Permit 741 CITY OF TIGARD MECHANICAL PERMIT
� � - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00020
Date Issued: 01/12/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S110BC11000
Jurisdiction: TIGARD
Site address: 12042 SW STRINGER LN
Project: Johnston Subdivision: Lot: 0
Project Description: Install A/C unit. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: ROTH HEATING & COOLING Owner: JOHNSTON, BILL
PO BOX 1265 12042 SW STRINGER LN
CANBY, OR 97013 TIGARD, OR 97224
PHONE: 503 - 266 -1249 PHONE: 503 - 747 -4556
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 01/12/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/12/2011 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 01/12/2011 $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 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signature: dAr e7 0
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.
�� FAX NO, 5032663478 Pr 01
JAN -11 -2011 TUE 11;15 AM ROTH HEATING
Mechanical Pe p n' � °` ,,,,
f it A nplication r , J r 'II
City of Tigard r oEi o1 ICE USE ONLY 1p11 Rt.iv
II 9 13125 SW Hall Blvd., Tigard, OR 97223 tt : AEI'
Phone: 5 03.639.4171 P N Date /
a Y / 44, / j� Pormit No j / — QQ
Pax: 503,598,1960 J' p1i)Plan Review �
TIOARD Inspection Line: 503.639.4175 �� q T jY+� .1]ato /J3y: 4thcrPermir.
Internet: g - or,gov — 1::;( C � �- , '`ll otl,
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\l t -�1i l — Sup m Inrnrmation
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, :, , , 6 f t r ±g $.01cn4 >G,r'�'�sia6i��cr��.rsr�'
New construction t Add ition/ alteration /replacement
(] Demolition Other:
Mechanical permit fees are b ased an tlrc valtie of the work
1
perfornted Indicate the value (rounded to the nearest dollar) of all
anica materials, equipment, labor, overhead, and milt.
IriCch
.. i. ' 1.Pli C rYC0t?R' ' Off'::;00N0 ` Tt10,1101Y '.
V4 Value: $
N 1 - and 2 - family dwelling ❑ Commercial /industrial 1iFsSIr) 1\
❑Accessory building
E. T4 L.Ef.OP)V1 1 yTilS7i(S'I E S r i Ls ;
❑ Multi family ❑ Other:
M For special i/tformation use checklist. aster builder
p Jab
J B {lR',1 Description Qty, Ea. Total
job site address. f � ("1",;/ s , r r , d � ..' Ifcatlrr � /coolie
W ifi el t° p - 1 a _, Air conditioning
1111111.1 City/State/ZIP; G i t irr At (rer sires site Lain showing placement) 5 ' -r
41 t li "� ' - Jttrnnee ! 00,, IJ (slocts /veins)
t
000 )�T
IV
Suits /bldg, /apt, no,; 46.4.9] 7,5
Project Wattle: Furnace 100,0004 BTU (ducts /vents
j
Cross street /directions to job site: Heat pump _
61,06
Duct work �
Hydronic hot waters stern 23,32
Residential bailer (radiator or
hydronic) 23 12
Unit: healers (fucJ1ypc, not electric),
Subdivision: — in -wall, in -duct, sat - ended, etc. 46,75
Lot no.:
Flue/vent for any of above 23.32
map/parcel no Other: 23 32
,,; AFh1C Other a ). fiances
Tax
' . a O'D�ON� VO A` I� h '� 1 ..1 Water heater
. -, r r 23.32
al Qua fire lace = 33,39
Flue vent for water heater or gas
fireplace - 23.32
_Log lighter (gas) 23.32 i n
Wood/pellet clove
..
Wood fire lace /htserf. - 39
f 23
�; �'1;f1P..L1tTY O C 23.32
V i , „ ; C t*i.N71;, � ah Chimney /liner /flue /vent
23.32
Name: � '
l , • it Other. 23.32 --_
Address: Environmental exhaust and ventilation
i Range hood /other kitchen
- City /Stale /ZIP: cquipmenl 33,39
C dr er exhaust 33.39
Phone: ( 1 - —
I " � � �j�,, Fax; ( ) Single -duet exhaust (bathrooms,
Phone: — .
i;1. �I� 1'hT G`A.I �'4,:i: i , r ' „, I r ; / , r toiletoomparut)ents utility rooms 23.2
I ' ;•i ' ` (.iQIiV'',e'0' ` M , 1SC11V h i Aftic /crawls ace fans ��
Business flume; Other:
23.32 ME
Contact name; O h � I4eJ piping
Address; I 1 J $14.15 for first four; $4.03 for each additional
nil
"w AL, Furnace, etc,
Ci[y /State /Z1P: � - - - Des heal: rum =�
(13b t t I ( _
Phone; (
1 `�i i ra>;:: ) Water heater
E-mail:
1 - Fireplace
i'` ;ohs: li..,.i {ir4 'I ,I• ,
i i , g Barbecue
, i. r, 7.r�' II "`'�, I'�1'I i l n .ii �:I ;
hl " ��ll(�iSl'�11�1'Il r' t�r'�lr.I
Business name; ' . n1 I �'I nl , �4r�d I�� DOrhCCUC
/J� • G(.�7 <] {C� -YIG� � Clothes diver (r as)
I=
Addressti n t ) �/ Other
City /State /ZIP I {11VI A 1i i
( v! 3 _ I,Xxc�
Phone: (a13) !! U -- ��"" Subtotal , ,
2 W 4 Tax (r�(j y) 2 LP (p 2�1' p Minimum permit fee ($90.0o) r • up `
CCB lie.: J 4
p I 0 0 g Plan review (25% of permit fee)
1 State surcharge (12% of permit fee) MIDI
Authorized signature: // TOTAL PERMIT FEE /Oi? 1 , N
_t'� .. ' /Fr r{� �/� /L , �� This permit application expires if a permit is not obtained within 180
Print name: �, ( f j /y �� r /I days after ii has been accepted ns complete,
tC 6 � : L.f r / f / * Pee methodology set h Tri-
l:lnuildLr 1Pcrmas \MEC- I Date: r Y county Building Industry Sonice Board K PCr IApp.doc 10/0 IMP
440 -4617T (I1 /02 /COM/M ?8)
JAN -11 -2011 TUE 11:15 AM ROTH HEATING FAX NO, 5032663478 P. 02
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