Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00271
T [GA R I) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2012
Parcel: 2S104DA08500
Jurisdiction: Tigard
Site address: 13111 SW RAPTOR PL
Project: Panik Subdivision: QUAIL HOLLOW - WEST Lot: 71
Project Description: Install NC Must meet minimum 5' side yard setback and approved rear yard setback
Contractor: PYRAMID HEATING & COOLING Owner: PAVIK, JANICE S
9409 NE COLFAX 13111 SW RAPTOR PL
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 786 -9522 PHONE: 503 - 520 -6914
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Air Conditioning 05/23/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/23/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/23/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: oU APP C IQ kt,
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
u.
05/23/2012 WED 11:34 FAX 50 3432 PYRAMID HEATING Q001/003 S
Mechanical Permit Applic t in R. -_ R : !' roil orrice USE o \1,�
City f Tigard MAY Received `�
ty ga Y 2 3 2012 p ,By: 2,_.; s Permit No Mere, N113,,, 0 0 .11r
l a 1111 I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
.: Phone: 503.718.2439 Fax: 503.59011°1 q1, ti Other Permit:
Line: 503.639. � OF �I�,l��y(�� �y
T 1 Ci RD
Inspection et: www tigardor.gov BUILDING DIVISION Notified/Method 103. Supplemental t
.. nay �s,. �_. :� �- ... .` ;i!- t L L:C. Y 1 _ _��r.\ -:sue 1 ' "} ",�"T'__ _-
,`,�`.�.r' . ,''' _ . "i•_. u: _._ .-.._ "C �3 ` ...: C:.,� ? -'7:-1,---17S'. ry:1 i e5Ut IJ 1 �� .!:^ E., I Ji Lr(C�r: � ^xd'7�,, : t4� �.
Mechanical permit fees* are based on the value of the work
❑ New construction { Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, and profit.
F ���'! -1��" - . -� , - _ - - '^•t':,^';� .Yi'J' - Value:$
r r`�- s -,.� .k ' w�I.i.J,it0.F -_ .O; fr�r;;CQi {` . -_ .. 1 i e i
�_�r ,.....t�..rn. : �- .1_.- .. ....- , i.�.�F ....,. u� ,= . 7 .. =.:_... ..� -. -. � � b l6 $ ti JI . �9 �I{) i lk 7' / r [� P
[ - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spedal information we checklist.
❑ Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea I Total
`,. 1. . Aft { y z
Jc: , }tf5K I A ! �t F.: i J`Vn i } j HeatinR/000iin g:
...._ ._. Air w
Job site address: 3 l �rt � � t ►t ai, / (req site plan showing placement) ' 46.75 a fb. ' 7�
City/StatelZlP: / , ' F ace 100,000 BTU (ducts/vents) 46.75
♦ ►� Furnace 100,0001- B TU Wet/vents) 54.91
Suite/bldg. /apt. no.: Project name: Me\ Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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. 23.32
Tax map /parcel no.: Other fuel appliances:
t off ,,e�,E.. c s.n i # _. Water heater 23.32
1 1:. .�.: :.�w.l:e..:4.1+... .: {� m. u ..1� -: 3''..J. .l ^ ¢
c -... .4:=.a - it
���l Gas f vent water 33.39
G Flue vent for watce heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
5 , r j ,< t + •: Chimney /liner/flue/vent 23.32
t - I V ). 1 (..50 .I fr 0 }. � {2 , - j i... ' 1 . '.-'-''.1,1D:
- ..... r .., - I
:- - - - �. � ....,._. _ .. ... .i.r1 ._�-- � . : �.�other 2332
iiYi I G ( , L[rirl f ► . Environmental exhaust and ventilation:
Address: , W I o 0 \ , & c Range hood /other kitchen
equipment 33.39
City /State/ZIP: .i t jWi 7 ag3 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: OB ) , - , , ' Fax: ( - - . toilet compartments, utility rooms) 23.32
'•' : r 7F 1i4 sF i Kyta 1 t iL y ki Attic/crawispace fans 23.32
Business name: 'i.W � 7 .l Other 23.32
Fuel piping:
Contact name: , ` fEM. $14.15 for first four; 84.03 for each additional
Address: / ) " A 1 r Furnace, etc.
Gas heat pump
City/State/ZIP: M . !� Wall/suspended/unit heater
Phone: i v y ) 4 ( i . 4* a, d Fax: ) 2 , Water heater
E -mail: j l a v A u /. i�.�r AIRI,
Fireplace
r �
. ._ :.., ? u .1 *,e i f - ' Barbecue
Business name: ` Clothes dryer (gas)
Other
/
Address: IIIM / / 111121 11 `-, 4 `� ,� c' I v. i - u r i, r t �l is
,
:s
City/State/ZIP: Subtotal ' ,1 ti
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) 9D -
Plan review (25% of permit fee) ---
'y State surcharge (12% of permit fee) f () I
• /f TOTAL PERMIT FEE U00. .
Authorized Signature k rl This lit application expires if a permit is not obtained within 180
l'? days after It has been accepted as complete.
Print name: -77/10, / j , ) Date: 6 xi. i s I • Fee methodology set by Tri- County Building Industry Service Board
I:\Building \ PmbV�
niC- PemhApp.doc 03/07 / /1 12 JCJr 440.4617r(11/02/COMIWEB)
05/23/2012 WED 11:35 FAX 503 786 3432 PYRAMID HEATING X1002 /003
— 9409 Street, Portland, OR 97220
a M 9 NE Colfax -- - - -- - _ -- ----- ._.... — --- --
HEAT! G & COOUNG office 503386.9522 fax 503386.3432
www.p
withstanding the test of time
OR CCB: 59382 WA CC: PYRAMHC984P8
Address: 13111 SW Raptor PI (Department,) Cal/ type: 0
City Tigard State OR Zip 97229 (Problem) Job type: Job-Retro
County.
Jobe 17038
Estimator: Desiree
Mechanical Site Plan
Please Note: Direction — Gas meter locdon — Vent termination location — 001)locatimf1 Street name —
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