Permit , CITY OF TIGARD MECHANICAL PERMIT
`''-!" c . COMMUNITY DEVELOPMENT Permit #: MEC2010 -00330
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/14/2010
Parcel: 2S104BC07200
Jurisdiction: Tigard
Site address: 12650 SW BAILEY TER
Subdivision: BAILEY WOODS Lot: 8
Project: Fazal
Project Description: Install A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
FAZAL, ZUBAIR Description Date Amount
12650 SW BAILEY TER
TIGARD, OR 97223 Air Conditioning 07/14/2010 $46.75
12% State Surcharge - Mechanical 07/14/2010 $10.80
PHONE: 503-715-6595 Minimum Fee Adjustment - Mechanical 07/14/2010 $43.25
Contractor:
A- ACTION HEATING
18245 SW TV HWY
ALOHA, OR 97006
PHONE: 503 - 649 -3524
FAX: 503 -649 -6095
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 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 1.800.332.2344.
Issued By: I • Permittee Signature: `
Dn/ �"/ "L e
Cali 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.
10/29/2015 12:11 FAX [2,001/003
Mechanical Permit Appli a ' , . - - ) - T - O R 1 1 ( . 1 ()I l N t . ( ) \ I . \
City of Tigard - - Received -2 , lo i t, Permit No r 49 3
.11 13125 SW Hall Blvd., Tigard, OR 9 7 2 p, pl an Review
p Phone: 503.639.4171 Fax: 503.598' 3 L other Permit:
Date/By: i i , s , 1 , Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard or ` V - y Notified/Method: Supplemental Information
TYPE o >? W ORK 3
• �� r orrsmmtma®t
❑ New construction Ni ition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition • Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION ? }� t Value $
i t
1 and 2 -famil ion • Ot
Z
❑ Commercie stria) ❑ Accessory building r ` ` ' ' "•° i'
ulti- family 0 Master builder r ❑Other: For special information use checklist.
Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION _ l i LOCATION Heating/cooling
Job site address: f p Air conditioning / `�
l la . III . (requires site Plan showing placement) I / 46.75 [O
City/State/ZIP: IMP"
MilMi Furnace 100,000 BTU (dacts/vemsl _ 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydroaic 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
Subdivision: [Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION 0 WORK Water heater 23.32
Tijn `S
4 1 Gas fireplace gas 33.39
Flue vent for water heater or
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
f‘PROPERTY OWNER I ❑ TENANT NT
Chimney/liner /flue/vent 23.32
Other: 23.32
Name: 7 1.th a i ( r . . Environmental exhaust and ventilation
Range hood/other kitchen
Address: ` . , � � + �r r + equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: I .5 ' Cp 5 . 5 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ' • Attic/crawlspace.fans 23.32
_ CON . _ N .:
Other: 23.32
Business name: A- ACTION HEATINC & A/C
Fuel piping
Contact name: 18245 S.W. T.V. HWY $14.15 for first four; $4.03 for each additional
Address: ALOHA, OREGON 91006 Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
A- ACTION HEATING & A/C Other
Address: 18245 S.W. T.U. HWY t � , : 3.
•••
City/State/ZIP: ALOHA, OREGON 91006 Subtotal ---
P one�3) (4 -1 -3 Faxg3) 6q ? - . 6 6 5i Minimum permit fee ($90.00)
Pl an review (25% of permit fee)
CCB lic.: - 1 Clg 1 State surcharge (12% of permit fee) e/)�
TOTAL PERMIT FE UI J
Authorized signa This permit application expires if a permit is not obtained within 180
!>� days alter it has been accepted as complete.
' 27 �1I ' 1 • Fee methodology set by Tri- County Building Industry Service Board
Print name: ���� t/ 7
Date: L
I. M.. a. K..,,u_.... ;•AkAce_o.....4■..., A.... rnimmo �'" 440-44517r 1 1 1/M!rnmiwRm
10/29/2015 12:11 FAX 2003/003
r FTC
A '-Action Heating & Cooling, Inc. - ' ' rr.
18245 S.14 T.V. Hwy. JUL 1 3 2010
Aloha, Oregon 97006
CCB# 78369 CITY OF ; C.ARr)
503 -649 -3524 Fax: 503- 649 -6095
BUILDING (.'I1/I I }:`
SITE PLAN:
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SITE ADDRESS:
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