Permit III OF TIGARD MECHANICAL PERMIT
IN 2, COMMUNITY DEVELOPMENT Permit #: MEC2009 -00538
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 1 S 133DC09900
Jurisdiction: Tigard
Site address: 13145 SW SHORE DR
Subdivision: Lot: 0
Project: Arayamt
Project Description: Furnace and NC
Owner: FEES
KISHI, JUNKO Description Date Amount
13145 SW SHORE DR
TIGARD, OR 97223 Air Conditioning 10/13/2009 $46.75
Furnaces < 100K BTU 10/13/2009 $46.75
PHONE: 12% State Surcharge - Mechanical 10/13/2009 $11.22
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519 •
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: n/1AI Permittee Signature: !) App.
/ Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
git
10/09/2009 11:05 5035572990 A -TEMP HEATING PAGE 02/04
Mechanical Permit ADDUCatio nRECEIVED FOR OF'F1CF USE ONLY
. City of Tigard Received
n 131.25 SW Hall H[vd,, Tigard, OR 97223 Dmc11}y; M
' • • .Phone: 503.639,4171 Yu; . 503.598.1960 0 C T 0 9 2009 Pig Review
Date/By: Other permit:
TIGARIa Inspcctionl,.ine: 503,639.4175 Dntt RendyrBy: labs: _ Q See Page 7for
Internet: vwrw.tignrd- or,gov CITY OF TIGARD NotlfiedNkthod: I Supplcntcnta! tnrormntlnn
R11U.DING DIV
.,x,..1...,,..1.,,,..,,..: .: ....: .. .... .... !'..: •':;I•. I': '.': ";" 1; Ii.. .:1: :'1; :�•: ' ":' ,
1 /I*)C .Oli
" �O�tItiv . ..::.:....::'..; . "r.': :,:::- " �
•:.., ".::;::':. . COifli:•IERCLIL FEE SC'H.ra)L�J
❑ New construction Addition/alteration/replacement Meihntlical permit fees' are based on the value attic work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical S
.• materials, ment, labor. ov�erhead and profit,
•. �a:l:,,;:;., . ,..... ;1,:, 4 ! Velum ec:
. "'CAL
Ii:.0
C ommercial /industrial Ib> NTI,V; I .QUIPi�SL1V : ' %I';ST MS it
1 - nnd,2- family dwelling
!; ❑ 0 building ......:..:... .; .....�..:1.: ..,., ,...,..r..,,...,,..
Fo,• .special Information use checklisr.
❑ Multi-family ❑ Master builder ❑ Other:
Description
. ...... ,,..,, .... Total •
::'. ,.abll#;;.S1lP' , . b '.40:0H A;D' 1 . ; ; ��� ,: .
Job site address: 1'�I _ �� h . t v Air conditioning or heat pump i 6-75 a.�t ti r _coshes site plan showing ointment 14.00 r, r
City/State/ZIP: � ' I Furnace 100.000 BTU (ducts /vents) 14.00 �%! � �6 '7S
Suite/bldg. /apt. no.: Project name:
Furnace 100.000+ 13TU (ductahrcnts) 17.90
W �f a IA. . Gan heat pump 14.00
Cross street/directions to, job site: Inlet work . 14.00
,ydronie hot wnter s 'stint 14.00
•- Residential holler (rndintor or •
drnnic 14.00
. Unit treaters (lbel•type, not electric),
in -wall, in - duct, suspended, eve. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Outer fed appliances
;' ;,:' c '. Water heater
^• d fircpinec 10.00
�� J 1. L _ Flue vent for wa ter heater or gas
fireplace 10.00
a Log lighter (gas) 10.00 _
R Woodlpellet stove 1
Wood fireplace /insert 10,00
' .., .. :,I:: !R °r :.,,. , arc: , 1 .,, ,.r.�: . ,, Chimney/liner/flue/vent _
?'>X C1t NF,s! , . , ' Q ?1J1V_1NT C 10.00
.,. ` Other: ` 10.00
Name: • Environmental exhaust and ventilation
Address: Range hood /other kitchen
_, equipmen 10.00
City /State/ZIP: ) C7•(-e...1 Clotll r exhaust 10.00
Phone f ( 9(. � �� a toilet �rnrtme n t� , ( ut (bathrooms,
rooms) 6,80
.J4.
