Permit CITY OF TIGARD
MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2009 -00159
Date Issued: 04/15/2009
T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111 DD07200
Jurisdiction: Tigard
Site address: 15795 SW 88TH AVE
Subdivision: STRATFORD Lot: 70
Project: Sasaki
Project Description: Install a/c and attic fan.
Owner: FEES
SASAKI, VALERIE H Description Date Amount
15795 SW 88TH AVE Air Conditioning or Heat Pump 04/15/2009 $14.00
TIGARD, OR 97224 Attic/Crawlspace Fans 04/15/2009 $10.00
PHONE: 12% State Surcharge - Mechanical 04/15/2009 $8.70
Minimum Fee Adjustment - Mechanical 04/15/2009 $48.50
Contractor:
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217
PHONE: 503 - 281 -0752
FAX: 503 - 282 -5722
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue
Total $81.20
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
Issued By: \ /'b� l � ( v ' ` j U � l Permittee Signature: �� ,�`� I� �N
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Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 1
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 Pelrmjt Aplplicatl0 1 1 I('F USE (')iti I. \
City of Tigar , - I FOR OFF
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a 4 6 • r • I PermitNo.: k • ., et • • co
: r 13125 SW Hall Blvd., Tigard, OR 97223 Pla Review .
Phone: 503.639.4171 Fax: 503,598.1960 APR 1 2009 Other Pernik;
Inspection Line: 503.63 ).4I75 p atcJRy:
TI_,Ar.I) P� El Sec Page 2for
Inicm «: www.tigArd-or.gov CITY OF TIGARD j SUpp{vmg.ita lefermaeim
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Q New construction 0 Addition /alteration /replacement Mechanical permit fees" are based on the value of the work
[] Demolition 0 Other: performed, Indicate rite value (rounded m the newest dollar) of all
mechanical materials, equipment, labor, overhead and profit.
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® 1 - and 2- family dwelling ❑Commercial/industrial 0 Accessory building.
by l ixw a�19r�� 1>z �� a�ul�t ;��t
For special information use checklist.
❑ Multi - family 0 Master builder ❑ Other Description 1 Qty- f Ea. 1 Total
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eh Air conditioning or heat pump
Job site address: 15795 SW 88 Avenue •.uit+m Bite Ian showio: •laccmcnt 1 14.00 14.00
City / State/ZIP; Tigard OR 97224 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 28011
- Gas heat u 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydrottic) 14.00
Unit hearers (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no : Flur/vent for any of above 6.80
Other. 10.00
Tax map/parcel no.: Other fuel appliances _ _
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a? W �h"' , ;i }till Y.rl Ifit . ' ! 1i �d '. x, f } r iiI e i N C?ini,k! Water heater 1 0. 0 0 1
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Gas fireplace 10.00
Flue vent for water heater or gas
Install AC, Install attic fan. fireplace 10.00
_- - --- •- ----- I.og lighter (gas) 10,00
Wood/pellet stove 10.00
Wood fireplace/insert 1 10.00
w 1 s a tgarta al vrta r r. -. tu Chimney/liner /flue/vent 10.00
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„r,t - - f , fir ' ` , . .l � + ,eL' �:t ! . t r _ _' r S,x� ;: ,� Other; 10.00
Name: Valerie Sasaki Environmental exhaust and ventilation
Address: 15795 SW 88 Avenue Range hood/other kitchen
_--__ cquipmcnt 10.00
City/State/ZIP: Tigard OR 97224 Clothes dryer exhaust 10.00
Phone: (503)866 -5708 Fax: Single - duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) - 6.80 .
.1 r rJ r.+ �`'wr Y9 {,u tgsar9 I ii r i °. q r" �f:k �1iv fi u„ Jt a +'g16ft E uti 1;. 1 .r• �t JJ Attic/arawls ce fans 1 10.00 10.00
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Business name: Anctil Heating and Cooling C)thcr: 1210
Fuci piping
Contact name: Christine Barton $5,40 for first four; $1.00 for each additional
Address: 4320 N Williams Ave - Furuacesetc.
- -. Gas heat pump
City / State/ZIP: Portland OR 97217 Wall/suspended/unit heater
Phone: (503) 281 -0752 I Fax: : (503) 282 - 5722 Water heater
Fireplace '
E -mail: instaI1()anctilhvac.com Range
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Business name: Auctii Heating and Cooling
Clothes dryer•(gas)
other:
Address: 4320 N Williams Avenue 'rt�'t.dw ; .ex tx.:.,tJta, 4 r;' fitaig -
Ciry/ State/ZIP: Portland OR 97217 Subtotal 30.00
Phone: (503) 281 -0752 Fax: (503) 282 -5722 Minimum pemtit Rx ($72.50) 72.50
Plan review (25% of permit fee)
CCB lie.: 8897 State surcharge (12% of pemtit fee) -- 8.70
__ TOTAL PERMIT FEE 81.20
(�� � �� this permit APPlirate expires It a permit is not obtained within 180
Auihonzcd signature'; 1 ;i�1N- U � - d after r it has been accepted as complete.
Print name: Christine Barton Date: 4/10/09 " Ice ehetlnxtolugy set by'1'ri 4'tamty lluilding Industry Service Board
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