Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
411
J COMMUNITY DEVELOPMENT Permit#: MEC2022-00803
Date Issued: 9/2/2022
T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 i Parcel: 1S133DB07700
'1 Jurisdiction: Tigard
Site address: 13491 SW SUMMERWOOD DR j"N�
Project: Davidson Alpine Subdivision:>CHOLLS FERRY ROAD TOWNHOME: Lot: 3
Project Description: Replacement of AC. 10/27/22: REPRINTED permit to include furnace.
Contractor: BRUTON COMFORT CONTROL INC Owner: MONTGOMERY, CHARLES G FAMILY TRUST
12720 SW ALLEN BLVD BY DAVISON, JENNIFER A TR
BEAVERTON, OR 97005-5152 PO BOX 19423
PORTLAND, OR 97280
PHONE: 503-626-7477 PHONE:
FAX: 503-646-0126
FEES
Specifics: Description Date Amount
Air Conditioning 09/02/2022 $46.75
Type of Use: SF Furnaces< 100K BTU 10/27/2022 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/27/2022 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Electricity
Gas Pressure:
Total $104.72
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
Issued By: J — Permittee Signature: e€74
02.2-1 w
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.
Pteitce. add tz) Il?eizt711-1 /Pt(a7Ga. 6,y)&63
Mechanical Permit A licatio
City of Tigard ' ECEIVE vatotml
Daterity Permit No.:et is:c
, ,- 131-5 SW Hall Blvd..Tigard,OR 97323 Han Review
9 Phone: 503.716.2434 Far 503.598.1960 Dalle 13 ,
OCT 2 7 2022 r Other hermit
Inspection Line: 503.639.4175 Date aciady4iy. Alm 63 See pane'for
Internet: www.tigurd-ongna Supplemental information
rvrE OF woRK commtacIAL VW SCHEDULE - USETBECKLINT :
Meehamea ocrinit fees'are based oil the value or the work
E]Ntttk con s.tt tItt t'Kt n cittion,al lerat ion!rcp1 ' . pert-omit-a.Indicate the Val (rounded to the neariNt dollarl of all
- I temolifilin 0 Other: "? =nattiest materials,equipment,labor,overhead,and pro&
Value:5
CATEGORY OF CONSTRU : -
eand 2-family dwelling 0 Commercial/industrial 0 Accessory building Far xpetial infiumarion MC cherkika.
12 Multi-family []Muster builder 0 Other: Description 1 Qty. Ea. Tot:1F
---,,,,u,K.,,___ -nori. iietthigkooling:
SOB SITE INFORMATION AND EOCATI1-117- lal
Air conditng _
.1012 site atith etts: /6,C,ti , )1112e/4"eDa49 i'D Furnace 100,000 BTU thictsoreatio I ... 4466.'7735
City/State,'ZIP: 7)5. e1../9 oe., qi(20,3 Furnace 100,000+Pint tductsitentst 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work 23.32
Cross street/directions to job site: Hydmnic hot water system 23 32
Residential boiler t radiator or
hydronie) 23.32
Unit heaters t fuel-type,not electric),
111-wall.iii-duct,suspended.etc. 46.75
Flue/vent for any or above 23.32
Other: 23.32
Subdivision: Lot no,: Other fuel appliances:
Tax map/parcel on.; Water heater 23.32
DESCRIPTION OF WORK ties fireplacuallarrt 31.39
Flue vent for water heater or gas
al)(a(./..i!f!-11-/2Tr Cr '13L4-A-1"'Ki 61'C( 1 fireplace 23.32
Log lighter tgits) 23.32
Wood/pellet stove 33.34
Wood fireplacedosert 23.32
1 (hironeydinerditieivent 23.32
,
[ Other: 23.32
1.2-1/115OPTATT OWNER 0 TENANT
Environmental exhaust and ventilation:
1
Name. .s!!! itt.k...h's.,...),....0i41 1...!!!! ::kii) 1t -r....._.) , Range hood/other kitchen
Address: ?C.,) / q,f-lid_.„..."6 equipment
Clothes dryer exhaust 33.39
33.39
21.32
City/State/ZIP: '''' 0.,it../). CJZ C(7.2- t..) tsUilgtic-codiuci erixtiaust tub,aitihitr170:0s.,0
pi,, ;.( 15) ?.;---)7).. ((,,
.14 '4.< ['tor t ) Auielcrawispace faits 23.32
T 0 CONTACT PERSON Other 23 12 1
Fuel piping: j
i3tist licit;tiatnate)ribtly) ((flril ft,„-ya rnt,r).-1„- _. S14.1S On-first fourt,$4.03 far each additional
Contact rime: At/C.ILJ2Lk.e et...4-(-te.../‹...., Furnace,etc.
Address: ...--7,24-) 81,0,,......44/2,,,e1,_#fLIS/berrj flas heat pomp
WallisuspenticeFunit heater !
City/State/ZIP: be ectirapilvel Cgt...„. Q7Da\--- Water Waiter
Phone:6715 Co 21_,,-741 ) Fax::(955) Cy Oa,.0 2,44, Fireplace
Range
E-rnail: 'r vi to & 0 Lair Cit, cii)r--) Barbecue
tinter ow
Business name: 1,1(2,734.1 /1111 .11,74 71fe., Other
Ai.i1iii‘111111:717';;-1!71111‘,7.11114:711M1111.,1!!ali117----17,
Address; i 2720 SW) p9-i Le 6i 0 Subtotal
c,,,ysta.zw: t3eapei,q7j)'7 eir-24,1c77
Phone:(5;3) tp...2.446,1?("I') [ Fax:(L..35 . tir t-go.Cy240
oc, MlaitIlltal permit fer(590.00)
Plan review i 255k of perMit fee)
State surcharge 112%of mirth the)
CCB lie.: Ce ca4",(? TOTAL PERMIT FEE
This permit sppiirollon sspires If s permit it net atrial 'ibis led
days attar U Its*been accepted se complete.
Atittanised signature:i401,41262,11_if;4aal * Fat methodology set by Tri-County Building latifiStry Sah Int:Board
PrInt name: 0 chel I 6. gay+I i 2.,t i Date:/4_,y2,-14..1. ....
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