Permit CITY OF TIGARD MECHANICAL PERMIT
1 111 1
2 • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011
Parcel: 1S134CB05200
Jurisdiction: Tigard
Site address: 12560 SW SUMMER CREST DR
Project: LOPEZ Subdivision: Lot: 0
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING & COOLING Owner: LOPEZ, FRANCISCO E & SARAH G
8900 SW BURNHAM F -5 12560 SW SUMMERCREST DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE:
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/05/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/05/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/05/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 503.232.1987 or 1.800.332.2344.
Issued By: , I Permittee Signature: IP
Call 503.639.4175 by 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 ApplicationECEI \/E
FOR OFFICE I.-SE ONLY City of Tigard Received _
13125 SW Hall Blvd., Tigard, OR 97223 JAN 0 3 2011 Date /B I � , / Perm Na .• Jt / I/I
I - •
Phone: 503.639.4171 Fax: 503.598.1960
-
Plan Review
T t G n R D Inspection Line: 503.639.417 , Date By: Other Permit
CITY O)t..� IGARD
Date Ready/By:
Internet: www.tigard or t c ®See Page 2 for
BUILDIF.0 t IVISIO? Notified/Method: M Supplemental Information
TYPE OF WORK 1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction ® Addition /alteration'replacemenl
performed. Indicate the value (rounded to the nearest dollar) of all
❑ DemoIition 0 Other:
mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
® 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
❑ Multi - family ❑ Master builder 0 Other For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heatingicooling
Job site address: 12560 SW Summererest Drive Air conditioning
- (requires site plan showing placement) 46.75
City Tigard, OR 97223 Furnace 100,000 BTU (ducts vents) - 1 46.75. 46.75
Suite /bldgJapt_ no.. I Project name: Lopez Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work
- 23.32
Hvdronic hot water system 23.32 '
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in - wall , in su etc 46.75
Subdivision: I Lot Fhe/vent for any of above _ 23.32
Tax map/parcel no.: I - Other. 23.32
Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Replace existing Gas Furnace Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
wood/pellet stove _ 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER I 0 TENANT Chimney/1irter /flueh•ent 23.32
Hume: Francisco Lopez Other: J 23,32
Envlroomental exhaust and s•ent!Iallon
Address: 12560 SW Summercrest Drive Range hood/other kitchen
equipment 33.39
City /State/ZIP: Tigard, OR. 97223
Clothes dryer exhaust 33.39
Phone: (503-)579-7771 Single -duct exhaust (bathrooms,
0 Fax'. ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Atticrcrawlspnce fns 23.32
Business une: Other: 1 23.32 1.
n
Contact name: Fuel piping
$14.15 for first four; $4.03 for each additional
Address Furnace, etc. I
City/State/ZIP: Gas heat pump
Wall/suspendedlun it heater
Phone: ( ) l Fax:: ( ) Water heater
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Able Healing & Cooling, LLC Clothes dryer (gas)
Address: 8900 SW Burnham #F -5 Other:
MECHANICAL PERMIT FEES'
CityiState/Z_IP: Tigard, OR. 97223
Subtotal 1
Phone: (503) 579 -2250 Fax: (503) 620 -3980 Minimum permit fee ($90.00) 90.00
CCB lie.: 184392 L Plan review (25%ofpermit fee)
II J State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature: !r� This permit appticatian expires if a permit is not obtained within 18a
I Print name: Kelly V1 ilhi eo days after it has been accepted as complete.
I Date: 1 -04 - 2011 I • Fee methodology set by 'Fri-County Butidiug Industry Service Board
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