Permit ,� CITY OF TIGA MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: MEC2012 -00228
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2012 • . , . ..: D g Parcel: 2S109AB14300
Jurisdiction: Tigard
Site address: 13336 SW OUZEL LN
Project: Alpine View Lot 24 Subdivision: ALPINE VIEW Lot: 24
Project Description: Install A/C. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: PYRAMID HEATING & COOLING Owner: ALPINE ESTATES LLC
9409 NE COLFAX BY ARBOR CUSTOM HOMES
PORTLAND, OR 97220 735 SW 158TH AVE
BEAVERTON, OR 97006
PHONE: 503 - 786 -9522 PHONE:
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Air Conditioning 05/09/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/09/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/09/2012 $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: 4 Permittee Signature: �� /970/Old e. 4- 770,,./
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.
05/07/2012 MON 11:25 FAX 503 786 3432 ATING LJ0o1 /003 S/
Mechanical Permit ApplicaC
r uu 01 i(i 1 t),\1.1
• City of Tigard ' 1 2 012
. • 13125 SW Hall Blvd., Tigard, OR 97223 M A� P :"'"� � �,�j:� t ulo - a �/Q �a? , •
Phone: 503.718.2439 Fax: 503.598.1960 1 n i t p Permit:
Line: 503.639.4175 �''_y� • • ? 1: nit,:
l I,�AKf) Inspection Li 503639 �---
Interne www.tigardor.gov C' --.4P ' • ' By; t Ed See psge2tor
gv1L* Notifed/Metbod: 7m Supplemental Information
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U New construction ❑ Addition/alteration/replacement Mechanical p fees* am based on the value of the work
ID Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit
za .z ; +,' 1 1 ' r : ss i r: , t , r, i Value. $
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b 1- and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building : Far :pedal Information ase checklist.
❑ Multi- family ❑ Master builder
❑ Other: Description I Qty. I Ea. I Total
• t ' t � n: ,, , s` rf.. ,, 1 ;• : ' t 7 '.1 a /"e;3 , Heating/coaling:
Job site address: l 3 33 C S (2) Du I L an � � regib site plan showing placement) ( 46.75 4L0S
City/State/ZIP: -'i w t u . O k [1-7 2zi J Furnace 100,000 BTU (mwrsh ) 46.75
-1 `i 100,000+ BTU (dams/vents) 54.91
Suite/bldgJapt. no.: P name: Heat pump
(regents site Wan sheaving placement) 61.06
Cross street/directions to job site: Ductwork 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (flcel -type, not electric),
in -wall, in-duct suspended, etc. 46.75
Subdivision A j io , • t h e I Lot no.: 2y Flue/vent for any of above 23.32
l 23.32
Tax map/parcel no.: _ Other fuel appliances:
<: -.;. ._`, +1.-. }, r� v. y T 23.32
s p a ;. ..r r .. „ .; •'• .`v -. A., F :.$ t �) � �, "5� carer healer
(1as firep 33.39
Flue vent for water heater or gas
fireplace . 23.32
Log lighter (gas) 23.32
A - 1 ..
it Wood/pellet stove 33.39
Wood fireplace msat 23.32
§2F SY�I: )iYaO P- ;.., �. FT
NM
�; _fs " ,� , 1 2„ a ) , : Chimney/Una/fine/vent 2332
\ �. n) sr� c �:a Mal-1. ��. 23.32
Name: ES C c 13 kC h l� Environmental exhaust and ventilation:
Address: 5 SL) I SS • .( e, Range hood/other kitchen
ty / equipment 33.39
City/State/ZIP: e, l . 1 rib 0 ` S f• I Clothes dryer exhaust 33.39
Phone: (9)3) ' Single -duct exhaust (bathrooms,
,) • l e , toilet . utility rooms) 23.32
ti' , , 93:17 , 2 1.. 53 ` ,. 6 1P -. 15.W. irh 3 i) s1 `e"l • � ? s & ;; 4r ctawlspeoe 23.32
s. ._ - F�, ".c... a+ '� Rs- ,rn=.'o';:'V'��;. wk „Lr. nle.'ti�t � A ttiC/ .
Business name: Pyramid Heating & Cooling Omer 2332
Fuel 11101110:
Contact name: 9409 NE Colfax St. $14.15 for flet fear; $4.03 for each additional
Address: rornana, VII :i( U e -
Gas heat pump
City/State/ZIP: /y 7 '7 a WaWsuspended/unitheater
Phone: ( 3)�$•� e v f s c 2. I Fax:: (�3j 7F o 1 .4 32 Water heater
E-mail: III ail . I ' h ILIA/ h4 II g t k , t -11`1 R
1 rt, .?„,...--47g. w,s4 � , „ y" _ ' e z i t . ,,1 / l • i f 4 , ` � .
Business name: Pyramid Heating & Cooling Clothes dryer(gas)
Address:
9409 NE Colfax St. Other:
Portland, 011 `07220 �'` r`� ,'n' . y . s ° :�s
City/State/ZIP: Subtotal
Minimum permit fee
Phone: ( ) I Fax: ( ) perm ($90.00) ��
_ Plan review (25% of permit fee)
� 2_
CB tic.: ' 5 31 State surcharge (12% of permit fee) i 0. gp /
/ TOTAL PERMIT FEE I ( /), ✓
Authorized signature: 4 # This permit application expires if a permit Is not obtained within 180
days after It has been accepted as complete.
Print name: � 1 • . it .. Date: 2 e Fee methodology set by Tri- Cotmty Betiding Industry Service Board
1:113nildfeglPamitAMEC-PermrtApp.doc 09/09/10 44o.4617T(11/02FCOM/WBB)
05/07/2012 MON 11:25 FAX 503 786 3432 PYRAMID HEATING Q003/003
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