Permit Support Document (2) w
IIIIIIu CITY OF TIGARD MECHANICAL PERMIT
B .. COMMUNITY DEVELOPMENT / / Permit#: MEC2020 00651
'j/7/ '�'f 9Date Issued: 10/5/2020
T I C A P D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134C601300
Jurisdiction: Tigard
Site address: 12280 SW SUMMER ST
Project: ABUNNADI Subdivision: SUMMER HILLS PARK Lot: 12
Project Description: GAS PIPE FOR FURNACE RELOCATE, REPLACE FURNACE AND A/C, DUCTWORK ALTERATIONS. 10/7/20:
REPRINTED permit to include gas piping for fireplace and barbecue. 6/17/2021: REPRINT to add gas piping for
water heater,range and additional deck location.
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 06/17/2021 $22.21
12%State Surcharge-Mechanical 06/17/2021 $0.96
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $155.71
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 ttoOUNC by calling 503.232.1987 or 1.800.332.2344.
4W4.4„.1.6/ 4.___,)Issued By: Permittee Signature: / 1'Z/ L 7—"Ai 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.
E :IV ., 6— o fie 4202.1
Mechanical. Permit Application
City of Tigard ,itiN ' 0 2.0r Received i v Permit No.: IYti4^x.�l../L)J-W�M
Date/By:t . 13125 SW Hall Blvd.,Tigard,OR 9722, Plan Review
Phone: 503.718.2439 Fax: 503.- F T Other Penult:
Datc/fi v
TIGARD Inspection Line: 503.639.4175 .ri Date Readylily: luris. 63 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
TYPE OF WORK COMMERCIAI. FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction [d Addition/alterationlreplaceinent performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION - —
_ PRESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/eooling:
�h� �{.� Air conditioning 46.75
Job site address: IZ9ya f YV e `-'t r c Furnace 100,000 BTU(ducts/vents) 46.75
City/Stale/ZIP: ,Q Ill 4 q I L, 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: I lydronic 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.: Other: 23.32
Other fuel appliances:
Tax map/parcel Ito.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
-0nTo/'� �� l�J trt J t'l�� Flue vent for water heater or gas
fireplace 23.32
t r P► ,`1 raL64 pone) Log lighter(gas) 23.32
nn�� �Ar� lt,n,�' � �/� Wood/pellet stove 33.39
— e s iA , VOA o P hut.+`I ton, Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: atiern ( Range hood/other kitchen
� equipment 33.39
�n
Address: "e, 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
0 APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:Same as Contractor Fuel piping:
$14.15 for first four;S4.03 for each additional
Contact name:Diane Mason Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water]rater
°i
Phone:( ) Fax::( ) Fireplace d
---- - Range r7
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other: r ?',,
Business name:Tri County Temp Control
?.,i :' I. /
___.......---..-...-. MECHANICAL PERMIT FEES*
Address:13150 S Clackamas River Drive Subtotal
City/State/ZIP:Oregon City,OR 97045 Minimum permit fee(S90.00)
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
days after it has been accepted as complete.
Authorized signature: , Fee methodology set by Tri-County Building industry Service Board
Print name:Diane Mason Date: t0K 202
t\nuilding,Pcrntits'MEC_PennitApp_040113.doc 440.4617r(I 1/02icomtwGn)