Permit CITY OF TIGARD MECHANICAL PERMIT
13 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00445
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/07/2010
Parcel: 1S133CD02700
Jurisdiction: Tigard
Site address: 13725 SW ASHBURY LN
Subdivision: COTSWALD MEADOWS Lot: 25
Project: Lee
Project Description: Replace gas furnace and venting.
Owner: FEES
LEE, VIVIAN Description Date Amount
13725 SW ASHBURY LN
TIGARD, OR 97223 Furnaces < 100K BTU 09/07/2010 $46.75
FlueNent For Any of Above 09/07/2010 $23.32
PHONE: 541- 941 -9741 12% State Surcharge - Mechanical 09/07/2010 $10.80
Minimum Fee Adjustment - Mechanical 09/07/2010 $19.93
Contractor:
AAA HEATING & COOLING
5017 NE GRAND AVENUE
PORTLAND, OR 97211
PHONE: 503 -284 -2173
FAX: 503- 284 -1552
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 : ' ca i0 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 . ect questions to OUNC • calling 503.246.6699 or 1.800.332.2344.
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Iss • d By: ,_ _ Permittee Signat j A i L 1 Jr /d—e----
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.
From: 09/07/2010 09:38 8880 P.001/002
Mechanical Permit Application _ Q � ± � . j ; � i c
v s \D i c i i i I < 1 `si :'! > i
sty of Tigard 'r� \ �,�� \`7 •r/ /� PcrmitNo.; pi 6/0 "T..
13125 SW Hall Blvd, Tigard, OR 9 c -
C ` Phone: 503.639.4171 Fax: 503.598.1' , u j V\ C\ P Oder Permit
1 ((, u Inspection line: 503.639.4175 f
hllanet www.tigardor.gov 5 C Date Ready/ , sera Page 3 for
Notified/Method: � hod: S S lementoi information
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❑ New construction EAddition /alteratfdlf/�rep1 it Mechanical Pamir 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
rr " n S'.�: i ?�.i n.J-y a°, _ /_�p...�f/.. Bch_» 'F;ia_".',:�µ?'a`'w;'-'. ^�`�' -' ; S`a"! 111C: s �5'i:4.i!) t" .�• T ' y .w l� tt' .:_ :. r o �Vi`,C / 1.01 -;•. i��r:' nL'r� 3FC :-1�' �Y LY..'.. =.R4,;: - - 1-4P710/70..k.-.10117:25.2g; V8 ... -.
E 1- and 2- family dwelling ❑ ConunatiaaUmdustrial ❑ Accessory building
❑ Multi-family ❑ Master builder ❑ Other: For weds,' 6+(orraaflovr rase cheeJFli
r c ; ° °f'' .'' :� �_,, _� x;: �: �vnl. r;' on 1 Qty. I Fa � Total
r:- k. JOB 831 ,1 o-t ,x`0.7,, OCA1 i •.�. , Heating/ nu
Air conditioning
Job site address: `7x1 L5 StA.2 o1 �q,t,Ae. (requites s showing placement) 46.75
City / State/ZIP: ` tiCA l7� C'1 Zt Furnace 100,000 BTU (ducts/vents) 1 46.75 e. 7 P
Funiace 100,000+ BTU (dacrs/venta) _ 54.91
Suite/bldg./apt. no.: I Project name: `r €_ Hest pume 61.06
Cross sheet/directions to job site Duct wodc 23.32
Hydronic hot water system 23.32 _
Residential boiler (radiator or
hydronic) 23.32
Unit beaten (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: rm.: Flue/vent for any of above 1 23.32
Odic: 23.32
Tax map/parcel no.: Other foal appliances _
���� �" -�x�. it ig ` ; t:: �+�W�RiC ` :�: -.� :: , AAA- - v' 1A Watt heater 2332
��� �4:ex. Y... i .._..�- .«� ...... � . n -.. 1._-,._....., w' ��.•-' Mf` L' w '.`�i'�} .�'a.;( ��' ' '1 = .'.�v':S<;xo-1 W
I - 't -C CGl.f F-t. �ZLf.l-Q 4 V ,` y Gee vended 33 39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
1 1 Wood Sreplacdmsest 23.32
' rt2ht r' :v.. + , . c r a ClmmeY/linc /9udvem 2332 2332
x r
:5 ..._, m rt^r"A:n
Name: V 1 V 1 1/41 yam, Environmental exhaust and ventilation
Address: 13 "� 2.5 lu •- Range hood /other kitchen
�btic y \ .Wt.. ` 0:nutmeat _33.39
City /State/LIP: '" cCr L 1 L7 Clothes dryer =beast 33.39
- Single-duct exhaust (bathrooms,
Phone: - a c - Y 1,1 4.1 y Fax. ( ) y toilet compartments, utility rooms) 23.32 '
' .. ,.. ®, APPIICA11Pf .: r A (' =f_ cawlvpaoe fans 23.32 •
:.:r..: .•tvJlr'�.... ,........ r- H .,. ! 9G;a.."°. BEM ysa.. -.- .... -: -. �'.�..,..�„•.�..n �:c�� .� Acher
/
Business name: AAA HEATING & COOLING INC.
Other. 23.32
Fuel
Contact name: V `�V, A..... . t `I �!1 15 for first four; 54.03 for each addltlonal
Address Farnaee, etc. .
Gas heat pump
City /State/ZIP: Wall/suspended/unit heats
Phone: ( ) I Fax:: ( ) Water heated
E-mail: Fireplace
Range _
•SCR: �:`;:
Ras
Business name: AAA HEATING & COOLING INC. Clothes d> ()
Other:
Address: 5017 NE GRAND AVE
'�.: - . -. -; '.:1 .�.�•( P� IY \a� - j 4
City/State/ZIP: PORTLAND OR 97211 Si1.14 . ' 71
Phone: (503) 2844173 I Fax: (503) 284 -1552 Minimum t (590.00
Plan review (25% of . :1 ee) --7- o
CCB lic.: 000222 State
surcharge ( 12% of permit fee) YS..,-1,43 YS..,-1,43 /0"'
TOTAL PERMIT FEE P •�O
Authorized signature: - Tub permit application expires If permit is not obtaloe wit t
� days after h has been accepted as complete. /a°
I Print name: VICTORIA EN Date: L /1/ I Q I ' Fee methodology set by Tri-County Building Industry Service Board ( I :\ Building \fhmtr\141EC- PamitApp.doc 10/OI/09 440•4617T (1U0 • UCOOM/WED) ` C