Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
°k'! I n COMMUNITY DEVELOPMENT Permit#: MEC2020-00651
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Date Issued: 10/5l2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t. '-
Parcel: 1 S134C601300
7 I Jurisdiction: Tigard
Site address: 12280 SW SUMMER ST
Project: ABUNNADI Subdivision: SUMMER HILLS PARK Lot: 12
Project Description: GAS PIPE FOR FURNACE RELOCATE, REPLACE GAS FURNACE AND AIR CONDITIONER,DUCTWORK
ALTERATIONS. 10/7/20: REPRINTED permit to include gas piping for fireplace and barbecue.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: ABUNNADI, KAZEM M
13150 S CLACKAMAS RIVER DR 12280 SW SUMMER ST
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: (503)557-2220 PHONE:
FAX: 503-557-0919
FEES
Specifics: Description Date Amount
Air Conditioning 10/05/2020 $46.75
Type of Use: SF Furnaces< 100K BTU 10/05/2020 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 10/05/2020 $23.32
Occupancy Grp: 12%State Surcharge-Mechanical 10/05/2020 $15.72
Stories: Fuel Piping 10/05/2020 $14.15
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $146.69
Required Items and Reports(Conditions) 1
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:
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Call .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 Applicatkort— t
City of Tigard . Received
'' Date/By:
• 13125 SW Hall Blvd.,Tigard,OR 97223V l'-:- -4 77 ''l i-":.
INPlan Review Permit No.: MIEC070.00/45 I
Other Penult:
Phone: 503.718.2439 Fax: 503.598.1960 0 C I ri 2 020 Date/By:
nspecton Line: 503.639.4175
TIGARD I i Date Ready/By: kris 0 See Page 2 for
Internet www.tigard-ongos Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE*
Mechanical permit fees*are based an the value of the work
El New construction 53 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
ID Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY CW CONSTRUCTION , __
RESIDENTIAL EQuipmErwswms,FEES* ''--7,ry
[E I-and 2-family dwelling El Commercial/industrial D Accessory building l•or special information use checklist.
0 Multi-family E Master builder El Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 122.2,0 •‘I\1 elairaCr birra.+- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -n84 ° (Ar12-2b: Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
ACta-0 rl TO 6\46(97-6'PeriT1 It fireplace 23.32
-C1.0547iPC) ie f-i replan 41 ee,nt Log lighter(gas) „‘ 23.32
- Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:
El 23.32
PROPERTY OWNER LiTENANT
' ' Environmental exhaust and ventilation;
Name: Kcasin A-boat:14C I Range hood/other kitchen
equipment 33.39
Address: iaarne) Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
E] API LIcAn"r El CONTACT PERSON Other 23.32
Fuel piping:
Business name:Same as Contractor $14.15 for first four;$4.03 for each additional
Contact name:Diane Mason Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace I
Range
E-mail: I
Barbecue
Clothes dryer(gas)
Other:
Business name:Tri County Temp Control MEC!!ANICAL PERMIT FEES'
Address:13150 S Clackamas River Drive Subtotal
City/State/ZIP:Oregon City,OR 97045 Minimum pennit fee(590.00)
Plan review(25%of permit fee)
Phone:(503)557-2220 Fax:(503)557/0919 State surcharge(12%of permit fee)
CCB lie.:72623 TOTAL PERMIT FEE
This permit application expires if a permit Is not obtained within 180
signature: eiy2A4,..0,--"'11, W) days after it has been accepted as complete.
Authorized
* Fee methodology set by Tri•County Building industry Service Board
Print name:Diane Mason Date: te,I/t2(92.10
IMIttildingTertpitiMEC_PormhApp_040113 doe 440-4617T(11,02/CONLAVE0)