Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00419
Date Issued: 09/20/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S104AB09500
Jurisdiction: Tigard
Site address: 12303 SW 131ST AVE
Project: GABRIO Subdivision: MORNING HILL NO.6 Lot: 124
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING & COOLING Owner: GABRIO, GERALD R & KRISTI M
16285 SW 85TH AVE #105 12303 SW 131ST
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE:
FAX• 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/20/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/20/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/20/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressure
Total $100 80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232 1987 or 1.800.332 2344
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Issued By: 4111 . Permittee Signature: _
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Call 51 .-175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application „„;. °�„ 1 .� FOR OFFICE I. SE ONLY
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City of Tigard � a' ' '',ii o Received Gp
• • �' g � Date/By: I L � permit No. 1 L i∎- A /7 '
13125 SW Hall Blvd., Tigard, OR 97223�\-� ', \
Phone: 503.718.2439 Fax: 503.598.1960r I- Da e /B Other Permit:
TI GARD Review
, ' DatelBy.
Inspection 503.639.4175 % pate Read /B Jura
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• Internet: www.tigard-or.gov C j�� , big° Ready y. �' Er See Page 2 for
� ,'� o );,," :c.,::,(:_ ryTloti$ed/Mettiod, - . Supplemental Information
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TYPE OF WORK S �' `'" COMMERCIAL FEE" SCHEDULE — USE CHECKLIST
r.,-)1.'"' Mechanical permit fees" are based on the value of the work
❑ New construction ® Addition /alteration:replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Q Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
® l - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi - family El Master builder ❑ Other: Description Qty Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/coolinl
Air conditioning
Job site address: 12303 SW 131 AVE, (requires site plan showing placement) 46.75
City/State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts'vents) , 54.91
Suite/bldg.tapt. no.: Project name: GABRIO Heat pump
(requires site plan showing placement) 61.06 '
Cross street /directions to job site: Duct work 23 32 _
Hydronic hot water system 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 map/parcel no.: , Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
REPLACE EXISTING GAS FURNACE Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert : 23 32
® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23 32
Name: JERRY GABRIO Environmental exhaust and ventilation:
Address: 12303 SW 131 AVE. Range hood/other kitchen
equipment 33.39
City /State /ZIP: TIGARD, OR. 97223 Clothes dryer exhaust 33.39
Phone: (50321 0927 Fax: ( ) Single -duct exhaust (bathrooms,
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 fist four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wal /suspended/unitheater
Phone: ( ) Fax: : f ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue '
' Business name: ABLE HEATING & COOLING LLC Clothes dryer (gas)
Address: 16285 SW 85 AVE. SUITE 105 Other:
MECHANICAL PERMIT FEES"
City /State /Z1P: TIGARD, OR. 97224 Subtotal 46.75
Phone: (503) 579 -22 50 Fax: (503) 620 -3980 Minimum permit fee ($90 00) 90.00
Plan review (25% of permit fee)
CCB lie.: 184392 Slate surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized sierra �� + `�
This permi application expires it a permit is not obtained within 181)
• _ days after it has been accepted as complete.
I Print name: KELLY ILHI Date: 09 - 19 - 2010 • Fee methodology set by Tri County Building Industry Service Board
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