Single-duct
) t 'Ica wm
.;r1,hf1 I3 T , : i , • 'C , F:: t' " :i Auid ernwis ace fat s
:......... .._... ,r"- ..�,.,.,, "': ?,� ' r,:,.;;' k�:: 7.:; 1+ 1i�::: ��1ty $`!l "C,{`�`'i.�? P t 10.0 , • ..
W
, �• , , ., _ � .,.,, , ..., ,,, ,.,,•, :a - :,,�r i �� � , 0 •
Other: .10.00
Business name: -.-1
Push piping
Contact name: A-TEMP BEATING AND COOLING, )Ni $5.40 for first four, $1.00 for each additional
Address: 16000 SL Evelyn Si. Furnace, etc.
---- -c nTas,01M015-- Otis heat pomp
City /Statc/Z IP: 503 - 650-5014 Walt /euepondotvunit heater .
Phone: ( ) Fate : ) 55 F e0 _ Water heater _
Fireplace
E-mail:
Rmtge
�
B ar b ecue
Business name: Clothes dryer (gas)
4
�4- TElll�'$I1BA7'OS bN1D�K._INC
Other:
Address: • -- 16000 SC Evelyn Si. - .,. .;•:_
C)zttkairatua, O1 9'm3S
City/State/ZIP: r i:::,:;;.: r •
: .: :N IEtr13�i \ICAL PERi111T. L P .,.. t
1. .;.. : :::. ;
tot .,...- ,..;,,.: • :
1
5 :65150U Subtotal 3.0 Phone; ( ) _ Fax; Minimum permit foe ($72,50) R „ t , q
f' Plan review (25% of permit Re) --'•
CCB tic.:
- 411P __.._�
State surcharge (12°/s of permit fro) s `I•aa
• '
. TOTAL PERMIT FEE :21:11001:
Authorized gi$napt ` / This per nppilention expires if n permit is not obtntne w thin tan
�a 1 _ . . days niter It has been accepted in complete.
Print name; MM. a - , I Date: : M pas methodolo set by Tri.Cnunty Building Industry Service Board
l:t RnldintWennit •IMtC- Pnnnitnpu.doc 00o6io• 440 461TT(II /02/COMIWQa)
li
10/09/2009 11:05 5035572990 A -TEMP HEATING PAGE 03/04
ATemp- Heating & Cooling, Inc. .
SITE PLAN . . .
• . . . • . j„ , _ pew .e...._, - . , _ I .
Customer Name: ' c Address :',3 l , 4C , . ,a - S' 1-} .33 (-. , .
Customer Phone: o c - 2-241. .0 .' I � .
Property Boundary Line
r , -....----1
., V .
-SJ
T ,
. .17. . . . .
. .
..
. .,. ,
. ,-- . .. .
. .
. . .
. .
House .
3
r S •
n - rte-_J • .
• , • Street ,
III OF TIGARD MECHANICAL PERMIT
IN 2, COMMUNITY DEVELOPMENT Permit #: MEC2009 -00538
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 1 S 133DC09900
Jurisdiction: Tigard
Site address: 13145 SW SHORE DR
Subdivision: Lot: 0
Project: Arayamt
Project Description: Furnace and NC
Owner: FEES
KISHI, JUNKO Description Date Amount
13145 SW SHORE DR
TIGARD, OR 97223 Air Conditioning 10/13/2009 $46.75
Furnaces < 100K BTU 10/13/2009 $46.75
PHONE: 12% State Surcharge - Mechanical 10/13/2009 $11.22
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519 •
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: n/1AI Permittee Signature: !) App.
/ Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.