Permit CITY OF TIGARD MECHANICAL PERMIT
tl> COMMUNITY DEVELOPMENT Permit #: MEC2011 -00164
TtGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/14/2011
Parcel: 2S112CA08900
Jurisdiction: Tigard
Site address: 7540 SW ASHFORD ST
Project: Gray Subdivision: RENAISSANCE WOODS Lot: 15
Project Description: Replace gas furnace.
Contractor: ANCTIL HEATING & COOLING Owner: GRAY, WILLIAM J & S DIANE
4320 N WILLIAMS AVE 7540 SW ASHFORD ST
PORTLAND, OR 97217 PORTLAND, OR 97224
PHONE: 503 - 281 -0752 PHONE: 503 - 639 -8710
FAX: 503 - 282 -5722
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/14/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/14/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04 /14/2011 $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: Permittee Signature: ,0 Si . � �
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 OFF1( l • I I S I . ( ) l . \ '
City of Tigard � pa'teee y + `� r , Y /NA NO" Permit No,; �r i. � 0 0 /
Ii
I ■ 13 125 SW Hall Blvd., Tigard, OR 97223 �J Y �tf ,-
�j 1 an Review Other Permit:
Phone: 503.718.2439 Fax; 503.598.19t1� b Date /By
f [ < 1 R I > Inspection Line: 503.639.4175 � `L� Date Ready /Sy him: ID Set Page 2 for
Inten ct: www.tigard- or. gcw PQ R \ AQ , Notified/method: Supplemental infor
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Mechanical permit fees" are based on the value of the work
0 New construction 0 Addition/ulteration/ 4+ -. t
t performed. Indicate the value (rounded to the nearest dollar) of al
0 Demolition 0 Other: _ mechanical materials, equipinett,_labor, overhead, and profit.
v Iv nn t :. .�;ar 1 a r yl,l *it l2 t (ry (1 r vti A t r��w vi ' Value:S
g • i run 1 r l 1 1 . i c�t a of I t „ ;1';;,.:1 4 y . ' fix 1 + i i r A M r
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® I- and 2- family dwelling 0 Commercial /industrial 0 Accessory building For special itifoiwuitlon use checklixsx
❑ Multi- family O Master builder ❑ Other: Description I Qty, I Ea. 1 Total
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w�� A '7••.'••.. ,qn•r rr ar , r" '• yr ^" rrv_ o r . . t1 sfiiR.{i''Pet`_iplt�; ft' Heatin• coolie•
J ob site " 2dd rl te5 r 5 7540 SW ASTiFO �� � .�Wyrtr i� yllty l4t?Nr ' tw + � a iylFli �� An conditionin
(requires site plan showing placement) 46.75
----- Furnace 100,000 BTU (ducts/vents) „ 1 46,75 46.75
City/ State/ZIP: TIGARD OR 97224 Furnace 100,000+ BTU jdnehavents) 54 -
Suite/bldg./apt. no.: Project name; #29423 Heat PmnP
` (require;, site plan showing placement) , 61.06
Cross street/directions to job site; Duct work 23.32
Hydronic hot water system 2332
Residential boiler (radiator or
hydmnic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 46.75
Subdivision; Lot no.: Flue/vent for any of above 23.32
,--- Other: 23.32 _
Tax map /parcel no.: Other fuel appliances:
�,t r ) , , ..�4 t it ^yt� t) - Mtir �i" '' 7 ' ,�a,,qy tt + aµrn;�a,a `: "i +rfli _ Water heater 23.32
1 (h.`wM.;:;a.,u.•eh;lw . rG. 'P::. ..vr2i" iYi;rde�r S
. ,.; �l� l O "lvl9F� +.iiS + car Yn
PUSH/ PULL GAS FURNACE Gas fireplace 33.39
a
Flue vent for water heater or gas
fireplace 23.32 ,
Log lighter (gas) _ 23.32
Wood/ Het stove 33.39
Wood fireplace/insert 23.32
� w � ,,:r: :..: E ri? v .;;.,:;:: y:;;
t^k�l�"ydS 1r4,.,;.,.ryrllu.: t, .;,,, y.r_..,. ,;f;371'':5'i'�:f "4;n;r:; . Chimney/liner/flue/vent 23,32 _
;0:;'„'„ 1 fn .,;. rZ w .��t� A r � t _. ` ,1 ,,, ' ,. rIt, ePk!.. /$'Wyh/ 7I!t"15,v UG1�� ,?' l � ell'',`' iP ^'Y f; r;
Other; _ 23 ,
Name: BILL GRAY Environmental exhaust and ventilation:
Address: 7540 SW ASHFORD STREE Range hood/other kitchen
—� equipment 33.39
City /State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
�w Single -duct exhaust (bathrooms,
Phone: (503)639 - 8710 Fax: ( ) toilet compartments, utility rooms) 23.32
Attic /erawtSpaec fans
1t4 + 8 ° ., !il $y'' ,, yy� ! .7 � Btr'{GjW. , 1�( r" : M t \ ' I}};; f re a t "" p a N' 'r: ir�1C "v 2.3.32
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Business name: ANCTIL HEATING AND COOLING Other: 2332
. _ — Fuel piping: •,,,._,__
Contact name: CHRISTINE BARTON $14.15 for first four; $4.03 for each additiorusl
Address: 4320 N WILLIAMS AVENUE Furnace, ate — _
— -,. _____ -- --.-- Gas heat pump _
City/State/ZIP: PORTLAND OR 97217 Wall/suspended/unit heater
Phone: (503) 281 - 0752 Fax: : (503) 282 -5722 Water heater
- - ---• -' Fireplace ,
E -mail: INSTALL(a),ANCTIL.HVAC.COM WRange
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Business name: ANCTIL HEATING AND COOLING Clothes dryer (gas) .,.,,.,-
- - -- Other:
Address: SAME AS ABOVE . ilia1e 2 El rl uinr' r " A 3 I I N N: d''kl .k��rnr
Cily /SraiGZIP; Subtotal 46.75
i 90.00
� ...... ......... _. ... Minimum permit fee ($90.00)
Phone: ( ) Fax;( )
— . _ . — _ Plan review (25 of permit fee)
CCRlic.:8897 State surcharge(12 %ofpermitfee) 10,80
— - _ TOTAL PERMIT FEE 100.80
` 'Mit permit application expires li a permh Is not ubturned within 180
Authorized signature 1 ((L�, c,1 'I ,,- -\ days after It hes been accepted us complete.
Print name: CHRI STINE: BARTON Date: 4 /14/11 ' Fee methodology ;tet by'Iii.enuiliy Building IlnduVtry Serviµd lie;ird
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