Permit
n CITY OF T'IGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2010-00075
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/18/2010
Parcel: 2S 103AC02800
Jurisdiction: Tigard
Site address: 11075 SW ERROL ST
Subdivision: Lot: 0
Project: Pierce
Project Description: Add a/c.
Owner: FEES
PIERCE, AMY Description Date Amount
11075 SW ERROL ST Minimum Fee Adjustment - Mechanical 02/18/2010 $43.25
TIGARD, OR 97223 Air Conditioning 02/18/2010 $46.75
PHONE: 503-620-4946 12% State Surcharge - Mechanical 02/18/2010 $10.80
Contractor:
ROTH HEATING & COOLING
PO BOX 1265
CANBY, OR 97013
PHONE: 503-266-1249
FAX: 503-266-3478
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 N ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules
or d' ct questions to OU C Ilin 503.246.6699 or 1.800.332.2344.
sued By: Permittee Siona ure: A If
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
I A.
FEB-17-2010 WED 11:32 AM ROTH HEATING FAX NO. 5032663478 P. 01
Mechanical Permit AiDWA iEIVED
City of Tigard Received o2 / 7 I o Permit No.: f yOe le - 007
17 21~1t~ y.
13125 SW Rall Blvd., Tigard, OR 972&pp 8 Plan Review
9 Phone: 503.639.4171 Fax: 503.598,1960 Datelliy: Other Permd,
Inspection Line: 503.639.4175 1 nF T]GARD Date o luri.: BI 6ec Pape 1 for
Internet: www.tigard-or.gov NatificdilNotld/Methrod: ~ppkmentttt tntorm■tfon
TYPE OF WORK COMMERCIAL.,FEIr"; SCHEDULE = USE CHEGIQ.IST .
Mechanical porrnil fees' are based on the value of the work
❑ New construction Addition/alteration/rcplacement performed, Indicate tho value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials a ui ent labor overhead and profit
CATEGORY OF CONSTRUCTION Value:
RESIDENTIAL EQUIPMENT/SYSTEMS FEES;
1- and 2-family dwelling ❑ Commercial/industrial Accessary building For special igformadon use eheeklist,
Multi-family ❑ Master builder ❑ Other: Description Qty. Ea- Total
JOB SITE WORMATION AND LOCATION Readn eoolin
r01 c _ rcAir conditioning ~0•
Job site address rr
G ~J ~3 nirex site plan ehowin tacement 46.75
~t Furnace 100,000 BTU ducts/vents 46.75
Cily/5tateIZIP: l Furnace 100,0004- BTU ducts/vents) 54.91
Suiteibldg./apt. no.: Project name: Heat pump 61.06
Cross s[reet/dircclions to job site: Duct work 23.32
H dronic hot waters stem 23.32
Residential boiler (radiator or
h dronic 23.32
Unit heaters (tWel-type, not electric),
in-wall in-du su ended etc. 46.75
Fluelvent for an of above 23.32
Subdivision: Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances
Water
bFBCRIP7TON OF: WORK heater 23.32 Gas C. d a Flu fireplace 3339
Flue vent for water heater or gas
fireplace 23.32
Lo lighter as 23.32
Wood/ ellet stove 3339
Wood fire lacelinsert 23.32
Chimnc lincdfiue/vant 23.32
,Q9 PROPERTY OWNER Q TENANT Other: 23.32
Name: 606,m IMLL& Environmental exhaust and veatilution
Range hood/other kitchen
Address: 33.39
equipment
City/State/ZIP: Clothes d r exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: c50~ 0, L4 (p Fax: ( ) toilcl compartments, utility rooms 23.32 23,32
'APPLICANT ❑ CONTACT :PERSON; Ousher awls ace fans
23.32
ther
Business name: Fuel piping
Contact name: $14.15 for first four; 54.03 for each additional
Furnace etc.
Address: Gas heat um
City/State/LIP: Wall/sus endod/unit heater
Water heater
Phone: ( ) Fax: ' ( ) Fireplace
E-mail: Ran e
CONTRACTOR Barbecue
Clothes dryer
is)
Business name, U ` 6 1 G Other:
Address: p ~ Ui Q- " ME fUNICAL PERMIT FEES'
City/State/ZIP: Subtotal
C_.6LI1 0!2 X7013 Minimum permitfcc($90.00) 0.00
Phone: (rjp3) d (1: Ln ! v7 1 Fax' (5 )LP~~ -3~ Plan review (239%of omit fee)
CCB lie.: State surcharge (12%ofpermit fee)
TOTAL PERMIT FEE O
This permit application expires ifs permit is not obtained within tact
Authorized signalu / days after it has been accepted as complete.
~ Pee melhodolatty.ct hy'rrt-County Dint/roatm.uwynrn:~r, Uoor,l
Print nnma: 1'76• _U Date:
1:IBuilding\Pennit.\NIEC•Per tApp.doe in/ot/oo 44o4611T(I1/021CO\t/WL•n)
FEB-17-2010 WED 11:32 AM ROTH HEATING FAX NO. 5032663478 P. 02
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