Permit y CITY OF TIGARD MECHANICAL PERMIT II
Irp
a _' :. COMMUNITY DEVELOPMENT Permit #: MEC201200485
T IGAARD` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/24/2012
Parcel: 1 S134BD07700
Jurisdiction: Tigard
Site address: 11675 SW PENN CT
Project: Alder Subdivision: PENN LAWN ESTATES Lot: 5
Project Description: (1) heat pump installation
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: ALDER, MARK D AND CATHY L
1637 SE NEHALEM ST 11675 SW PENN CT
PORTLAND, OR 97202 TIGARD, OR 97223
•
PHONE: 503 - 235 -9083 PHONE:
FAX: 503 - 235 -0454 .
FEES
Specifics: , Description Date Amount`
Heat Pump 09/24/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 09/24/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 09/24/2012 $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 44(,j.Jt11 ` 7 j��/' OUNC bycalling 50 987 or 1.800.332.2344. Issued By: .wwl Perm Signature: ss���C.....aaL[[[
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.
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Mechanical Permit Ap d > i ard: A � � FOR OFFICE ICE Usti ONLY
Cl of Tigard L - - - Received q
114
`J g Date'By: ?-11/0- sr Permit No.: xl&e.:24,101.- 8
• 13125 SW Hall Blvd., Tigard, OR 3 6� Plan Review
Phone: 503.718.2439 Fax: 503. 60 2012 Date'By. Other Permit: A.j.6T O f - Q'c
T 1G A K I) inspection Line: 503.639.4175 Date Ready:By: Jura. la See Page 2 for
Internet: www.tigard or.gov 1 �, 'y • NotifiedrMethod: (0 Supplemental Information
�..z.. ,, .-. :n, -,;r, a ,- 1 : . c� s='A.'. t;� r-V,; ls-:_- :, 'y „ r.. , ::K; s``:`° f `r § - D :
' ' j�a - f?3: °== $; 'sr`��- -, a„ �:?),. , ' v+'. -. �,� -.� �m�a� %mss
^'' ` ° ' . 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.
s- 3 � Y__ / ♦}� y� y� ��� Value: $
+' 3 _ :41_ ' ~ - mot+.? 3R_" k- {i.A*.a? �Vi):kf w - �`''�{g n l > " � •^ . k # . u -s - , - ' 1 ';' _ -
��?- x.' K. *., �c'r ,.. .. ,i- s�Lr- €� ,'.t"LP .: i ; �- -- .f��.. ' ;'a ,. 7i.. t1 '. . BfI T ,N n.• >i1;�. - y - ..,.. '-�_- •'-T1
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
y . Y •,; '. : Heating/cooling:
' a a' r I O I ..
--.� , � �+ ,�.- .1IQ8�" f = ��.�'� :�', -'? �s_= rz
. `., Air conditioning
Job site address: 11675 SW PENN CT. (requires site plan showing placement) 46.75
City /State/Z1P: TIGARD, OR 97223 Furnace 100,000 BTU (ducts vents) 46.75
Furnace 100,000+ BTU (ducts!vents) 54.91
Suite /bldg. /apt. no.: ( Project name: ALDER Heat pump
(requires site plan showing placement) I 61.06 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:
.`,�' : 4r' . . -iA'- 4 4 k', :ia.+ _Q =r6k _''5- ??' '.'� - * " : :V. ? Water heater
;,4"...v -_ - ;_ '4,`- ' .-
ti;;:.._' > -^, -.= ... ,. �/ '• � .. n 5 .,`s , 23.32
-
Gas fireplace 33.39
INSTALL DUCTLESS HEAT PUMP.
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplaceinsert 23.32
4RAPJ Rti' -O' S*R< - ; :s . _ "' , v_. Chimney/liner;flueivent 23.32
Other: 23.32
Name: CATHY ALDER Environmental exhaust and ventilation:
Address: 11675 SW PENN CT. Range hood/othe' kitchen
equipment 33.39
City /State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
(503)939-7159 ( ) toilet compartments, utility rooms) 23.32
r� "� :.��., Ctf;: Attic/crawlspace fans 23.32
Business name: SKY HEATING & AC, INC. Other 23.32
Fuel piping:
Contact name: TAMI HAGEMAN $14.15 for first four; $4.03 for each additional
Address: 1635 SE NEHALEM ST Furnace, etc.
Gas heat pump
Ci /State/ZIP: PORTLAND, OR 97202
tY Wall/suspended/unit heater
Phone: (503) 235 -9083 Fax: : (503) 235 -0454 Water heater
Fireplace
E -mail: TAMI@SKYHEATING.COM
Range
-'F� '
, =a ' Q M1mc i . 1 ' d R "'= ' : - x F, ,yam °. y °
.r . " Barbecue
dryer ryer (gas)
Business name: SKY HEATING & AC, INC. Clothes _
Other:
Address: 1635 SE NEHALEM ST "n:. _ -
_ _ ' ' . . 4 =�• . Y=J1'IECH�43�?� PF.�'[liT -FF�': . . � � - >„ -..
City/State/ZIP: PORTLAND, OR 97202 Subtotal 61.06
Minimum permit fee ($90.00) 90.00
Phone: (503) 235 -9083 Fax: (503) 235 -0454 Plan review (25% of permit fee)
CCB lic.: 50244 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
This permit application expires if a permit is not obtained within 180
Q/yt,LJ
Authorized signatur . y
days after it has been accepted as complete.
Print name: TAMI HAGEMAN Date: 9/21 /2012 • Fee methodology set by Tri County Building Industry Service Board
t BuildinpPemits `MEC•PermitApp.doc 09/09110 440 -4617T (1 UO2'COM!WEB)
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