Permit CITY OF TIGARD MECHANICAL PERMIT
�'`' ; , COMMUNITY DEVELOPMENT P ermit #: MEC2011 00427
Date Issued: 09/27/2011
T1G'A1 _D 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S102CC07200
Jurisdiction: Tigard
Site address: 13680 SW BEREA DR
Project: KNEPPRATH Subdivision: BEREA Lot: 33
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING & COOLING Owner: KNEPPRATH, DAVID & ELENA
16285 SW 85TH AVE #105 13680 SW BEREA DRIVE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE.
FAX: 503 - 620 -3980
FEES
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Specifics: Description Date Amount
Furnaces < 100K BTU 09/27/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/27/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/27/2011 $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.
Issued By: Permittee Signature:
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 Applieati ®n � J OROFFI(E l!SE•O\LI' ,
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illh City of Tigard 1 ? Recewod permitNo.;
13125 SW Hall Blvd., Tigard, OR 97223 Day - � ' Ammo la — -
S EP 2 6 2 011 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Perm
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T t GAI:Iy: Inspection Line: 503 4175 pate Read • mr
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Ready/ By. See Page 2 for
Internet: wzttiv.tigard- or_gov
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TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Additionlalterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition E Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other Description city, L Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
lob site address: 13680 SW BEREA DRIVE (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/venrs) 1 46.75 : 46.75
City / State/ZIP: TIGARD, OR. 97223 Furnace 100,000+ BTU (duclsrvents) 54.91
Suite/bldg./apt. no.: Project name: KNEPPRATH Heat pump
(requires sate 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, to -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 1 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 /fluelvent 23.32
Other: 23 32
Name: DAVID AND ELENA KNEPPRATH Environmental exhaust and ventilation:
Address: 13680 SW BEREA DRIVE Range hood/other kitchen
equipment 33 39
City /State /ZIP: TIGARD, OR. 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)412 -8943 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32 ,
Business name: -
Fuel piping:
Contact name: 514.15 for Grst four: $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) f Fax: : ( ) , Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: ABLE HEATING & COOLING LLC Clothes dryer (gas)
Other:
Address: 16285 SW 85 AVE. SUITE 105 MECHANICAL PERMIT FEES*
City/State/ZIP: TIGARD, OR 97224 Subtotal 46.75
Minimum permit fee ($90.00) 90.00
Phone: (503) 579 -22550 I Fax: (503) 620 -3980 Plan review (25% of permit fee)
CCB lie.: 184392 State surcharge (12% of permit fee) 10.80
T iIT FE 100.80
/) J This permit application expires if a permit is not obtained within ISO
Authorized signature: (/ ( days after it has b een accepted PERD as com plete.
Print name: KELLY IHT J Date: 09 -26 -2011 ' Fee methodology set by Tri- Count) Building Industry Service Board
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