Permit CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00426
Date Issued: 08/15/2012
T [ G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112CD03000
Jurisdiction: Tigard
Site address: 7685 SW BOND ST
Project: Capps Subdivision: BOND PARK Lot: 10
Project Description: (1) A/C replacement 2.5 ton Must maintain 5' of side yard setback and approved rear yard setback
Contractor: EASTSIDE HEATING & AIR CONDITIONING Owner: CAPPS, SHARON
7200 SW JOHNSON CREEK BLVD 7685 SW BOND ST
PORTLAND, OR 97206 TIGARD, OR 97224
PHONE: 503 - 774 -3281 PHONE: 503 - 562 -9334
FAX: 503 - 774 -3057
FEES
Specifics: Description Date Amount
Air Conditioning 08/15/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/15/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/15/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /� / --
Issued By: ,c4/111)1/ ( / Permittee Signature: Oki 4/ 2 / e!^ -- r � God
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From: 08/14/2012 07:28 #236 P.002/003
Mechanical Permit Application FOR OFFICE Fst: ONLY
City of Tigard Rec 'yea (4112.
Permit N &/ / jpl a.�
Il ' • t � • 13125 SW Hall Blvd., Tigard, OR l J Pl an n Review
�/i QQ� • Phone: 503.639.4171 Fax: 503. . 1 Date/By: Other Permit:
f I � i A R D Inspection Line: 503.639 q Date Ready/By: lab ® See Page 2 for
Internet: www.tigard or.gov i.\1,11) y 4, A 7 q 1 /_ Notified /Method. a Supplemental Information
::... .;: •'.., TYPE OIWilWiltiA 1;. '' COMMERCIAV ",SCF0 1lI,E= U$E'CI{ECIQIST
❑ New construction Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: E
dwelling :c; '`RESI DENT lAL•EQUIPMEPTT : /#STEMS, FEES!.' i •
0 and 2-family g ❑ CommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑Master builder 0 Other:
Description I Qty. I Ea. I Total
„JOB SITE:. INFORMATION Heating/cooling
-- 1 Air conditioning
lob site address: S e 5 W I jOCNA, 5 i
(requires site plan showing placement) ` 46.75 'il0• 1
City /State /ZIP: •-"r1 alG.,A I 0 9'122 -IA Furnace 100,000 BTUfductsrvents) 46.75
CA� ^ Furnace 100,000+ BTU (diatvcnt) 54,91
-PPS no.: Project name: rr Heat pump 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
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
. ;DES CRIPTION? ;O1F.!WORK;;'':':::i:.:'::: ... ... , <,.;:>•.,;
Water heater 23.32
Gas fireplace 33.39
e p1 0.( e . 2. S -\-0r-, 00..E C' 0 A. \0>r,c1 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
- _. -- ti , :`: - �, / „ - ;, ;_ „ .,. Chimney/liner /flue /vent 23.32
1{uPROPER#4)) NER, _, ..... - ., ® TENANT _ ' Other: 23.32
Name: S Environmental exhaust and ventilation
Address: '1Lp S S I ` �OV J \ Range hood/otherkitchen
equipment 33.39
City /State /ZIP: 1 0 _, x -8. , O?, C\ - 1 2.2. 4 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms.
Phone: ( 503) SG ,Z - 9 SS y Fax: ( ) toilet compartments, utility rooms) 23.32
? MI '- A_PPIICANT;': ', "Q : COsititi , PERSON � .. ' ., • Attic /crawlspacefans 23.32
1 1
,.. \\ Other: 23.32
Business name:
Ec�S�Slde.l'l'A.�� A�� (^rMr�t�v�iv� Fuel piping
Contact name: - s - o \ r „ str‘ E , W 0nA $14.15 for first four; 54.03 for each additional
Furnace, etc.
Address:
'12.0 SE " So \ nhS,V\ C-tee W»k Gas heat pump •
City /State /7_IP: "?0 or\t7.`f1U ` O'_ all 2OLP Wall /suspended/unit heater
Phone: (5 03 .1-1 t,-\- -32 l Fax:: (5 0 3 ) ' r -\ . -3051 Water heater
\ \ \ Fireplace
E -mail: 1 rVO Q e._\ Ne.0- ve\ C.
NTRAC'I
i s
''CO
. OR :.- '.. ■• Barbecue
\ Clothes dryer (gas)
Business name: acts S 1 dl �e_p., t .4 k,.., Ca`f�,. \O`n,v-.�
Other:
Address: J e. A S Mr.NoV > MECHANICALPERMIT:Ff ES!
City /State/ZIP: Subtotal
Phone: Minimum permit fee ($90.00) 9c -oO
( ) \`� Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 325 \ - State surcharge (12%of penult fee) 1 a•gd
�'��\ TOTAL PERMIT FEE I )Q vita
Authorized signature. I - s 1 This permit application expires if a permit is not obtained within 180
. //'"�� days after it has been accepted as complete.
Print name:1 �02._V -e.., - S I Date: g - t y - 12 • Fee methodology set by Di-County Building Industry Ser'•ice Board
I \ Building \Permits\MEC•PermltApp dnc 10/01/09 440- 4617T(11 /01'COM/WEB)
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