Permit •, CITY OF TIGARD MECHANICAL PERMIT
11 " COMMUNITY DEVELOPMENT Permit #: MEC2011 -00105
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2011
Parcel: 2S110BB01900
Jurisdiction: Tigard
Site address: 12425 SW CORYLUS CT
Project: Minter Subdivision: Lot: 0
Project Description: Replace (2) furnaces and (2) heat pumps.
Contractor: ABLE HEATING & COOLING Owner: MINTNER, THOMAS E AND SANDRA T
8900 SW BURNHAM F -5 12425 CORYLUS CT
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE: 503 - 639 -9597
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/11/2011 $93.50
Type of Use: SF Heat Pump 03/11/2011 $122.12
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/11/2011 $25.87
Occupancy Grp:
Stories:
Fuel
Fuel Types: Electricity
Gas Pressure:
Total $241.49
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
issuan - , or if w• "s suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Cente . ose 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 OUN• ..'y calli . I .232.1987 or 1.800.332.2344.
Iss • d By: k i Permittee Signa ure: �, , .'�
• 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 Application
FOR OFFICE USE ONE\
III Received
. City of Tigard a Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
MAR 1 1 2 Dale/By, 0 /t' // ' Q��/ �/
Phone: 503.718.2439 Tax; 503.598.1960 R G Plan Review
/1
�' : ci a tt I7 [ ^YPcawn Liuc. 503.639.4175 �t"�Y' Other Permit:
Internet: www.tigard or.gov Date Ready/BY:
` NotifiedNethod Bl See Page 2 for
Supplemental Inform ail on
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction _X Addition/alteration/replacement
El Demolition Other: performed. Indicate the value (rounded to the nearest dollar) of all
—' mechanical materials, e.uipment, labor, overhead, and .rofit
CATEGORY OF CONSTRUCTION Value: $
X 1- and 2- family dwelling 0 Commercial /industrial RESIDENTIAL EQUIPMENT, SYSTEMS FEES"
❑ Accessory building
❑ Multi- family Master builder For special information use checklist
❑ For Description
Qty
JOB SITE INFORMATION AND LOCATION Heatio eooli ,•: Ea Total
Job site address: 2 A, V r Air oonditivn
(f re. wren site .Ian ihowin : ■ lacement
City /State/ZIP: I G 02 q 1 zz . 4ti.75
(.�:G Furnace 100,000 BTU (ducts/vents) 1,� . ��.
Suite /bldg ✓apt. no.: Project name: I�fl � Furnace 100,000 + BTU (ducts /vents) 54.91
1 Heat pump
Cross street/directions to job site: ufres site .tan shoain 1'z
ace tnentl 61.06
Duct work
H droaic hot water system 23.32
Residential boiler (radiator or
dronic) 2332
Uers uel -type, not electric), Ill Subdivision: Lot no.:
in - in -duc sus . !nded, etc.
46 -75
Fluelvent for an of above 11.11 23.32
Tax map /parcel no.:
Other:
23.32
rc
DESCRIPTION OF Other fuel a • • dances;
arc . " I I Flue vent for water heater or gas _ 33.39 MIN
Lo: li, hter (. , IIMIZIMINII
Wood /. - llet stove MN 3339 MIN
Wood firC. laceJinsert
:' PROPERTY OWNER
• 0 TENANT 23.32
'name: 'a ■ at t �� 1 e4�
Other: = 23.32
Address: ' i p Environmental exhaust and ventilation:
_ Y Y Range hood/other kitchen
City/Slate/ZIP: t , [) 1� e. ui.ment
Clothes dryer exhaust 33.39
Phone: ) / MI 3339 MOO ilt/ Single -duct exhaust (bathrooms,
663 CI APPLICANT CONTACT PERSON toilet com.artments, utili rooms
23.32
Business name: tJ _it
Contact name: Other:
MI 23.32 Mil
Address: 514.15 for first four, S4.03 for each additional
I Furnace, etc.
City/State/ZIP: Gas heat . um . 111111111111111111111
Phone: ( ) Wallisus ended/unit heater ��
Fireplace ��
CONTRACTOR Ran a 1111.11.11.1.
Business name: i ' Barbecue
l a / �O Clothes d er •as
Addre 410 / s
!
11 Ai' Other: ��
City/State /ZIP: + 4 • g1 M1IECI#ANICALPERhIITFEES*
1
Phone: (J a w Subtotal P �r MIN
L F ax: >♦__y ..- / Minimum permit fee (590.00)
di AL J Plan review (25% of perm it fee) Milli
State surcharge (12% of permit fee)
Authorized sign atur . / / MEM
This TOTAL PERM
pp PERMIT FEE
permit application expires if a permit is not obtained within 1: 1)
set b
Print name: �,��� Date: days after it has beenaccet
d j i as dusty re,
rAlikikbraTcrmitoMEC Fee mahOdolo6ry by -ounty Building
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- A ; ABI.E HEATING & COOLING Air Conditioning Site Plan
• 8900 SVii Burnham Se Suite F5
TIGARD. OR 97223
(503) 443 -2058 Fax (543) 620 -3930
cce=a4332 Email_ ablehvac2 @aol.cam
Customer -'... 1111" 4> Mite& ra ( c`
address 1)(11,--(- s Q . L't
� \I S o(L 17) zip 5.7224
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