Permit n CITY OF TIGARD MECHANICAL PERMIT
1111
- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00605
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/27/2011
Parcel: 2S112CA10700
Jurisdiction: Tigard
Site address: 7517 SW ASHFORD ST
Project: WALLUCK Subdivision: RENAISSANCE WOODS Lot: 33
Project Description: Gas furnace and venting for water heater.
Contractor: ANCTIL HEATING & COOLING Owner: WALLUCK, CHRISTOPHER B/TRACY V
4320 N WILLIAMS AVE 7517 SW ASHFORD ST
PORTLAND, OR 97217 TIGARD, OR 97224
PHONE: 503 - 281 -0752 PHONE:
FAX: 503 - 282 -5722
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/27/2011 $46.75
Type of Use: SF Chimney /Liner /FlueNent 12/27/2011 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/27/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/27/2011 $9.86
Stories:
Fuel
Fuel Types: Natural Gas
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.
12/27/2011 10:17 FAX 5032825722 Anctil Heating & Cooling Q0001/0002
Mechanical Permit APPlicati ECEIVED FOR OFFICE USE ONLY
City of Tigard V Day ea /�
I II te/By:
= ° 13125 SW Hall Blvd., Tigard, OR 97223 7 Phone: 503.718.2439 Fax: 503.598.1960 DEC 1 2 O 1 Plan Review Date/By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready/By: Juris: El See P: ge 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
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Mechanical permit fees* are based on the Ja1ue of the work
❑ New construction ® Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
; C?7?EORY;OF - .; CTIOLY: :
,,,., IDEN1w.; !EQUSI'. l ►'I /Si;st
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description Qt)i. Ea. Total
... . _.., .. �..... *E• ...........,. - :...:.::.:....: .::,:_.:• x,,:- ,,.,..,:...,, . .... Air conditioning
Job site address: 7517 SW ASHFORD STREET rec uires site plan showing placement) 46.75
City /State /ZIP: TIGARD, OR 97224 Furnace 100,000 BTU (ducts/vents) 1 1 46.75 46.75
Furnace 100,000+ BTU (ducts/vents) 1 54.91
Suite/bldg. /apt. no.: Project name: 29869 Heat pump
(requires site plan showin • placement) 61.06
Cross street/directions to job site: Duct work 1 23.32 .
W 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
Other: 23.32
Tax map /parcel no.: , Other fuel appliances:
DES WORM -`:`. :;:.' :: ".'.: ::: ..:: ' ~::ri
Water heater 23.32
Gas fireplace 3339
PUSH/PULL GAS FURNACE
Flue vent for water heater or gas
VENT WATER HEATER fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
- = -, ° • �. -- •- Chimney/liner/flue/vent 1 23.32 23.32
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.......- - . ,_�........._ .... ...........:.... ....... .,..•. . ; ..... ..._ _......... _.. �:,:...........:.. : is'�i.
.._ ...... Other 23.32
Name: CHRIS WALLUCK Environmental exhaust and ventilation:
Address: 7517 SW ASHFORD STREET Range hood /other kitchen
equipment 33.39
City /State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
(503)620-2176 ( ) toilet compartments, utility rooms) 23.32
.... ,- rw fans PI,ICANT::r .; : ::;';= ';�:` } ;:: " :; : � i ., ::' 8� CQN�' ACT;-PF�LSOh.T� ?.;:�� Attic/crawlspace tticic a 23.32
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Business name: ANCTIL HEATING AND COOLING
Other: 23.32
Fuel piping:
Contact name: CHRISTINE BARTON $14.15 for first four; $4.03 for each additional
Address: 4320 N WILLIAMS AVENUE Furnace, etc. l
Gas heat pump + I
City /State/ZIP: PORTLAND OR 97217 WalUsuspended/unit heater
Phone: (503) 281 -0752 Fax: : (503) 282 -5722 Water heater
Fireplace
E -mail: INSTALL@ANCTILHVAC.COM Range
Business name: ANCTIL HEATING AND COOLING Clothes dryer (gas)
Other:
Address: SAME AS ABOVE ... : .• . ,..... ... . ; .. _ - .. ... -....
:•..:.
:-:.>,::::. ....- PERMITFEES": -.s
City /State/ZIP: *total 1('. 0
- Minimum permit fee ($90.00) a
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) --
CCB lie.: 8897 State surcharge (12% of perrnit fee) 10
1
t TOTAL PERMIT FEETfk), `e)
Authorized signature: C ` (\ t This p ermit applicat expires if a permit is not obta ed within 180
),.. days after it bas been accepted as complete
Print name: CHRISTINE BARTON Date: 12/27/11 • Fee methodology set by Tri -County Building industry Service Board
P\Rniliir,o \Permit< \MFC.Perrn4 Ann Are 09/09/10 440 -4S1Tr fl 1 /02JCOM/WEBI