Permit II CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00254
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012
Parcel: 2S112BD09200
Jurisdiction: Tigard
Site address: 14726 SW 78TH AVE
Project: Pacific Evergreen Subdivision: BRITTANY MEADOWS Lot: 28
Project Description: Install Heat Pump
Contractor: PYRAMID HEATING & COOLING Owner: PACIFIC EVERGREEN HOMES LLC
9409 NE COLFAX 16615 MAPLE CIRCLE
PORTLAND, OR 97220 LAKE OSWEGO, OR 97034
PHONE: 503 - 786 -9522 PHONE: 503 - 664 -6423
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Heat Pump 05/16/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 05/16/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/16/2012 $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. J�
Issued By: Permittee Signature: t� J A PLj 64 - 7704
____,,,
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.
05/16/2012 WED 12:35 FAX 503 786 3 Fe 2111 ._ ;NG Zj001 /003
Mechanical Permit Application MAY 1 6 2012 FOR OITICL USE ONLY
City of Tigard Received I , y PermitNo.:M �
q 13125 SW Hall Blvd, Tigard, OR 97223 CITY ®� �0�`;� ��
;
IN I Phone: 503.718.2439 Fax: 503.598.1960p ��±± , other Permit r je/ coo i
T I G A R r� Inspection Lice: 503.639 BUILDING D) `OI$1i)02111111111'.' El See Page 2 for
Internet: www.tigardor.gov Supplemental Information MI
:.,�... .,... ...,_. ., zi: r: K::- n.- ia :�:� ..�� - e-.. : _ ^,. _- _.... - wfT .te- . :.. 7.., �. : : -: �:_ t::Y'� - R
4�;?"�- -i4... .r- r - `sr�'1, i01:' "ol. ' �° { _ .' s,ti : �15���: + a,�,5.r1 - 1 ,i iCJ..n,,�I.�i' n
�_ � : � s �..:._ - , -,.. ' ? _. „ __ � - Mechanical permit fees are ba on the value of the work
❑ New construction XAddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. .. mechanical materials, equipment, labor, overhead, and profit
` = r ,3 E 7 - ,a; - Value: S
and 2 -family dwelling El Commercial/industrial ❑ Accessory building For spedal information use checklist.
Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea. I Total
r--." • .,:,,- ._, , -∎- .- - •it-- °rn:-'",r - .L "- nm_v_::cr=, -.='' --- ... ::2 're.,,.ea<;.a:p :t. _ti._L-� - --
' gir,voilt! a •0` . 'S +i v t y ri ` c r •- '47 ai ' Rocco conditioning
P- r • - . ' .r 'G 'L ci l- - •v._: 4�_ ! � ��I�• - ' � E : 4.. . i ,*,-r: :-,
.,.. � �, .�-.. • ..... .. .». • & _..__._: + =, Att.
Job site address : / 1 ! V 1 I (req ui es site plan showing placement)
City/ State/ZIP: 46.75
v r .1
1 V` Furnace 100,000 BTU (ducts/vents) 46.75
100,0004- BTU (ducts/vents) 54.91
Suite/bldg. /apt no.: I Project name: 4 T.tki fJ Heat pump
! 1 (requites site plan showing Plaameat) ) 61.06 �(/
Cross street/directions to job site: V Duct work 23.32 - l
Hydtonic 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 I Lot no.: • Flue/vent for any of above 23.32
Other. - 23.32
Tax map /parcel no.: Other fuel appliances:
- •- :i - : ... .... -.. .s ' _ . :s_ _ � -:.. .:e.
^ ^°-- a .- .'" ; , ;...,: : ot , �':'. °
`C�;1T,. PJ'' �:� - ::- 7�j�� I._. 'y_`r' �"'., -* -�` ' -'�5;� _ _
; c:
v - -_....:: . r �f .. ;i9?ef;E .. -:v., G 23.32
Gas fineplacdinsert 33.39
WW e 11111 1 /, 11 A Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
I r; f• 9 - ; r -., Chimney/linedflue/vent 23.32
� . ,_...y: ,. ,:.�____ _....---- - ..,.... ,. � ... Other. 23.32
Name: °R �l f I 1 ,� ; ��y l i �
( Environmental exhaust and ventilation:
Address: )L U 1 )&10, 4 U ' Range hood/other kitchen
w Z equipment 33.39
City/State/ZIP: 1 . , 4 1 11-Y Clothes dryer exhaust 33.39
Phone: 1 / i Fax: Single -duct exhaust (bathrooms,
t+�) ID " > >. ( ) - toilet compartments. utility rooms) 23.32
- ' °S; a •: _ -s: ter•... �, = E e . c g -
7 . - s - -- � � � (u ( v t L :-:< -,. �.: _ ,��_ s :-� - t . v - y - - ' '1 Attic%tawtspace fans 2132
� Other. 23.32
`/�. _11 / �l / lid , F piping:
Contact name: , fie 4. ,_' _ � A '1 � $14.15 for first four, $4.03 for each additional
Address: � Furnace, etc.
'� "'[ ' % /.i�J Gas heat pump
City/ State/ZIP: It
57 .. /, t.A. iMIKFM 1-. WaWsuspended/unit heater
Phone: 0503 ) Op ...41K-' a 3� Fax: : (03) 76-6 - (3v ?,� Water heater
tt ! J`� Fireplace
E-mail: If 0 4 :, ;l ti / { 4 a A `.. - A. Range
v 51�'1 4 `.1 r4+ � - s . t � e ,
c r ... 1., � I `' ( } :i'lr-' i Barbecue
Business name: Clothes dryer (Ras)
Other.
Address: 1 l )� / , ..:E,. r, ril �� ' 0.14_+ G�i . I f
City/State/ZIP: � F 1 Ivy Subtotal tivf b
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) ,0
Plan review (25% of permit fee) 1
CCB lic.: 61 (Q iik State surcharge (12% of permit fee) �j) V-
C TOTAL PERMIT FEE ] r� ` pV l
3 This perm application expires If a permit is not obtal thin 180
Authorized Siga[ure: it days after it has been accepted as complete.
Print name: I Date: 5.... I(i f • Fee methodology set by Tri-County Building Industry Service Board
1:\Buildtng\PermmMEC-PamitApp.doc 03/07/12 410-4617T (II/)VK:OM/W ®l
05/16/2012 WED 12:36 FAX 503 786 3432 PYRAMID HEATING 2002 /003
• i 9409 NE Colfax Street, Portland, OR 97220
HEATING ; 4 & COOLING office 503.786.9522 fax 503.786.3432
www.pyramidheating.corn
withstanding the test of time
OR CCB: 59382 WA CC: PYRAMHC984P8
Address: 0 1 t -1 - 1 Zio ` J W 8 4.11 1 1 (Department) Can type: 0
City 0 MG Afup State 0 012 Zlp 0 (Problem) Job type: Job -Retro
County:
Job# 0
Estimator. 0
Mechanical Site Plan
Please Note: Direction — Gas meter location — Vent termination location — 00U locafiorr Street name _
la / LioC
4
r
HasT PsrtsP
OUr floo l. l
WZIT
AousC
S44
raze 844-Ave.