Permit CITY OF TIGARD MECHANICAL PERMIT
1111 ° COMMUNITY DEVELOPMENT Permit #: MEC2009 -00516
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009
Parcel: 2S102DB00604
Jurisdiction: Tigard
Site address: 8825 SW OMARA ST
Subdivision: Lot: 0
Project: Tombleson
Project Description: Replace existing heat pump.
Owner: FEES
TOMBLESON, BRUCE Description Date Amount
8825 SW O'MARA ST
TIGARD, OR 97223 Heat Pump 10/02/2009 $61.06
12% State Surcharge - Mechanical 10/02/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/02/2009 $28.94
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062
PHONE: 503 - 692 -1565
FAX: 503 - 691 -1879
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp: •
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State ofOR. 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
issua - . i . 'suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon •
Ur Notification Center. Bose rules are et forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
direct questions to OUNC I or 1.800.332.2344.
sued By: , I, ' , / . Permittee S nature: , w •
Call 503.639.4175 by 7:00 a.m. for an inspection th.t • mess 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.
,x''10401/2009 08:05 5036911879 ARROW MECHANICAL PAGE 02/03
, l Pe t A .. Llca EN • D FOR OFFICE 1!;il l)NI.l
Mechanical CA
Received - Perna No.: A O V /
City of Tigard Dnte/B / 0 < , �'�
• 13125 5W Hall Blvd.. Tigard. OR 97224-q- T O 1 2009 Pion Review Other Permit:
' IN 111 phone: 503.639.417 Fox: 503,598.1 ITn°By. !� sec Pepo 2 for
Inspection Line: 503.639.4175 ,1 N Date Ready/By: 21 Ste F entnl Information
r I c..�, �� Internet: www.t; -0r. OF
t s CTI
gl O Lp1 NG D1VIS
T YPE :OF .�voit>Er; • ColttaittaitL7310.:'SCIterit1LE.-' USE CHECKLIST
Mcehaaicnl permit fees* two based on the value of the work
❑ New construction ria Addition /alteration /replacement. performed. Indicate thc value (rounded to the nearest dollar) of all
❑ Other mechanical materials, e:It, labor, overhead. and profit.
Demolition _ value: S
CATE(,OR t OF CONSITtt1_N »N I7AL EQt7 11 1sT 1 SYSTEMS EMS*
_-.. --
54 1- and 2- family dwelling El Commercial/industrial 0 Accessory building For special use checklist
❑ Multi- family 0 Mas bu ild e r 0 Other: Description I Qty. , Ea. I Total
-
JOB SITE INFORMATION AND LOCATION ]ileethi coolht .--r—
—
Air oondidotting or heat pump 14.00
Job site addr _ Q�4 ra��Jl.• : — re e site an she Iac cmmS )
Furnace 100,000 BTU (duets/vents) 14.00
(,:ity /Statc/7.1I Q Furnace 100.000+ BTU (dude/won 17.40
Project name: gY � a G era heat pump _ _ 14.00
Suitc/bldg,/apt.no.: Ta tt► 1, 1 6C..4
.--
(:roes street/directions to Duct work 10.00
job sift: -- Hydronic hot water system 14.00 -
Residential boiler (radiator or ) 4.00
bubonic) Unit beaters (fuel -type, not el.ectric),� 14.00
in -wall, in-duct, sended, dc.
. - Flut/vcntfor any of above 6.80
Subdivision:
Lot no.: — ea .. 10.00 Oth
Other fad a I>mc�e
Tax map/parcel no.: a 10.00
DE SCRIPTION OF WORK tsar liir 10.00 _ Water
Sroplsae
M �.,` ,Q Flue vent for water heater or pa 10,00 _ _
�C,, —.�/ J 1 rV.— -
— Sh (es) 10.00 - _
Wood/pallet stove 10.00
. —" Wood tare lace/insert 10.00
Chimncy/lincr /Aue/vent 10.00 -
pROPBRTY_OWNER T ANT Other. 10.00
�� - Emir' exhaust and ventilation
Name�� O/R Range hood /other kitchen 10.00
Clothes dryer exhaust 10.00
City/State/ZIP: Si g1c -duct exhaust (bathnmms,
Fox: ( ) toils conxpartmenta, tAili room) 6.80 .�
Phone: ( ) i APPLICANT ANT I / ic/,rawlspncefans 10.00 _
i APPLICANT CONTACT PERSON Other: 10.00
liusinosa namc_M�p 01,0 / GA� _: _fad prig' .
_ $5.40 for fiat four", $1.00 for each additional
Contact name: J s'r� r �, . — Furth etc ,
- Address: _ 10 , 936 , 6,,,,,t �v A►l�'�►I n o °----- (l :tehcn nip --
Wall/suspended/unit heater
City/State/ZIP: 'rawl�T► D� �7o6Z - - A . , . -- weterheatce —
• Phone: (Cad ).64z 9 ' Fax: : (. 471^1 —. _ pircglace - - -,.- --
1 -mail: set hv Range
Barbecue
CONTRACTOR I —„ Clothes dryer (p�►.$) .� —• •-
Business nam�� lr'�,IS'Gi otter:
I-- -- �� MF CHANICAL PERMIT FEES"
Address: te .5jo , yi� �7N 1e . Subtotal x
city/State/ZIP: city/State/ZIP: "�^�, ���, e' Z 4� — . . 8 — — M inimum permit fee (572.50) 0•
7 /t Z Fax: (� 3 ) 6017 /pa Plan review (25 %ofpermn fcc) - /O.
Phone:( ) q ��$"LS
mgc (l2% of permit fcc) ,$d
... tic_ 3 - -, — — State surch 1'OTAI.F13R1V11T FE1S Qp7)
.. —,
This permit application mina s tr n pandit u not obtntn wlthln tfW %�D, r
.�J � � days after It luta been accepted n: tompleta. /
/luthorired gignntur �S�' _ — •
In� t � • � ry • Foe ntrJhnd�tlnt!v 'I'ri- Counev I3Uildinu Ii
rnvsUV Service lionrd
P.:..t ,. m.. Y Yp
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