Permit q CITY OF TIGARD _ MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2014-00423
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2014
Parcel: 1 S135AA00806
Jurisdiction: Tigard
Site address: 10211 SW JEFFERSON ST
Project: Mills Subdivision: METZGER,TOWN OF Lot: PTS 8-1
Project Description: Replace heat pump with like kind. Placement of heat pump must meet manufacturer's clearance requirements.
Contractor: BULL MOUNTAIN MECHANICAL Owner: MILLS,MICHAEL E AND
6520 ROSEWOOD ST BEVERLY A
LAKE OSWEGO,OR 97035 10211 SW JEFFERSON
TIGARD,OR 97223
PHONE: 503-612-6677 PHONE: 503-704-9214
FAX: 503-692-3084
FEES
Specifics: Description Date Amount
Heat Pump 08/12/2014 $61.06
Type of Use: SF 12%State Surcharge-Mechanical 08/12/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/12/2014 $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 qu • OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: /, � Permittee Signature: O!/ / :•�
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.
Mechanical Permit ApplicaltECEIVEP FOR OFFICE USE ONLY
City of Tigard Received Q L( -
Date/By: ('2_ ( � p� Permit No.: /
13125 SW Hall Blvd.,Tigard,OR 97223 �/L�i �����! �3
g Phone: 503.718.2439 Fax: 503.598.19 G 1 2 2014 Da e/By:�W Other Permit:
T t G A R D Inspection Line: 503.639.4175 _
Internet: www.tigard-or.gov Date Ready/By: 3tvis: See Page 2 for
CITY OF"TIGARD Notified/Method: Supplemental Information
E g rAidir r' I I`') 1() COMMERCIAL FEE* SCHEDULE- USE CHECKLLST 1
Mechanical permit fees*are based on the value of the work
❑New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:S
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
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
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: /0'.- I $,.. 4 , Air conditioning 46.75
d7N OL Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: o f ,. J G) � , Furnace 100,000+BTU(ducts/vents) 54.91 _
Suite/bldg./apt.no.: Project name: ( Heat pump 61.06
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 23.32
Subdivision: Lot no.: � 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
r ` � J Flue vent for water heater or gas
V r �^ �- - ',ILA,' Itte,,' - 9 p fireplace 23.32
J r Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
/Z PROPERTY OWNER ❑ • ENA Other: 23.32
Environmental exhaust and ventilation:
Name:
01;C--ket V,•1,S Range hood/other kitchen
equipment 33.39 Address: i 001_1 1 S W ..t.�..4 ✓ O N A`
Clothes dryer exhaust 33.39
City/State/ZIP e r 1 d ! /i✓ C� I-2.2-3
Single-duct exhaust(bathrooms,
Va- toilet compartments,utility rooms) 23.32
Phone:(9), ) - tE 11� Fax:( ) Attic/crawlspace fans 23.32
. ❑ APPLICANT
CONTACT PERSON Other: 23.32
Business name: '1`' Fuel piping:
��� ov-v071.�� #� 'I- --I S" "'-' $14.15 for first four;$4.03 for each additional
Contact name: -+�- t
J t1k_CL._ \--\--a. SQir\ Furnace,etc.
Address: 6,6 2,0 4 0 se w OUL� Gas heat pump
�+' ��]. _ ' Wall/suspended/unit heater
City/State/ZIP: , 1-'� �e_ Osf,,,2 ' cre._ 9 9-035 Water heater
Phone: ff / Loci���) �p � ems- l0 tC�-� Fax::�3 ) W l 2... 30 0 Fireplace
Range
E-mail: j \ LA 11 me tk h v,YYl e c-.(•1 - Lt OVY` Barbecue
CONTRACTOR Clothes dryer(gas)
Business name11 ► 1 O Other
r� / 1 �l V�}t7�'r l�A (�� C�K.�1S �G'l MECHANICAL PERMIT FEES*
Address: LP.20 1 e_w 0v I s}
� w �l Subtotal
City/State/ZIP: �.-1k (s � 0-f2. el 7035 Minimum permit fee(S90.00) t:�Q 0"'
Phone: `� t V 1`� Plan review(25%of permit fee)
(�rp)j )4, 1----A- Fax:(503) (o9 _ ?Jp Elf State surcharge(12%of permit fee) /0•$V
CCB lic.: 4 1 g ILi-
TOTAL PERMIT FEE /00 a 6i)
AltAilL.--/"--42...c41a.4-lAs-Q.-4--- This permit application expires if a permit is not obtained within 180
dfteit hbtd ltAuthorized si ature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: r 1 e_f,e_ h c,..e.," Date: g-. 1 I -
1:\13uilding\PennitsTNEC_PennitApp_0401I3.doc 440-4617T(11/02/CO/WEB)