Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00053
TIGAR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
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Parcel: 2S109DD11500
Jurisdiction: Tigard
Site address: 15716 SW GREENFIELD DR
Project: Gonzalez Subdivision: BELLA VISTA Lot: 45
Project Description: Install A /C. Unit must meet 5 ft minimum rear and side yard setbacks
Contractor: CENTRAL AIR LLC Owner: GONZALEZ, ALVARO III
PO BOX 433 PULIZZI, JESSICA D
CLACKAMAS, OR 97015 15716 SW GREENFIELD DR
TIGARD, OR 97224
PHONE: 503 -656 -1908 PHONE:
FAX: 503 - 650 -3898
FEES
Specifics: Description Date Amount
Air Conditioning 01/27/2012 $46.75
Type of Use: SF Minimum Fee Adjustment - Mechanical 01/27/2012 $43.25
Class of Work: ALT Type of Const: VB 12% State Surcharge - Mechanical 01/27/2012 $10.80
Occupancy Grp: R -3
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: 0/ ` / Permittee Signature: GN A p j` LTc 7._T
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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.
01/25/2012 12:00 5036503898 CENTRAL AIR INC PAGE 01/03
Mechanical Permit Appli. Ili : e 0 1^v� FOR OFFICE USE ONLY
City of Tigard Received a M.. Date/BY: Permit No. t_ g o i A_ 000
II 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439 Fax: 503,59& 2 5 2012 Pl eview
Other Permit:
I l Ci A I: D Inspection Line: 503.639.4175 —
Internet: www.tigard- or.gov P, Dace Ready/By. rsria: see Pale 2 for
CITY OF TIGARD NotitiedNetbod: 9appiementalInformation
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❑New construction Addition/alteration/replacement 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, ove e
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��i ��'; ^YJr � � to gar � rl (J ,r • , ( �Ct � 3 f k � eI d�'.'� a A � "� Via} . mx �"`i'y �'3 n Value $ yy
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1. and 2 dwelling ,`= r µ ., E `, c x..F::1
y g ❑ Commercial /industrial �] A ccessory b uil d ing For special infbroration use checklist
0 Multi family ❑ Master builder
❑ Other: DescriPlion Qty. Ea Total
lob site address: 15716 Sw Greenfield Dr 1
City/State/ZIP: Tigard OR 97224 100 000 B 46.75 ME
Furnace r1101
Suite/bldg. /apt- no.; Project name: Heat pump .
- re•uires site • Ian sbowin c •lacement 61.06
Cross street/directions to job site: Duct work
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dronic hot water system
"" Residential boiler (radiator or
hydronic)
Unit heaters (fuel -type, not electric),
in -wall, in -duct, s vended, etc.
Subdivision: I tot no.: — Flue /vent for any of above 23.32 11111111
Tax map /parcel no.: Other: MEM�
5. , Other fuel appliances;
W as xd \! , 71 . ., 7�,?. ef t 4 1 �,- , S: Fr1fi ' �« ",s . ' •7r z r x
_ a ....z ., w.t!. .Li . ,: C { . � , E. .,. 7 k. ," ; 1,i = Water heater 23
Install Ac - � Gas T rep aev
Flue vent for water heater or gas
fire • lace
Log lighter (gas)
Wood/ 'diet stove
r w n v* M Wood fireplace/insert 23.32 ME
i 1 . J , . - isy a r 1trk :: a� ` tV; = % wt ^" - ' 9 c" A a tics 1 , 7 7.A : Chitin /liner /flue/v
- i _ _ 1-7.3 1 . > ,, t ...;.... .,7. � 4 '� she .' , .._ rf ~ y ,,�..: , _ 2332
5Y ,rte_ other En1�
Name; Al & Jessica Gonzalez
Environmental ertlanst and ventilation:
Address: 15716 Sw Greenfield Dr hood/other
City/State/ZIP: 'Tigard OR 97224 Cloth dry exhaust
Phone: (818)857 -6368 Fax: ( ) Sin -duct exhaust (bathroorrts,
toilet ments utility rooms) a .,.. . < ^' + „Tbb a mS *,»;�L:...a�{'t ..•- , W avw. fang }
,. i,.w ..._., �� "�� ” � '� e 1 ��� � �"�nr� �� .- � �� .41It1C/CraW15 pace
Business name; Central Mr Inc. Other: 23,32
Contact name: Traci' Fuel •'
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_ 914.15 for first four; $4.03 for each additional
Address: 8849 Se Jansen Rd Furnace, etc.
City /State /ZJI': Clackamas OR — Gas heat pum _�
Wall/sus • ended/unit heater
Phone: (503) 656 -1908 Fex:: (503) 650-3898 Water heater
Fir , lace
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Email Traca@ccutralairpdx.com
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Business name: Central Air Inc Clothes d er as
Address: Po Box 433 1
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City/State/ZIP: OR 97015
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Phone: (503) 656 -1908 Fax: (503) 650-3898 t `gyp • CI()
Plan review (25% of permit fee)
CCB lic.: 178624 .
State surcharge (12% of permit fee) 0 . i: CD
/ TOTAL PERMIT FEE / • . e
Authorized signature i A 0 / i 4 • This permit , -. cation omp IP a permit r a ed
p � ,(.�_ JCoI da after it has irea been accepted i as roprobtpl� withh so
Print name: Trace terse» Date; I) abi 1 rr„-- • Fee methodology set by 7d -County Building Industry Service Board
I: WoildirsgTmrnlre\MEGpwmitApp.doo 0910210 440 - 4517T (11 /0VCOANWEB)
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