Permit •
CITY OF TIGARD ' MECHANICAL PERMIT
g- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00191
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011
Parcel: 25104DA22300
Jurisdiction: Tigard
Site address: 12938 SW PRINCETON LN
Project: RHODES Subdivision:)UAIL HOLLOW SOUTH TOWNHOME; Lot: 49
Project Description: A/C installation with new supply vent to master bedroom. 5/5/11, this permit revised to approve 1' setback per
Planning Department.
Contractor: ROTH HEATING & COOLING Owner: RHODES, STEPHEN MICHAEL
PO BOX 1265 12938 SW PRINCETON LN
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 503 - 348 -8240
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 05/03/2011 $46.75
Type of Use: SF Duct Work 05/03/2011 $23.32
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/03/2011 $19.93
Occupancy Grp: 12% State Surcharge - Mechanical 05/03/2011 $10.80
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 qu UNC by (ling 503.232.1987 or 1.800.332.2344.
Issued y: Permittee Sig 1 ",
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.
14 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Pe COMMUNITY MEC2011 -00191
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011
Parcel: 2S104DA22300
Jurisdiction: Tigard
Site address: 12938 SW PRINCETON LN
Project: RHODES Subdivision:)UAIL HOLLOW SOUTH TOWNHOME: Lot: 49
Project Description: A/C installation with new supply vent to master bedroom. NC unit must meet 3 ft. minimum rear and side yard
setbacks.
Contractor: ROTH HEATING & COOLING Owner: RHODES, STEPHEN MICHAEL
PO BOX 1265 12938 SW PRINCETON LN
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 503 - 348 -8240
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 05/03/2011 $46.75
Type of Use: SF Duct Work 05/03/2011 $23.32
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/03/2011 $19.93
Occupancy Grp: 12% State Surcharge - Mechanical 05/03/2011 $10.80
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800. 44.
1
Issued B c Permittee Signature: ' J
.Z, Cal " . .4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
APR -29 - 2011 FRI 12:03 PM ROTH HEATING FAX NO, 5032663478 P. 01
Mechanical Permit Application rot; OFrici: I SI. 0N1,
City of Tigard )� Received
Clate/ay: " = ,
!hr 13125 SW Hall Blvd., Tigard, OR 97223 t`,
Phone: 503,718.2439 Fax 503.598,19 � j ^ Other Permit;
TI it ❑ Inspection Line: 503.639,4175 �� q�Q ` C • Date A cndY /l y- a See Page 2 for
Internet: www.tiglyd- or.gov V J Notified/Method: Supplemental Information
Yll'E , O � N`!Q �Q ? 1 I 0 � „ 4)QMWRt " Y + EE * .S001)�Tt E I� USVizIU C LI
' � ( Mechanical permit f ees ' are based on the value of the wort
❑ New constructionddition /alteration arit performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: -�� mechanical materials, eceipmcnt, Iabor„overhead, and profit.
R$II>NTQ
a; C II F+ OT y; 41' ll�4Q>tI RTICT�4N I ! l IAL tR pm-E rg ./..sygE tiilvErs4 ,,,
5r1 and 2- family dwelling D Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea, Total
I �,,, ! i ' I li Q ' , 1 II±'I Belgian/cooling: 1 .', , r
�� ��[a - Y � ilr,...Aa ,I I I I , i ^ , f �I I c
Job site address: �. -•' Air conditioning r
� I;>T >� � T 1 1 I �, �� N
/ immures silo pion showi 1placolnnt) 4646.75 la, ,
4 ?,,,,,,),e40,, ` " '' 1 — Furnace l 00,400 BTU (duets/vents) 46.75
City /State /ZIP: -- 7,' a. v, • -z-- Furnace 100,000+ BTU (ducts /vents) 54.91
1
Suite/bldg. /apt. no.: Project name:
Heat pump
— tp (� 3 (requires Biter an showing placement) 61.06
Cross street/directions to job site: Duct work / 2332 Z3.2.
-- - Hydranic hot water system 23.32
4 Residential boiler (radiator or
hvdronic) 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: 1 23.32
Tax map/parcel no.: rT� r��T /y���re * ' l Other fuel appliances:
1 , i., ; :' 'i '�.Di.Sl t:IONIT ; WY4 I 1l ' . ,�, i '� 1 1 I l �, Water healer _ 23.32
ff
Gas fireplace 33.39
,•1 C �/)4,. j,p>E., of - at f` eca,7 C�r 7f14 .J' - Flue vent for water heater or gas
41 fireplace 23.32
Art • . ■ ∎ • 0 j Log lighter {gas) 2 3,32
v - Wood/pellet stove 33.39
Wood fireplace /insert _ 23,32
l i l h 1 A • tot I� i ' i ' l .,' ' i 1 . . i+ sit,: i , 1 ,, , ,.. , ,,, : il „ Chimney /liner /flue /vent 23.32-
^ II 1 NI 111 F11t A.' J\ I 1 � I II �'
JI► Other: .
Name; / h �, Environmental exhaust and ventilation: 23 32
Address: Range hued /other kitchen 1 9 .s s � 0 ,, , eA�; _ equipment 33.39
City/State /Z1P; t-, .. a, O tt2 a l ' - Clothes dreexhaust 33.39
S - — Single -duct exhaust (bathrooms,
Phone: (0;) 2 1W'$ -8 7-41 o FaX ( ) }},, R N toilet compartments, utility rooms) 23,32
4 ,ll''1 I 1 1 I I � f ,j 1 ' 1 J. � Iglu 1 I,1 II CVST'AIT. P R ON I t �,ldli 1 l i �,: Attic /crawls.acc fans 23.32
l� + t Other: 23.32
Business name:
P.-c2,4 -1-1 .,,,s1._ 44 rte- .--_ Fuel piping:
Contact name: O - $14.15 for first four $4.03 for each additional
�`e- )h �'i ( Furnace. etc.
Address:
Gas heat pump
City /State /ZIP: tial healer
Fire place
E-mail: RAM' e
T Y 1,� °� t 1 i 1 1 T�,v*� , ° I 1 I 1 �l h .!''I ! 1 '1'4Barbecue bcCUC
' .IIf1E', li 11 �, 1 1 1 1� 1��1 �'I q I'. J� '16fi'1 I1 l .Kti!,71 ! .I elk 1 I 1. l; 11 i . ,i'I�� I I1 � 7 Ba
IY _
Business name: a �n �--�,e p�� , C.00 ('� Clothes tamer (gas)
Other
Address: C7 soy._ 124 • I ' ; 1 . •,rli ti'OirlioipAI . I matteg
Citylstate/ZIP: `� 0 tZ Oi c, I . Subtotal -47 .
\ `� . Minimum permit foe ($90.00) 9 . oc>
`! Phone: (S ) 2 ( ii "I F ax: •
(5b) Z(�, t 1.i Plan review (25% of permit fee)
CCB lic.: / t/ C C7 9 — State surcharge (12% of permit fee) .14
TOTAL PERMIT FEE /OP .AO ,
This permit application expires if a permit is not obtained within 180
Authorized signature: days after It has been accepted as complete.
Print name: - ✓"�.- trie yy ! / Date: Q z
• Foo methodology sot by Tri- County Building Industry Service Board
a: Ul uildina \PormildlMEC.PermitAppAdn" 0o /07110 440- 46171' (11 /0 !WM/WEa)
APR -29 -2011 FRI 12:03 PM ROTH HEATING FAX NO, 5032663478 P. 02
TF ,Dtca i
c
Ai\
)
�I��Ci1o�J
S7REE - T 5w KIlacc- old 0044.