Permit t CITY OF TIGARD MECHANICAL PERMIT
:'
• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00209
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2012
- Parcel: 2S 109DA06500
Jurisdiction: Tigard
Site address: 14991 SW GREENFIELD DR
Project: Worrell Subdivision: SUMMIT RIDGE Lot: 42
Project Description: Replace heat pump. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: HYBRID HEATING & AIR CONDITIONING CO. Owner: WORRELL, BOBBY & STEVE
PO BOX 329 14991 SW GREENFIELD DR
CORNELIUS, OR 97113 TIGARD, OR 97224
PHONE: 503 - 357 -5663 PHONE: 503 -201 -4506
FAX: 503 - 357 -0668
FEES
Specifics: Description Date Amount
Heat Pump 04/26/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 04/26/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 04/26/2012 $28.94
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: Permittee Signature: , l / t/ 41-70/2- ./e47.-77 /t
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.
•
Mechanical Permit A licatio FOR (WC ICE ('SE ()NIA
City of Tigard • EKED Received By y Ls i L 4 gaA Permit No .20/.2 _D0 20 '
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
•' Phone: 503.639A171 Fax: 503 .598-1 2 4 2 012 Datemy. other P / / _ 7
1 . l Inspection Lint : 503.639.4175 F+ pate Ready/Sy:' n Ste Page 2lbr
Internet: www.tigard - or.gov CITY OF TIGAItD Notified/Method: supplemental Information
V SIOL4 . :. 1
Mechanical permit fees are based on the value of the work
❑ New construction jEr Addition/alteration/replacement permed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other. mechanical materials, equipment, labor, overhead, and profit.
Value:
:CATEGORY UCTIO
• O
)F
¢I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building — For special information use rheckitsr.
0 Multi - family ❑ Master builder ❑ Other: Description . 1 Qty. I Ea i Total
JOB :STFE INFORMATION: :AND LOCATIU19' ; - ....., .. .Heating/cooling .
.,. _ _
J 1• q I / V ( (T IA- 4e k/ "L » Air con diti
,
oning
Job site address: heouiros site plan allowing pleceetmt) 46.75
City/State/ZIP: r- b2 7a .Furnace Fuaee 100,000 BTU (ducts/vents) 46.75 _
�-- Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJapt. no.: Project name: (A.)OiYr Heat pip 1 61.06 4 i, r)J,
Cross street/directions to job site: Duct work 23,32
Hydronic hot water system . 2332
Residential boiler (radiator or
hydronic) 23.32 • •
Unit heaters (fuel-type, not electric).
. in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
•
Tax map /parcel no.: Other fuel appliances
Water heater 2332
DFS (,xt1(1''CiON.,OE :WO$'1C•'.. :. , .. .., ,
: • ,.... • _. .. : :.. Gas fireplace 33.39
I ^, q � , Q I , . Flue vent for water heater or gas .
' fireplace 23.32
Log lighter (gas) 23.32
Wood/peilet stove 33.39 '
Wood fireplace/insert 23.32
Chimney/liner /flue/vent _ 2332
. EROPE rbr . :.. :.. : '.D :61NNA 17' .. .. Other: 23.32 •
Name: 11) a.. A h L4) p rr eA [ Environmental exhaust and ventilation '
• Range hood/other kitchen
Address: / '-/ / S (Ai 6- Id b y equipment 3339
City/State/ZIP: e r A,,-p - J v J , 0 g7AQ � / Clothes dryer exhaust 33.39
`� Single-duct exhaust (bathrooms, •
Phone: 63)a,0 r_.. y ax: ( ) compartments, utility moms) .
fans
Fax: toilet comp ts, u ms
. 1=1 APPLICANT : > �� : :GQN`I'AQ° :;h fit SON i;; ... Attic/aawlspace 2332
• ` Other. 23.32 •
Business name: Fuel piping •
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) . I Fax: : ( ) Water heater
Fireplace
E -mail: . Range •
Barbecue
• : . •
��, t tr •
V Clothes dryer (aps) . .... , ...
Business name: � E f l / :
1 J Other. .
Address: P. . goy . 3a 9 ,,, ). :..: ,. . C M$Z15e ,, .I. •-'. ! ° ,. ..., •n r .. Ar :
•
City/State/ZIP: l z ne I ((AI o le, 07/1-3 Subtotal i /.
P Re: ) Fax: 3 57 - D � �g Minimum permit fee (590.00) o . �
��p Plan'review (25% of permit fee)
CC$ lic.: 2 � ( State surcharge (12%ofpermit fee) /. D, r o
• TOTAL PERMIT FEE 100• st t./"
nam
Authorized si tttTC' This permit application expires if a pert,oit a not obtained within 180
� -� days after k has been accepted as complete
I Paint e: j Date: Z • Fee methodology set by Tri•Coanty Building Industry Service Hoard
1:18uaaing> a MEC- Permit.dp.doc 10/01/09 440.451 (11/02/COM/WEB)
Hybrid Heating & Air Conditioning
McClenny /RHC
Refrigeration /Heating/ Cooling
P. O. Box 329- 230Baseline- Cornelius, Oregon 97113 Office 503- 357 -5663 fax 503 357 -0668
;SITE PLAN
•
1 fill •
b ‘ 4
PONT dcwc
•
•
NOTE — Tease show the following on the site plan:
Location of Indoor Unit and Outdoor Unit -41111111+1111111—'
l„cica e how the flue wiil be run (thru the roof -- out the side.vail — etc)
l, ca :e with dot 1ine hcw _ e lineset will be run and approx. distance
Indicate how the condensate will be run
Hybrid Heating & Air Conditioning
•
McClenny RHC
P. 0. Box 329 • •
Cornelius, Or 97113
Phone: 503-357-5663
Fax: 503-357-0668
•
Fax
Ifrri H ybrd Heating & NC 4N
Date VA!.11:0 4 -11,2 z_
Pages incl. Cover AF
•
Fax: 53 - 5 • CC:
Urgent For Review Please Comment Please Reply Please Recycle
'Comment: •
,7ettse- P- lil a jr fAtc- tit.S.ag,.. •
,.•
•
• •
• •
•
•