Permit IN CITY OF TIGARD MECHANICAL PERMIT
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2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00592
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/15/2012
Parcel: 2S111AD03000
Jurisdiction: Tigard
Site address: 14540 SW 89TH AVE
Project: Ralstin Subdivision: PINEBROOK TERRACE Lot: 27
Project Description: (1) furnace installation
Contractor: PYRAMID HEATING & COOLING Owner: ROBINSON, SHARLA
9409 NE COLFAX 14540 SW 89TH AVE
PORTLAND, OR 97220 TIGARD, OR 97224
PHONE: 503 - 786 -9522 PHONE: 503 - 718 -8293
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/15/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/15/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/15/2012 $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: Permittee Signature: at A�I,/ Q/ -n0li
____A:Upl_____Lt_ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. u �l c�� d
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.
1 1 /1 4 / 201 2 WED 13:47 FAX 503 786 3432 PYRAMID HEATING R1002/002
. •
Mechanical Permit A 1ppisiECEiv.E FOR OFFICE USE ONLY '
'
City of Tigard - .. Fteceived
Peni' n N°.: LI _ i I X -005
.11 I' 13125 SW Hall Blvd., Tigard, OR 97223 .40V 1 4 2012 Plan Review
' III Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit:
T I C; Ap, D Inspection Line: 503.639.4175 . ,
Date Ready/By:
Internet: www.tigard CITY OF TIGARD
Notified/Method: ME SI See Page 2 for
pm Supplemental Information
laUILQINciPIVISION ,
, c'r'P- 2 : 0141-F4 fAgi - ...1z:'+': =: '? . : 41j Ugg 4 5:41 = 4: 7 41**EtiatefIl d r:iaeli.galailigkatfatilkt a;WI :Wail_ _____00.___.. ..100.,,, riit.,, ..,,W.J.J1
Mechanical per
ai permit fees* am based on the value of the work
fl New construction El Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
r3 Demolition 0 Other mechanical materials, equipment, labor, overhead, and profit.
Value: S
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El I - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal information use checklist.
0 Multi-family 0 Master builder El Other: Description 1 Qty. 1 Ea. 1 Total
:•' '''.U11 . 4*; Heating/cooling:
;;Kil.
riltiilif.f0f3.90Th*Tf r:,,,,L..,-,,,,37.■2.-----ur...,--,-- Ai con •
Job site address: 14540 SW 89 AVE (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
City/State/ZIP: TIGARD OR 97224
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg/apt, no.: 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, Mc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other. 23.32 _
Tax map/parcel no.: Other fuel appliances:
W h ea t er 23.32 •
....
Gas fireplace/insert 33.39
INSTALL OF FURNACE •
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
''-' " , 4, -"• ,, -m -- •-Isigri-4s
Chimney/linen/flue/vent 23.32
tit ,,,,,, 1 -111Mig-Mbi - gi4litl:-.4 1 4T4117-491 1 g-IW-, . , :i-ggit-NZ-:. ............ other: 23.32
Name: SHARLA RALSTIN Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 14540 SW 89 AVE
- equipment 33.39
City/State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)718-8293 Fax: ( ) toilet compartments, utility rooms) 23.32
ASIfiFROATiliqVidii ' Attic/crawlspace fans 23.32
Business name: PYRAMID HEATING AND COOLING Other: 23.32
Fuel piping:
Contact name: LISA MILLER $14.15 for first four, 54.03 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 Fax: : (503) 786-3432 Water heater
Fireplace
E-mail: LMILLER@PYRAMIDHEATING.COM
Range
- .. ,,,, - --- '+: -41 :4 4- 6gmfg - ff i tsmmaforEisfl - EiNqgxeztpEgag,Tafigi _
CATZICcIt Barbecue
Business name: SAME AS ABOVE Clothes dryer (gas)
Other
Address:
City/State/ZIP: Subtotal
Minimum permit fee (590.00) 90.00
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB tic.: 59382 State surcharge (12% of permit fee) 10.80
1 TOTAL PERMIT FEE 100.80
• This permit application expires If a permit is not obtained within 180
Authorized signatur .mip
.
..., . days after It has been accepted as complete.
Print name: LK sk ■, \ L AN., Date: - j 11 • Fee methodology set by Tri-County Building Industry Service Board
1: \ BuildinglPermits\ MEC-Permi1App.doc 03/07/12 440-461 (11/021601WWEB)