Permit CITY OF TIGARD MECHANICAL PERMIT
• °: ' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00046
TIGARD` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012
Parcel: 2S 110BA06700
Jurisdiction: Tigard
Site address: 12058 SW WILDWOOD ST
Project: Majors Subdivision: SHADOW HILLS NO.2 Lot: 50
Project Description: Replace gas furnace.
Contractor: ABLE HEATING & COOLING Owner: MAJORS, WILLIAM
16285 SW 85TH AVE #105 '12058 SW WILDWOOD ST
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE: 503 - 639 -7150
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/20/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/20/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/20/2012 $43.25
Occupancy Grp:
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: .j(/ /9/0/°/, lCe9 of
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 Applicati n riEIVCn
LAJ FOR OFFICE USE. ONLY
City of Tigard JAN 2 0 2012 Received / PetmitNo C. ".. r 7:
13125 SW Hall Blvd., Tigard, OR 97223 ,
Phone: 503.718.2439 Fax: 503._98.1960 Date 3 y: vle
CITY OF TIGARD DatelB Other Permit
TIGARD Inspectio Line: 503.639.4175
Readyi By En et See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION N sate otifie Supplemental information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction E Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
M I- and 2- family dwelling ❑ Commercial)industrial ❑ Accessory building For special infornrotion use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. [ Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 12058 SW WILDWOOD ST, (requires site plan showing placement) 46.75
City/State/ZIP: TIGARD, OR. 97224 Furnace 100,000 BTU (ducts/ vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: MAJORS Heat pump
. (requires site plan showing placement) 61.06
Cross streeddirections 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: I Lot no : Flue/vent for any of above 23.32
. Other: 2332
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
REPLACE EXISTING GAS FURNACE
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
® PROPERTY OWNER El TENANT Chimney /liner /flue /vent 2332
Other. _ 2332
Name: William Majors Environmental exhaust and ventilation:
Address: 12058 SW WILDWOOD SF. Range hood/other kitchen
equipment 33.39
City /State/ZIP: TIGARD, OR. 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)639 - 7150 Fax: ( ) toilet compartments, utility rooms) 2332
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 2332
Business name: Other: 23.32
Fuel piping:
Contact name: 514,15 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
Business name: ABLE HEATING & COOLING LLC Clothes dryer (gas) f
Other:
Address: 16285 SW 85 AVE. SUITE 105 MECHANICAL PERMIT FEES*
City / State/ZIP: TIGARD, OR. 97224 Subtotal 46.75
P e: (503) 579 - 2250 Fax: (503) 620 - 3980 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 184392 S tate surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 190.80
I This permit application espires if a permit is not obtained within 180
Authorized signature: 41A14 days after it has been accepted as
4 - 1v._�. +.��F11ri Y complete.
Print name: KELLY W LHITE / I Date: 01 - - 2012 • Fee methodology set by Tri County Building Industry Service Board
t:'Buildiag\Permits1MEC-PermhApp .doe 0919 440-1617F(11012JCOMJWEB)
L, ' d 026£OZ9£09 6ugoo31g buiTeeH eiciv d176 : Z6 OZ uef