Permit CITY OF TIGARD MECHANICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: MEC2012 00346
TI G A R t) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/0312012
Parcel: 2S110CB08200
Jurisdiction: Tigard
Site address: 12476 SW AUTUMNVIEW ST
Project: Domogalla Subdivision: MOUNTAIN VIEW ESTATES Lot: 7
Project Description: Install A/C Must be within 5' minimum side yard setback and approved rear yard setback
Contractor: PYRAMID HEATING & COOLING Owner: DOMOGALLA, DAVID
9409 NE COLFAX 12476 SW AUTUMNVIEW
PORTLAND, OR 97220 TIGARD, OR 97223
PHONE: 503 - 786 -9522 PHONE: 503 - 703 -0650
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Air Conditioning 07/03/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/03/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/03/2012 $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. .1 u. - � Il 1987 1.800.332.2344. A �I
Issued By: C � Permittee Signature: OM A T Q P�C.4- akl_
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.
07/03/2012 TUE 15:34 FAX 503 786 3432 PYRAMID HEATING al 001/001
Mechanical Permit Applic, A CEIVED FOR OFFICE USI ONLY City of Tigard Received Permit N a
4 13125 SW Hall Blvd., Tigard, OR 97223 � 0 3 2012 P a n Re �� OO Ill Phone: 503.7182439 Fax: 503.598.19� Plan Other Per.;, D03 ife
T I G A R 17 Inspection Line: 503.639 T
CITY OF IGARD Date Ready /By: l See Page 2 for
Internet: www.tigard
CITY 1 fl7 Notified/Method: Supplemental Information
BUILDING DII/� I N
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L r. : �'�' : . vF3i� = 1 , � rbm .r iaa''''' Ka - ° ;33- ec '_. p ni ,n 1permit fees* are based on the value of the work
^.v.;K'.. ' .'p ry_• sit_ `.a...�..
Mechanical per
❑ 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.
.s4gal `. l�q� -tL ,:- _ ... ....,... ; .. .. _ Value: $
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® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spedal Information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
c;,° _ a 4 H,k.•• W TIMI •_ . . , , T LAW. Heatinrimling:
l _ _ ° � " _ :, n +.h3a �ssi . +. �' _. � .: 62 Air conditioning 46.75
Job site address: 12476 SW Autumnview St (requires site plan showing placement) 1 46.75
City/State/ZIP: Tigard OR 97224 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: I Project name: 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: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.:
Other fuel appliances:
p .. p ` . 706:17-3,717--71---.E,:---v , cam � _ . G ...,....... Water heater 2332
Gas of A/C s fireplace/insert 33.39
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
:... .= t, 7 ' ,7 ,, ' 4 s !� "°
? „ h , -{ �, , n,. y " x5: Chimney/liner/flue/vent 23.32
v; CRr m ��.4 `.���.° Chimney/liner/ 23.32
Name: David Domogalla
Environmental' exhaust and ventilation:
Address: 12476 SW Autumnview St Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Tigard OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)703 -0650 Fax: ( ) toilet compartments, utility rooms) 23.32
v :J ®� �. iT.' &c f3 {a F s _° J� +`�e t Attic/crawlspace fans 23.32
Business name: Pyramid Heating & Cooling Other: 23.32
Fuel piping:
Contact name: Lisa Miller 514.15 for first four; S4.03 for each additional
Address: 9409 NE Colfax Furnace, etc.
Gas heat pump
City / State/ZIP: Portland OR 97220 Wall/suspended/unit heater
Phone: (503) 786 -9522 I Fax: : (503) 786 -3432 Water heater
Fireplace
E- mail: lmiller@pyramidheating.com Range
Ir:, "::,r' t p ,u ...� n�I4atIM a� - 7 ;,. _ „1 Barbecue
Business name: Same as above Clothes dryer (gas)
Address: Other: S '
< ;- Mi�-- 1 46:`L'
City/State/ZIP: Subtotal 46.75
one: ( ) ' Fax: ( ) Minimum permit fee ($90.00) 90.00
CCB lic.: 59382 Plan review (25% of permit fee)
State swcharge (12% of permit fee)
SO
Authorized sign tilt TOTAL PERMIT FEE .90:00 (OD
•_ _ • ; no ► A This permit application expires If a permit is not obtained within 180 �►
Print name:
r 1I lav �/ i ��6ate: 'J days after it has been accepted as complete.
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I:+ Buildiag�Pc rmitsut5C- PumitApp.doc 03/' /12 44. • 177'(- /02/COMIWEB)
07/03/2012 TUE 14:34 FAX 503 786 3432 PYRAMID HEATING g1003/003
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9409 NE Colfax Street, Portland, OR 97220
13YRAN.JED .. .
, „ HEATING ( & COOLING office 503.786.9522 fax 503.786.3432
,,..4,,,;V:, www.pyramtclheating.corn
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withstanding the test of time .
OR CGS: 59382 WA CC: PYRAMHC964P8
Customer Name: David Domocialla
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