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Permit CITY OF TIGARD MECHANICAL PERMIT O COMMUNITY DEVELOPMENT Permit #: MEC2010 -00245 Date Issued: 05/27/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104CD03400 Jurisdiction: Tigard Site address: 13506 SW HILLSHIRE DR Subdivision: HILLSHIRE ESTATES Lot: 34 Project: Le Project Description: Installing (2) NC units. Owner: FEES LE, PAULINA Q Description Date Amount 12254 SW 114TH TER TIGARD, OR 97223 Air Conditioning 05/27/2010 $93.50 12% State Surcharge - Mechanical 05/27/2010 $11.22 PHONE: 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 $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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1 a e07332 72344. Issued By: T/1111 - � - - Permittee Signature: ! l� 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. MAY -26 -2010 WED 11:35 AM ROTH HEATING FAX NO, 5032663478 P. 01 Mechanical Permit A Heat CEIVED WIZ r)l.b'IC'l, l ISE ()NIA City of Tigard Received r 13125 SW Hall Blvd., Tigard, OR 97223 MAY 26 1 ate /By ' S ► s / • Phone: 503.639.4171 Fax: 503.598. 1960 Ia Revie I i ; ,.,j, 1 y Inspection Lino: 303.639,4175 Di ne/By Other Fermin: CITY OF TIGARD Internet: www- tigard- or.gov Data ��y�r: ® Page z for BUILDING DIVISION 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 ® Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all © Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY : OF , CONSTRUCTION Value: $ y dwelling ❑ Commercial /industrial ❑ Accessory building REBID Fa rsAc ta� UoPMENT1S ® 1 -and 2 -famil dwellin ssory SYSTEMS FEES" Pe >!I matlon use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty, Ea. Total • JOB SITE INFORMATION AND LOCATION' Heating/coolintt Job site address: 135 l� ,VU M' 11 S h 1.r br . Air conditioning JJ ,� (requires site plan showing placement) c7S 46.75 q ,"7� City/Statc2iP: - 1 - 1 . 5 (mod 0 it C t 72 3 Furnace 100,000 BTU (ducts/vents) 46.75 Suite/bldg./apt. no.: J Project name: Furnace 100,000+ BTU (ducts/vema) 54.91 Beat pump 61_06 Cross street/directions to job site: Duct work 2332 . __ Hvdronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -typo, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: 1 Lot no.: Flue/vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other Net appliances t } " DESCRIPTION OF WORK Water heater 23.32 05 Crt 1 l � d GI Gas fireplace 33.39 �: Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 3339 Wood fireplace/insert _ 23.32 - -- Chimney/liner/flue/vent , :,1 PROPERTY. OWNER ❑ TENANT 23.32 Other: 23.32 Name: LC-it ("CoGL tie Environmental exhaust and ventilation Address: f Range hood/other kitchen equipment _ 33.39 City /State/ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (4771'i el e/g- E ' 7 1 Fax: ( ) toilet compartments, utility rooms) 23.32 • r LI APPLICANT ;!:: D CONTACT ° PERSON ?. ' ' Attic/crawlspace fans 2332 Business name: Other: 32 Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gus heat pump City /State/LIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater E-mail: I/ Fireplace Rimgc CONTRACTOR Barbecue Business name: / Clothes dryer (gas) _ O `�4 1 "t't i - 12 . `r 1 (i0IA:1, )( Other: _ Address: j o . b c< 12, lP 5 J . MECHANICAL PERMIT FEES* City/State /ZIP: ahui I,/ ` 012. '77P/ ,3 Subtotal '73.50 C� Phone: (5Q3) (t ( �� Tax, (( ) tP(13 -.3�/ Z7e Minimum permit five ($90.00) F Plan review (25% of permit fee) CCB tic.: ) Lf (j State surcharge (12% of permit fee) 1 11, 2,7- TOTAL PERMIT FEE 1 Q4 12- Authorized signatu `.tom . /lL��- This permit application expires If a permit b not obtained within 180 days after it has been accepted as complete. Print name: , 11 7�, i f . • • / 1 ' Fee methodology set by Tri- County Building Industry Service Board l:\auildina\Yermits\MEOPer aApp.4oc 15/01109 440 4617T(11/02/COM/Wea) MAY-26-2010 WED 11:36 AM ROTH HEATING FAX NO. 5032663478 P. 02 • A /p TE F)L • r, „._. • Ui 5.E 7 1 1 -,6‘ FIN - r• • • • 4 . • . . 5"7RE. . . • ADR-E- SE: 1350 SyQ f-1 W. •