Permit !1I C!TY OF TI R MECHANICAL PERMIT
4 COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00657
� GARD r DATE ISSUED: 12/27/2006
T': 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S133AD -14700
SITE ADDRESS: 12698 SW SORREL DOCK CT ZONING: R -7
SUBDIVISION: SUMMER LAKE LOT: 028 JURISDICTION: TIG
Project Description: Gas furnace replacement.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
HERSHEY, WILLIAM T + CAROL J Description Date Amount
12698 SW SORRELL DOCK CT
TIGARD, OR 97223 [MECH] Permit Fee 12/27/20( $72.50
[TAX] 8% State Surcha 12/27/20( $5.80
Total $78.30
Phone: 503 -524 -4202
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -284 -2173
FAX 503- 284 -1552
Reg #: LIC 222
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. AN 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: e z e 'C t
Call 503.639.4175 by 7:00 a.m. for inspections 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.
Igor 11:354 AAA HEATING AND COOLING 503 284 1552 p.2
• - REG u ,i u. 1 i City of Tigard D; y 1.?" 11vto 94 1 Permit No.M6C—
/,5f
13125 SW Hall Blvd., Tigard, OR 97223 DEC � 2UU I P i -��
Phone: 503.639.4171 Fax: 503.598.1960 DCI� U .a�r ++ I ni Date/13y: ��` PC111 ` t
Inspection Line: 503.039.4175 411 +,• r li'1 See I'a e 2 far
r. Dat ReadyJ S
Internet: www.ci.tigard.or_us al f Or
y I � iU ', p I. Notified/Method: ...-or Supplemental information
' a r OR K COMMERCIAL FEE* SCHEDULE — USE CH ECKLIS"
Mechanical permit fees* are based on the value or the work
❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) or:
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: 5
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
ii 2-family dwelling ❑Commercial /industrial 0 Accessory building
For special ;,,furrttntror, use checklist.
0 Multi- family ❑ Master builder ❑ Other. Description 1 Qty. 1 Ea. 1 Tota
JOB SITE INFORMATION AND LOCATION Heating/cooling
�` J Air conditioning or heat pump
(requires 1obsiteaddress: tc ,�rreLL ui Cooft 14.00
yy J ) `� L Fumace 100.000 BTU (ducesrvetus) 14.00 I
City/StattIJZIP:� j ��+ CA"' 7
►I _- Furnace 100,000+- BTU (ducrsrvents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 i
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00 1
Residential boiler (radiator or
hydronic) 14.00 1
Unit heaters (fuel -type, not electric), I
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00 1 Jo.
Subdivision: 1 Lot no.: Other: 10.00 1
Tax map /parcel no.: Other Curl applianeees
DESCRIPTION OF WORK Water )seater 10.00 1
Gas fireplace IOAO j
-4 Rei - lk PirP d f ` \-� 94 Flue vent for water heater or gas 10.00
L fireplace
l4, \ e ti Yip, p Lo g lighter (gas) 10.00
_ Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10
PItOPERTX OWNER 1 ❑TENANT Other: 10.00
Name: r 3L .$ 1 t .`. X5 Env ironmental exhanstandventilation
�C� Range hood/other kitchen
Address: 1 9 ' � J `. l Jr aL ^(6 co V t equipment Clothes dryer exhaust
1000
City /State/ZlP C q ra ( r C7 Clothes l O.OD
JJ �) a` Single -duct exhaust (bathrooms,
Phone: 3) k-L — 1.0.0)._. *San: C� toilet compartments, utility rooms) 6.80
❑ APPLICANT '� ❑ CONTACT PERSON Attidcrtwlspace fans 10.00
Other. 10.00 _
Business name: Fuel piping
Contact name: SS.40 for first four, 51.00 far each additiona
, Furnace, eta.
Address: Gas heat pump _
City/State/ZIP: Wall/suspended/unit heater
Water heater
Phone: ( ) Fax: ( ) Fireplace
E-mail: ag .
CONTRACTOR Barbecue .
MA / Clothes dryer (gas)
Q �
Business name: "N U■ »- 4 (O(fo [ e),?* Outer:
Address: 44 /S YT E Yr7 1114 -J2 i rL / d / MECHANICAL PERMIT FEES*
City/State/ZiP: �'jla? �(� / 7,� Subtotal !
Minimum permit fee (572.50) Z- L
Phone: ( 3) t ( F Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee) 5,?;
/ TOTAL PERMIT FEE 7f,
This permit application expires if a permit is not obtained withir
Authorized sig alum , days after it has been accepted as complete.
Print name: 3 . L,,ti S i 4 I.2 2A Date: /2 — 2.4.-e4 • Fee methodology set by Tri- County Building lndusry Service Bo
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