Permit " CITY OF TIGARD MECHANICAL PERMIT
° '1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2011
Parcel: 2S104CCO2700
Jurisdiction: Tigard
Site address: 13983 SW HILLSHIRE DR
Project: LAMBERT Subdivision: HILLSHIRE ESTATES NO. 2 Lot: 133
Project Description: Gas furnace replacement
Contractor: ABLE HEATING & COOLING Owner: LAMBERT, KEVIN J & SUSAN PAIGE
8900 SW BURNHAM F -5 13983 SW HILLSHIRE DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 791 -7000
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/04/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/04/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/04/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1* ; • ;:. 3 •
Issued By: / / � ermittee Signature:
4.
Call 503.. 0 .y 7:00 a.m. for the next available inspection date.
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 Applicati�l °''r CDs '
14 ® -d• ('.f *° FOR OFFICE 1 :5EONLY
- City of Tigard Recei ^
• 13125 SW Hell Blvd., 'Tigard, OR 97223 DEC 3 12010 Date By _ : ilr?. � Permit No., >�
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
'� ' -
Ins ection Line: 503.639.4175 CITY CF !�w Date/By: Other Permit:
TIC A N P P o V 1 iF �(la,4RD Date Ready!Ay Jur'
Internet: Line: ward -or. v H Site Pa_e 2 for
BUILDING DIVI Iol \' holified/Melhod: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑New construction ddition /alteration!replacement Ivfechanieal permit fees* are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ O ther: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
4�'I - and 2 - family dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS FEES"
g ❑ Commercial /industrial ❑ Accessory building
11:1 Multi ily ❑ Master builder Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION _ }leafing/rooting
Job site address: ` Air conditioning
4::\C‘ � ��'� ! `5�� \� C�t( \t: r . (requires site plan showing placement) 46.75
- Cily!State/ZIP: --\---(..,i441...,11 C1 Ci
\
% [`� , f r� Furnace 100,000 BTU (ducts vemsl 46.75 r1
Suite/bldg. /apt. no.: Project name: �� F 100,000+ BTU (ducts/vents) 54,91 _ s �
— ' " �l' l = Heat pump 61.06
f Cross street/directions to job site: Duct work 23.32
I - Hydronic hot water system 2332
_ Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duet, suspended, etc. 46.75
Subdivision: f 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 23.32
�� C �� c-- .K - ~- Gas fireplace 33.39
\In C k_ kkA\ A1IA(v,r= Flue vent for water heater or gas
(� J � fireplace 23.32
Log lighter (gas) ' 23.32
-
Wood/pellet stove 33.39
Wood fireplace/insert 2332
IB OPERTY OWNER I ❑ TENANT Chimney/liner/flue /vent 23.32 —
1 __ �.`
Other 23.32
, �+ " Environmental exhaust and ventilation
Address: l q 1 � 1 J ` , U) . ,.L1 1\ � l e,, `�11 RNLI t�:
equipment hood /other kitchen
`F� 1 33.39
City/State/ZIP: �` ( � t l ` �
(y ry � Clothes dryer exhaust 33.39
Phone: (51„ _ 1 Sin dun e xhaust (bathro oms,
/\q +1 �t) 0 F ax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attio /orn...lep000 Fare
a3.az_ ,
Business name: Other 23.32
Fuel piping
Contact name:
$14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat
City. /Stale /ZIP: pump _
Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail: _ Fireplace
_ Range
CONTRACTOR Barbecue
Business name: Clothes dryer (�)
1�� ~A� l. f. C_rw.av, ) � O ther:
Address: 1/4. C n ► � _
�` !L ti • ' ' MECHANICAL PERMIT FEES*
City/5tate/ZIP.7 /� - •
1 1� , Subtotal
Phone: ).. 4 k„.„,..., , .�J 0 , Fax: ( 1 Urz lL . - ��(, r, _ Minimum permit I {$90.O �� •�
CCBIic_: C7► ff �� _ Planreview(25%ofpermitfee
^' `� l°�-' State surcharge (12% of permit fee) 1 \ l `
TOTAL PERMIT FEE% \c)O , go
Authorized sigtature: This permit application expires if a permit is not obtained within 1130
dais after it has been accepted as complete.
Print name' '
li Date: e, • Fee methodology set by Tri -County Building Industry Service Board
i:lauilding`,PermiL, MEC- Permit. p. doe .0101109 44C (I I /02/COMJWEB)
L'd 086£
6ui1000 +g 6ui }t:aH alqy