Permit CITY OF TIGARD MECHANICAL PERMIT
:' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00439
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/21/2009
Parcel: 1 S 133DD 13600
Jurisdiction: Tigard
Site address: 11920 SW 127TH PL
Subdivision: VILLAGE AT SUMMER LAKE PARK 4 Lot: 173
Project: Taniguchi
Project Description: Replace existing gas furnace and A/C with new gas furnace and heat pump.
Owner: FEES
TANIGUCHI, TAKAO & MITSUKO Description Date Amount
11920 SW 127TH PL Air Conditioning or Heat Pump 08/21/2009 $14.00
TIGARD, OR 97223 Furnaces < 100K BTU 08/21/2009 $14.00
PHONE: 503 - 524 -1948 12% State Surcharge - Mechanical 08/21/2009 $8.70
Minimum Fee Adjustment - Mechanical 08/21/2009 $44.50
Contractor:
ABLE HEATING & COOLING
12420 SW SUMMER CREST DR
TIGARD, OR 97223
PHONE: 503 -443 -2058
FAX: 503 - 620 -3980
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: r Permittee Signature: mi
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
.141: ABLE HEATING & COOLING Air Conditioning Site Plan
• • 8900 SW Burnham St Suite F5
TIGARD, OR 97223
-
Mechanical Permit Application RECEDE
FO O FFICE LSE ONLY
IN City of Ti i eeeivea 9
i 131 Hall Tigard Blvd., Tigard, OR 97223
AUG A U G 2 0 Z00 D ec'
a:d13 ,20 0 ' �!�;�M'� , J
Phone: 503.639.4171 Fax: 503.598.1960
Inspection Line: 501639.4175 CITY OF TIGAR Ready/By: Ot1lerPermd' See P 2 for
Internet: www.tigard- or.gov BUILDING DIVIS Er,i ,ed/1,,ldhod: Supplement Information
TYPE OF WORK : COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction {2 /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
-
CATEGORY OF CONSTRUCTION Value: $ i
• �,� 1� 1 -and 2- family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
t
g ❑ Commercialrmdustrial El Accessory building
❑ Multi-family ❑ Master builder iii Other:
Far special rnformartorl use checkii
Description Qty. I Ea. I Total -
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: `\ <ct W l ✓1\ , t'1 Air conditioning or heat pump `
C (requires site plan showing placement) I 14.00 i y
CityiState/ZIP: \ `„ '� t `�a Furnace 1 00,000 BTU (duet s/vents) / 14.00 / 4
Suite/bldg./apt. /apt, no.: `7 V l pro ect name � Furnace 100.0004- BTU Wants/vents) 17.90
` � S�^ t` Gas heat pump 14.00
Cro ss street/directions to job site: v Duct work 10.00
Nydronic hot water system 14.00
Residential boiler (radiator or
_ hydronic) 14.00
- Unit heaters (fuel-type, not electric),
in -wall, in -duct. suspended. etc. 14.00
Subdivision: Lot no. Flue/vent for any of above 6
' Other: 10.00 _
Tax map /parcel no.:
Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
R P/, _E- teGrr 64.r AAA!) VC- ( , t , 2 Flue vent for water heater or gas
J'_
J lrCJ?"4A - I `
fireplace 10.00
I
Log lighter (gas) 10.00
i - - -- Wood/pellet stove 10.00
Wood fireplace/insert 10.00
t2' itOPERTY OWNER ❑ TENANT Chimney/linertftuevertt 10.00
-' [�
Other: 10.00
Namera �{ e M It ,,k& i \ li. (`.I..7 Environmental exhaust and ventilation
. , L\
Address: \let?` t , \� .� , P Range hood/other kitchen '
z �,r
x y \ A equipment 10.00
City /State/ZIP: \ \ x- } . o e l Clothes dryer exhaust 10.00
% ` t Single-duct exhaust (bathrooms,
Phone: (S \ Fax: ( ) toi let et compartments, utility moms) s, nity 6.80
0 APPLICANT ❑ CONTACT PERSON Attielerawlspace fans 10.00
Business name: Other 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace etc.
Gas heat pump
City/State/Z1P; Wa►Usu
spendediunit beater
Phone: ( ) Fax: : ( ) ' Water heater
E -mail:
Fireplace
Range
CONTRACTOR Barbecue
Business name: � pt T t h „ . { ---cam rl£k_ + F: � t LL-1-..t -1-..t . Cl
Ott dryer (gas)
Address: O \ 00 .. k1 � � , LE ` - 5 MECHANICAL PERMIT FEES*
City/Stateriflelk_ CV( - C \ il q t� Subtotal
Phone :(504 _a Fax:4 )L J� \Q'b Plan review 72.. ` �� `cal a Plso review (:596 of petntit fee) cp
CCB lic.: \R \ ° 1r ✓ State surcharge (12% of permit fee) y' '7 0
TOTAL PERMIT FEE . PI , 20 ✓
Authorized Sigtature: - This permit application expires if a permit Is oat ohtahed within 180
r ---
days after it has been accepted as complete
Print name: ` ,. ` t e V � Date: O / x /j j I * Fee methodology set by T i- County Building Industry Service Board
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• • ABLE BEATING & COOLING Air Conditioning Site Plan
A : 8900 SW Burnham St Suite F5
• ; TIGARD, OR 97223
• • (503) 443 -2058 Fax (503) 620 - 3980
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