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Permit CITY OF TIGARD MECHANICAL PERMIT 1, a.. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00155 T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/13/2009 Parcel: 2S103AA01901 Jurisdiction: Tigard Site address: 10585 SW WALNUT ST Subdivision: Lot: 0 Project: Helmer Project Description: Install a/c unit. Owner: FEES HELMER, GARRY L BARBARA S Description Date Amount 10585 SW WALNUT Air Conditioning or Heat Pump 04/13/2009 $14.00 TIGARD, OR 97223 12% State Surcharge - Mechanical 04 /13/2009 $8.70 PHONE: Minimum Fee Adjustment - Mechanical 04 /13/2009 $58.50 Contractor: WILLAMETTE HVAC 3075 SW 234TH AVE. #206 HILLSBORO, OR 97123 PHONE: 503 - 628 -6841 FAX: 503 - 848 -2597 • Type of Use: SF Class of Work: ALT Type of Const: • Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressue Total $81.20 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 Notificati. enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules ... Irt4 Issued - �/ I i Permittee Signature: 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. Mec finical Permit Applicat' t ^^ FOR OFFICE USE ONLY ad :1 City of Tigard 30 J Date/By: y d ° Permit No.: If 1 -/5—S ° 13125 SW Hall Blvd., Tigard, OR 97223 7 Plan Review : ' Phone: 503.639.4171 Fax: 503.598.19. %OZ ` � Date/By: Other Permit: TI GARD Inspection Line: 503.639.4175 Ready/By: ® See Page 2 for Internet: www.tigard - ' T Notified/Method: Supplemental Information j nu1 TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest clonal) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ SIVIP0:I0' RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building M builder For special information use checklist. Multi -famil ❑ Multi-family ❑ ❑ Other: Description I Qty. I Ea. I Total • JOB SITE INFORMATION AND LOCATION' Heating/cooling Job site address: 10585 SW Walnut St Air conditioning or heat pump (requires (requires site plan showing placement) / 14.00 City /State /ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Helmer Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above . 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 Install A/c coil and outdoor condensor Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 PROPERTY OWNER _ . ❑ TENANT Chimney/liner/flue/vent 10.00 Itg Other: 10.00 Name: W t g (2— Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 - ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Same Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range . CONTRACTOR Barbecue Business name: Willamette HVAC Clothes dryer (gas) Other: Address: 3075 SW 234 Ave Ste 206 MECHANICAL PERMIT FEES* . City /State /ZIP: Hillsboro OR 97123 Subtotal Phone: (503) 628.6841 Fax: (503) 848.2597 Minimum permit fee ($72.50) 70 Plan review (25% of permit fee) .60" CCB lic.: 56951 State surcharge (12% of permit fee) . 70 TOTAL PERMIT FEE , Authorized signature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. Print name: Michael Malstrom Date: 4/13/09 • Fee methodology set by Tri- County Building Industry Service Board 1:\ Building\ PcrmitAMEC- PermitApp.doc 01/19/07 440- 4617T(11/02/COM/WEB) fnterMap Page 1 of 2 i,\ t Y I ntermap Geographic Information Systems • ,� RtGO• T Navigation: I GIS Home I New Search I Navigator I Help Parcel Report for Taxlot: 2S103AA01901 q Site Address: 10585 SW WALNUT ST. TIGARD OR, 97223 Active Tool: Zoom In Overview Ma. 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