Permit CITY OF TIGARD MECHANICAL PERMIT
111 11 : ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00102
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2011
Parcel: 2S104AB02300
Jurisdiction: Tigard
Site address: 12208 SW MORNING HILL DR
Project: Hartung Subdivision: MORNING HILL NO. 2 Lot: 57
Project Description: Replace gas furnace.
Contractor: A -1 AIR HEATING & COOLING Owner: HARTUNG, TRACEY ANNE
1093 SE 37TH AVE. 11067 NW DISTRICT CT
HILLSBORO, OR 97123 PORTLAND, OR 97229
PHONE: 503 - 645 -5900 PHONE: 503 - 646 -6702
FAX: 503 - 648 -9824
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/11/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/11/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/11/2011 $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 at 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 , r i is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit Notification Cent Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or d' ect questions to OUN y . ng 503.232.1987 or 1.800.332.2344.
Issu By: Permittee Signat re:
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.
Mar 10 11 07:56a A -1 Air Heating & Cooling 503- 648 -9824 p.2
Mechanical Permit Application .,`�
City of Tigard `� fi t+ R eceives
III
• 13125 SW Hal Blvd., Tigard � LQ r \ '� Pl Rev ew
t Q l Permit No.: M /�D i 1 � le
Phone: 503.718.2439 Fax: 1 % Dateltly: Other Permit: vt
TI G A R D Inspection Line: 503.639.4175` � �� 1 C tt.`�o Date Ready /By: 7uris= ® See Page 2 for
Internet: www.tigard or.gov N` \ � Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical
❑ New construction ® Addition/alteration/replacement p performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and .rofit.
CATEGORY OF CONSTRUCTION Value: $
- RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
E 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building For :pedal information use checklist
Q Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heati . eoolin_:
Air conditioning
Job site address: , - a o 8 3 , a . ,L, ) n2-4.,,, i n) 2 1-1 l C..e_ 02∎ U � (requires site plan showing placement) 46.75
Furnace City /State/ZIP: r 1 G�
/J.b .1 X2 Furnace 100,000+1311J (due ts/vents) t / tsivents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hvdronic hot water system 23.32
Residential boiler (radiator or
J dronic) . 23.32
- Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. . 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other: -
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater _ 23.32
Gas fireplace 33.39
/?.e to 4....1 r GAS I vr2 rv+ .e.. Flue vent for water heater or gas
fireplace . 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood Fireplace/insert 2332
® PROPERTY OWNER 1:1 TENANT Chimney/liner/flue/vent 23.32
Other: 23.32 -
Name: PR U r-v , j Cl 2 T /e.gtca l-! /4,e> 7 c-4 oi_.* Environmental exhaust and ventilation:
Address: Range hood/other kitchen
7 /E, 6, 4U Q1 5 J /Lt.c T - L' . /2 -- equipment
33.39
City /Slate/ZIP: pc r -re_,v m `1 '2 z•q Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms,
Phone: ( 5 cc.,./4,_ Gem o Z Fax: ( ) toilet compartments, Mil' rooms 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans EMI =
Business name:
Other:
Fuel piping:
Contact name: $14.15 for f rst four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump __
City/5tate/ZiP: Wall/suspended/unit heater �
Phone: ( ) Fax: : ( ) Water heater i_11111111
Fireplace
E -mail Range
CONTRACTOR Barbecue
f
I n
Business name: A - t Aire_ I - ? E. 1 te'.. r. I c. in es L. r .t) r^ Clothes dryer (gas)
Address: — Other:
d o °t <; 3_72 1_.t1.-F MECI IANICAL PERMIT FEES`
City /State/ZIP: ,,..j r rn 5 t.Z crz r, a /2_ e3 • t - 3, Subtotal OM
Iv inimum permit fix ($90.00)
Phone: (Ez,3) (e, 4 5'_S -c) o 6 Fax: ((„ ) 4 er _ 1 Z.y Plar review (25% of permit free)
CCB lie.: 424 c, State st ret
wge (12O of permit tcx)
• TOTAL PERMIT FEE .0 -
Authorized signature: °' � This permit applic atti i expires if a permit is not obtained within 186
.q. - - - l/j`'` � � 3 — I a — i t days afttr it bas been accepted as complete.
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