Permit 7 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00286
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011
Parcel: 1 S 136C B09700
Jurisdiction: Tigard
Site address: 11326 SW 84TH AVE
Project: Botney Subdivision: ASH CREEK MEADOWS Lot: 1
Project Description: Install a /c. Unit must meet required minimum 3 foot side and rear yard setbacks.
Contractor: A -1 AIR HEATING & COOLING Owner: BOTNEY, RICHARD
1093 SE 37TH AVE. 11326 SW 84TH AVE
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503 - 645 -5900 PHONE: 503 - 545 -1281
FAX: 503548 -982
,7 2 - Sly
FEES
Specifics: Description Date Amount
Air Conditioning 06/21/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/21/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/21/2011 $43.25
Occupancy Grp:
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 direc estions to ON • . by callin. 03.232.1987 or 1.800.332.2344.
Issue By: I //0 ; � Permittee Signa .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.
Jun 21 11 07 :03a A -1 Air Heating & Cooling 503 - 3726514 p.1
Mechanical Permit Application E F�r>,lz OIF lt'E 1 tit ONLY
City of Tigard �+�' even
v DateJB �� Petn,it No.: �! / '�� /,/�J /�
13125 SOU Hall Blvd., Tigard, OR 97223 r P� v S0
. ` a Phone: 503.639.4171 Fax: 503.598.1960 JUN 2 ± e By: Other Penal:
T IG:1 h D Inspection Line: 503.639.4175 ■ _ , sad tads:
Internet: www.tigard- or.gov , l �r y y 6a See Page 2 for
• CITY OFTI ' i i • d+Method: Supplemental Informat
BUILDIN DI iSION
. TYPE . OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Additionfalteration/replacetnent Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
)1 and 2 family dwelling ❑ Commercial/industrial E:1 Accessory building
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
For special information use checklist.
❑ Multi- family ❑ Master builder
❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling site address: // ) / 77f Air conditioning
f / J { f �l%l1 (��' , r (requires site plan showing placement) J 46.75 _. 4 . 2 City /State /ZIP: p��� �i 6';',/,' p 72 3 Furnace 100,000 BTU (ductarvents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
SuitelbldgJapt. no.: Project name: Heat m
Pu p 61.06
Cross street /directions to job site: Duct work 23.32
Hydronic hot water system i 23.32
Residential boiler (radiator or
hydronic) 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 mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
�I Gas fireplace 33.39
/ A, •f /7 - CE 2 rt'i2 a A,-/J i J7 Oi✓.i Flue vent fior water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 3139
Wood fireplace/insert 23.32
t"' PROPERTY. OWNER I ❑ TENANT Chimney /flue /vent 23.32
' Other: 23.32
Name: / (1 AG'Tit/x..l� • • Environmental exhaust and ventilation
f
Address: / j 3 , 7rf r Range hood/other kitchen
equipment 33.39
City/ State/ZIP: / A , G q , 22
Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms,
Phone: (,_s-iJ) ..Sy Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT . ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Business name:
Other: . 23.32
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
- Gas heat pump •
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
_ Range
CONTRACTOR _Barbecue 1-1/
)4,,,41-2,i, Clothes dryer (gas)
Business name /
J ' 1 4 //P r4 Coo Ll Other:
Address: /(I 92 ,c 7 a 4. r . MECHANICAL PERMIT FEES*
City / State/ZIP: Ai/ LL.f� „ , i?,2. 1 7/,Z Subtotal f 0.9U
Phone: (.1 f its =s"9 Fax: I,j 3 ) ? 22 _ 4 3- 74/ Minimum (25% fee ($90.00)
mitfee)
CCB lie.: 6:2_/ U2 State surcharge (12% of permit fee) 4. i(y
TOTAL PERMIT FEE /g } _ 6i 9
Authorized signal / This permit application expires if a permit is not obtained within 180
- pmt /L'�' C' / l days after it has been accepted as complete.
t U ^ ^' ^ ^^^• !� / � ` Y1�� 1, 6 - //
I • Fir melhnAnInov cn he T.i- f'n,mts Rftildino Ind Iry Service Rnar�l
Jun 21 11 07:04a A -1 Air Heating & Cooling 503 - 3726514 p.2
Air Conditioning Site Plan j
1
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11326 SW 84th Ave. Tigard 97223
Job Address