Permit �� CITY OF TIGARD MECHANICAL PERMIT
I - COMMUNITY DEVELOPMENT Permit #: MEC2013 -00283
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/2912013
Parcel: 2S112CB17300
Jurisdiction: Tigard
Site address: 8313 SW NORFOLK LN
Project: Jordan Subdivision: HAMPTON COURT Lot: 22
Project Description: Installation of A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: JORDAN, RUSSELL A & CHERYL A
19300 SW 118TH AVE 8313 SW NORFOLK LN
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503 - 691 -9699 PHONE: 503 - 639 -2715
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 05/29/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/29/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/29/2013 $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.
, _ 4 Issued By: Permittee Signature: /
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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05/28/2013 11:21 503- 691 -8556 OREGON HEATING PAGE 01/02
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Mechanical Permit APP1icati ECEIVED i O '' 01 i !( i � i r i)\l 1.
City of Tigard 1, ��
!EL i/ Permit No:
IIII e 13125 SW Hl B, TigOR 97223 I,M1 R.Y 2 8 2 013 permit
emit ,
Phone: 5017182439 Fax 503.598.1960 Date my:
T 1 , , . i , Inspection Line: 503.639.4175 Date Read ES li5 See Para 2 for
Internet www.tigard or.gov ; CITY OF TIGARD Notified/Method Supplemental Information
11111.DING DIVISION
TYPE O1B- WORT CO MEM RC ' FEE* SCIIIIHI .E.- U :.
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alter .tinn /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: echanical materials, profit
m als equipment, r overhead and pro
_ Value: a
CA Ti OR1 wOE CUI1SS'�' k — RESSDE1 'fli , E Q I 1Il7 7 / S S T, F EES' •
0 1- and 2- family dwelling ❑ Cosntnercial/ifdustrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description i Qty. I Ea. J Total
JOB' STYE, IIYEaRs4 LAND LOCATIO ,} Heating/cooling:
. 1 Air conditioning I 46.75 g4.7s
Sob site address' 3'ZL7 SW /V, /k ' Lone Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: T: i o n $ 2.2�i Furnace 100,000+ BTU (ducts/velats) 54,91
r f ar `/ � Heat pump 61.06
Suite/bldg./apt- no.: Project name: Alo : n Duct work 23.32
Cross street/directions to job site: 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 r 23.32
2332
Subdivision: Lot no.: Other: 1
_ Other fuel appliances
•
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
f- Flue vent for water heater or gas
in /a A..- G.le -.n9 - fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 3339
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:
1r PROPERTY OWNER I ❑'TENANT Environmental 23.32
_
At I - Environmental exhaust and ventilation:
Name /� a r. qnd Cfi tit, , ✓r /ial Range hood/other kitchen
equipment 33.39
Address:
it ? /.? Si,,,, /y L„„, Clothes dryer exhaust _ 33.39
City /State/ZIP: ''- q2 Single - duct exhaust (bathrooms,
gg rr� toilet compartments, utility rooms) 23.32
Phone: (,3"L y )( q --2 745- Pax: ( ) Attic/crawispace fans 23.32
® APPLICANT . El CONTACT PEIL4ON Other: 23.32
Business name: �/ Fuel piping:
C71 ! �% Pa hh 514.15 for first four•, 54.03 for each additional
Contact name: Z c i f C ft x ✓ Furnace, etc.
Address: , , i . /' / "ice Ossheat
/77
_ s Wall/suspended/unit heater
City/State/ZIP! T,4f, 4/2 9 Tor-f; Water heater
Phone: 5 03 ) 6?I r 7/9 9 Fax :: ( ) fireplace
Rul
E - mail: ° __. _.._.
Barbecue
CONTIEACTOR , Clothes dryer (gas)
Business name: Other:
MECHANICAL PERMIT FEES*
Address: (SgPI ear ,s4a r) _ Subtotal 4/6, 7S
City/Statenr: Minimum permit fee (590.00) 90 . —
Plan review (25% of permit fee)
P no: ( )
Fax: ( ) State surcharge (12% of permit fee) / U- $ o
CC lic.: /72 / TOTAL✓ PERMIT FEE / va- 80 ./
;: J// This permit application expires it a permit is not obtained within 180
`'�� "� —' 9
days after it been accepted omplete.
Authorized signature! ► Fee mcrhodoFy ol sec by Tri -County Building Industry Service Board
Print name: +rr, 44 ,, _ l _ - Date :��2 /ir