Permit CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2010 -00518
Date Issued: 10/22/2010
TIGAiLD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112CB01600
Jurisdiction: Tigard
Site address: 8026 SW ASHFORD ST
Subdivision: ASHFORD OAKS NO. 2 Lot: 30
Project: Hansen
Project Description: Install furnace.
Owner: FEES
HANSEN, MARY A Description Date Amount
8026 SW ASHFORD ST Fumaces < 100K BTU 10/22/2010 $46.75
TIGARD, OR 97224 FlueNent For Any of Above 10/22/2010 $23.32
PHONE: 503 - 307 -0256 12% State Surcharge - Mechanical 10/22/2010 $10.80
Minimum Fee Adjustment - Mechanical 10/22/2010 $19.93
Contractor:
ADVANCED HEATING & AIR CONDITIONING
6918 SE 48TH
PORTLAND, OR 97206
PHONE: 503 - 774 -0161
FAX: 503 - 774 -4391
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 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: _ Permittee Signature: 0 /17 /97"/" 4 / �; #170/1
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.
Mechanical Permit Application FoR oii ici•: um.: ()NIA'
City of Tigard �� I DteReceiB: Revyved iew
II �0 ZZ io • Permit No n/0 __00.5-1, ° 13125 SW Hall Blvd., Tigard. OR 97223 Plaan Other Permit:
P hone: 503.639.4171 Fax: 503.598.1960
C E Date/By:
•
T I G A R D Inspection Line: 503.639 0 I g 1 20 Date Ready /By: luris. ® See Page 2 for
Internet: www.tigard- or.gov C , LI Notified/Method: el Supplemental Information
- T E OF WORK C 1 ' i S u� COMMERCIAL FEE* SCHEDULE - USE.CHECKLIST
WI1)N Mechanical permit fees* are based on the value of the work
❑ New construction LLL��� Addition /alteration /r e ment performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • " - Value: $
I -and 2-family dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
} g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/'�� G ^ r Air conditioning
Job site address: SV / ,/n . ' ASH-- FD 9__{ ST-. (requires site plan showing placement) 46.75
City /State /ZIP: --1-16,A.00 ` J� ' Furnace 100,000 BTU (ducts/vents) i 46.75 4t b
/ 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
Hydronic 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 OF. WORK Water heater 0 23.32 I'
�;�:.� Gas fireplace 33.39
�� 4 ' 0 b ��'oI ..;-,...4..1: iY° ` "d �° t J` / — --. Flue vent for water heater or gas ��
fireplace � 23.32 ‘ ,.. - S, c ,, r V
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
ROPERTY OWNER 1 ' ❑ TENANT . Chimney /liner /flue /vent 23.32
• Other: 23.32
Name: m IV (� Environmental exhaust and ventilation A
v v Range hood /other kitchen •
Address: 'n om / 3 J � E S ASS t kt � • equipment 33.39
�
City /State /ZIP: C3 I' -1 ^3 /'!.n) 5- 2:21 Clothes dryer exhaust 33.39
l Single -duct exhaust (bathrooms,
Phone: ( - -b"2 ,(� l Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ' ❑ CONTACT PERSON. . Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater _
Water heater
Phone: ( ) Fax:: ( ) •
Fireplace
E -mail: Range
. CONTRACTOR Barbecue
�/ 2�� f�a �gA f � IA/m7� Clothes dryer (gas)
Business name:
/�u(/ /� (/e' O / / Other:
Address: 55 05 se si , , , MECHANICAL PERMIT FEES* • .
f�, � 2 �fJj Subtotal
Ci tylSt ate /Z[P: ,'-� Clvl �' (J`' ��fu um permit fee ($90.00) 7 •
Minimum (12.?- P ( 77/_- Fax: 3) 7 93,0 Plan review (25% of permit fee) O �
lic.: 9g5 State surcharge (12% of permit fee) ( C7,
v TOTAL PERMIT FEE (QQ, tip
This permit application expires if a permit is not obtained within 180
Authorized signature: / / '' days after it has been accepted as complete.
Print name: I‘l / 06/6- Date: • Fee methodology set by Tri- County Building Industry Service Board
1 \Building \Permits \MEC- PermitApp.doc 10 /01 /09 440 -4617T (1 I /02/COM/WEB)