vest for water heater err gas
fireplace 2332
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
r sue L [
l V 1 ` j y ' 'r= 9 Chime 2332
r..- - c = r dar1,:� .,,, U r J E T 1 f.!; i i t.. ,.s., .E "° eY /liner/fluelvent 23
Other 23.32
Name: � _ . t 5 �,L Environmental exhaust and ventilation:
Address: `� , 1 . , Range hood/other kitchen eguiomeei 33.39
City/State/ZIP: - ,. _ t _! - 1 a-a Clothes dryer exhaust 33.39
Phone: "" �) Fax. Single-duct exhaust (bathrooms,
� , ( ) toilet compartments, utility rooms) 23.32
m °tiY= -s=ty r `r 7.''' .,: /C vl..� _. ” - -,i ?i ;i
< h i1 a { t , ` � 1 i {c Atti /crawlspace fans 2332
-' . te r i:'v �i a .....1-ti , • ..,1,:a P :4 1, _ . t 1 _
Business name: 1 Odter 23.32
�r �a. •�i t .. .t.,4•t y i Lea Fuel pip
Contact name: t S14.15 for first four; 54.03 for each additional
Address: +
th • 11‘,611A1111FAMEIMMIll Furnace, etc. Gas heat pump
City/ State/ZIP: I \ P
�1_%.yy . \ ' WaB/suspeoded/umt heater
Phone: .t ) Fax: : 4 / • j Water heater
Fireplace
E-mail: li .le.∎ 1 i .►r.. t ' ►.. ell Range
F ' if--.. . C 1, 9,�, a e1 Y t Balhecue
Business name: Clow dryer (gas)
Other
Address: ��� • ' �I , :: " . .''' '' r- ! _ ° i c , r (e Si a ' ''' 1 r I , �• W' < T
City/State: .T ' ►, W I Subtotal in lit i
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: = C I, 4 - State surcharge (12% of permit fee) A. 3 / i q K
TOTAL PERbJs FEE f ��J '75- '75- Authorized signature: This permit application if a c e is not ob ¢t ea thin I
,� days ys after It t has has been accepte pted as complete.
Print name: „ \ Date: 31 a� ' & • Fee methodology set by Tri- County Building Industry Service Board
1: \BeildmgtPa \ M mitApp
mixaEC-Pa �� .doe 03/07/12 440-4617T(I1/02/COM/WEB)
03/21/2012 WED 10:09 FAX 503 786 3432 PYRAMID HEATING [1002/003
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